Unique Pharmacodynamic Profile of Methylphenidate: Self- Administration-Induced Dopamine System Alterations

UNIQUE PHARMACODYNAMIC PROFILE OF METHYLPHENIDATE: SELF- ADMINISTRATION-INDUCED DOPAMINE SYSTEM ALTERATIONS

ERIN SUE CALIPARI

A Dissertation Submitted to the Graduate Faculty of

WAKE FOREST UNIVERSITY GRADUATE SCHOOL OF ARTS AND SCIENCES

In Partial Fulfillment of the Requirements

for the Degree of

DOCTOR OF PHILOSOPHY

Program in Neuroscience

December 2013

Winston-Salem, North Carolina

Approved by:

Sara R. Jones, Ph.D., Advisor

Thomas J. Martin, Ph.D., Chairman

Rong Chen, Ph.D.

Brian McCool, Ph.D.

Steven Childers, Ph.D

DEDICATION AND ACKNOWLEDGEMENTS

First and foremost, I want to thank my advisor, Sara R. Jones, Ph. D. She gave me the freedom to explore many of my own interests while still providing important and insightful input to improve my projects and my writing. She gave her full support to my training at all times and helped me to develop as both a scientist and a person. I truly enjoyed working with her and admire her work ethic and dedication. The example that she has set for me will have a lasting impact beyond my scientific career.

Second, I would like to thank the members of the Jones’ lab. I could not possibly thank them enough for all of the help and support that they have given me over the years.

Mark J. Ferris, Ph. D, was instrumental in my training and often put as much effort into my projects as he did into his own. He was always there when I needed advice and although I was difficult to work with at times he always supported me. Jordan Yorgason was there with me every step of the way and helped me figure everything out, even when it was inconvenient for him. Jordan has the ability to fix anything that is broken, and I could not have done any of my work without his programming, soldering, or electronics skills. Mark and Jordan have become colleagues and friends (whether they like it or not) that I hope to continue to work with throughout my career. I would also like to thank

Joanne Konstantopoulos and Jason Locke for their training and help with many of my projects. Without their willingness to cover for me, even on weekends, none of this work would have been possible. Also, I would like to thank the other members of the Jones lab, Anushree N. Karkhanis, Ph. D, Jamie Rose, James Melchior, and Cody Siciliano.

Because of them, I enjoyed coming to work every day. The lab has been like my second iii

family, first at times, and there is not anywhere else where I could have had a better graduate experience.

I would also like to thank the members of my dissertation committee Drs. Martin,

McCool, Chen, and Childers. They have been a source of advice and support throughout my graduate career and played a large role in the development of this dissertation.

Additionally, their comments on my proposal contributed greatly to the National

Research Service Award that I was awarded from the National Institute on Drug Abuse, and for that I am very grateful.

Special thanks go to the Department of Physiology and Pharmacology and the

Neuroscience program. The people within this department contributed greatly to this dissertation in many ways. The collaborative environment at Wake Forest University

School of Medicine allowed me to learn numerous techniques and skills, many of which are included within this dissertation. I was able to form a network of collaborators that I will keep in touch with throughout my career. Additionally, the advice and support that I was given when applying for grants and postdoctoral positions was paramount to my success.

I would also like to thank my family. My mother, Ellen, and my father, John, have given me their full support throughout my entire life, but especially throughout my graduate career. They were constant sources of encouragement that kept me going during difficult times. Also, I would like to thank my sister, Megan, and brother, Brad. They are two of the smartest people that I know and they have motivated me to work hard and dedicate myself completely to anything and everything that I do. iv

And finally, I would like to thank the extracurricular groups and activities I was a

part of in my spare time. The Phys/Pharm softball team allowed me to display my

athletic prowess and make friends within the department. It was a consistent time each week for me to spend time with Alison Arter and Sarah Kromrey, and for that I am particularly grateful, although it is unlikely that anyone else is. v

TABLE OF CONTENTS

LIST OF TABLES AND FIGURES...... viii LIST OF ABBREVIATIONS ...... xiv ABSTRACT ...... xviii PREFACE ...... xxi

Chapters

CHAPTER I NEUROCHEMICAL AND BEHAVIORAL CONSEQUENCES OF METHYLPHENIDATE (MPH) SELF-ADMINISTRATION: MPH IS UNIQUE IN ITS ACTIONS AT THE DOPAMINE TRANSPORTER ...... 1

Manuscript prepared for submission in Brain Research Reviews, 2013

CHAPTER II EXTENDED ACCESS COCAINE SELF-ADMINISTRATION RESULTS IN TOLERANCE TO THE DOPAMINE-ELEVATING AND LOCOMOTOR STIMULATING EFFECTS OF COCAINE ...... 59

Published in The Journal of Neurochemistry, in press, 2013

CHAPTER III WITHDRAWAL FROM EXTENDED-ACCESS COCAINE SELF- ADMINISTRATION RESULTS IN DYSREGULATED FUNCTIONAL ACTIVITY AND ALTERED LOCOMOTOR ACTIVITY IN RATS ...... 146

Published in European Journal of Neuroscience, in press, 2013

CHAPTER IV TEMPORAL PATTERN OF COCAINE INTAKE DETERMINES TOLERANCE VS SENSITIZATION OF COCAINE EFFECTS AT THE DOPAMINE TRANSPORTER ...... 117

Published in Neuropsychopharmacology, in press, 2013

CHAPTER V METHYLPHENIDATE AND COCAINE SELF-ADMINISTRATION PRODUCE DISTINCT DOPAMINE TERMINAL ALTERATIONS ...... 146

Published in Addiction Biology, in press, 2013

CHAPTER VI METHYLPHENIDATE AMPLIFIES THE POTENCY AND REINFORCING EFFECTS OF AMPHETAMINES BY INCREASING DOPAMINE TRASNPORTER EXPRESSION ...... 184

Published in Nature Communications, in press, 2013

CHAPTER VII UNIQUE PROFILE OF METHYLPHENIDATE-INDUCED DOPAMINE SYSTEM KINETICS: RELEASE PROFILE OF A BLOCKER AND UPTAKE PROFILE OF A RELEASER ...... 218

Manuscript prepared for submission in PLoS One

CHAPTER VIII INTERMITTENT ACCESS METHYLPHENIDATE SELF-ADMINISTRATION RESULTS IN A SENSITIZED DOPAMINE SYSTEM...... 250

Manuscript prepared for submission in Neuroscience, 2013

CHAPTER IX DISCUSSION ...... 285

APPENDIX I CONSERVED DORSAL-VENTRAL GRADIENT OF DOPAMINE RELEASE AND UPTAKE RATE IN MICE, RATS, AND RHESUS MACAQUES ...... 325

Published in Neurochemistry International, 61(7):986-9, 2012

APPENDIX II AMPHETAMINE MECHANISMS AND ACTIONS AT THE DOPAMINE TERMINAL REVISITED ...... 347

Published in The Journal of Neuroscience, 33(21):8923-5, 2013

APPENDIX III AMERICAN CHEMICAL SOCIETY: COPYRIGHT CLEARANCE FORM ...... 355

vii

APPENDIX IV NEUROPSYCHOPHARMACOLOGY: COPYRIGHT CLEARANCE FORM ...... 357

APPENDIX V ADDICTION BIOLOGY: COPYRIGHT CLEARANCE FORM ...... 360

APPENDIX VI NEUROCHEMISTRY INTERNATIONAL: COPYRIGHT CLEARANCE FORM .... 368

CHAPTER X CURRICULUM VITA ...... 374

viii

LIST OF TABLES AND FIGURES

TABLES

Chapter III 1 Effect of 48 h withdrawal from a five-day binge cocaine self-

administration on rates of local cerebral glucose utilization in rat

brain……………………………………………………………...99

FIGURES

Chapter I 1 Animals acquire methylphenidate (MPH) self-administration at a

faster rate than cocaine (COC) self-administration……………...12

2 Methylphenidate (MPH) self-administration increases the preferred

intake level and reinforcing efficacy of MPH……………………18

3 Increased dopamine transporter (DAT) levels increase the potency

of psychostimulant releasers……………………………………..42

Chapter II 1 Cocaine self-administration results in escalation of first-hour

cocaine intake…………………………………………………….67

2 Reduced dopamine (DA) release and uptake following cocaine

self-administration……………………………………………….68

3 Cocaine self-administration results in tolerance to the dopamine

transporter (DAT)-inhibiting and dopamine (DA)-elevating effects

of cocaine………………………………………………………...71

4 Cocaine self-administration results in tolerance to the locomotor ix

activating effects of acute cocaine administration……………….73

Chapter III 1 Cocaine self-administration results in escalation of rate of cocaine

intake……………………………………………………………..93

2 Cocaine self-administration results in reduced locomotor response

to a novel environment…………………………………………...94

3 Cocaine self-administration does not alter baseline locomotion...95

4 Altered locomotor activity following cocaine self-

administration……………………………………………………97

5 Cocaine self-administration results in reduced functional activity in

a number of brain regions………………………………………..98

Chapter IV 1 Intermittent (IntA), long-access (LgA), and short access (ShA)

cocaine self-administration result in different patterns of self-

administration…………………………………………………..126

2 Differential effects of intermittent (IntA), short-access (ShA) and

long-access (LgA) self-administration on presynaptic dopamine

system kinetics………………………………………………….128

3 Intermittent access (IntA) self-administration results in

sensitization to the neurochemical effects of cocaine while long-

access (LgA) results in tolerance……………………………….130 x

4 Supplementary Figure 1, Intermittent access (IntA) self-

administration results increased potency, while long-access (LgA)

results in decreased potency versus short-access (ShA)………..133

5 Cocaine-induced increases in DA did not differ across groups...134

Chapter V 1 Escalation in rate of cocaine and methylphenidate self-

administration…………………………………………………..157

2 Baseline dopamine system kinetics following methylphenidate and

cocaine self-administration……………………………………..160

3 Western blot hybridization for the dopamine transporter after

cocaine or methylphenidate self-administration……………..…162

4 Tissue content of dopamine and metabolites in the striatum of

cocaine and methylphenidate self-administration groups……....163

5 Quantification of tyrosine hydroxylase mRNA levels, protein

levels, and phosphorylation by western blot hybridization and

quantitative polymerase chain reaction…………………………165

6 Significantly greater dopamine uptake inhibition by

methylphenidate, but not cocaine after methylphenidate self-

administration…………………………………………………..169

7 Significant reduction in dopamine uptake inhibition by cocaine,

but not methylphenidate, after cocaine self-administration ……171 xi

Chapter VI 1 Methylphenidate (MPH) is self-administered, increases dopamine

uptake (Vmax), and MPH potency……………………………….187

2 Methylphenidate (MPH) self-administration (SA) increases the

potency and motivation to administer releasers, but not

blockers………………………………………………………....189

3 Overexpression of the dopamine transporter (DAT) increases the

behavioral and neurochemical potency of methylphenidate (MPH)

and releasers…………………………………………………….192

4 Increased releaser, but not blocker, potency following

methylphenidate (MPH) self-administration…………………...202

5 Methylphenidate (MPH) self-administration increases motivational

effects of releasers and MPH, but not blockers………………...203

6 Increased releaser and methylphenidate (MPH), but not blocker-

induced DA overflow following MPH self-administration and

dopamine transporter (DAT) overexpression…………………..204

7 Oral methylphenidate (MPH) administration does not affect DA

kinetics or the potency of psychostimulants……………………205

Chapter VII 1 Maximal rates of dopamine (DA) uptake (Vmax) are positively

correlated with psychostimulant potency………………………227

2 Increases in dopamine transporter (DAT) levels by xii

methylphenidate (MPH) self-administration result in enhanced

potency of releasers and MPH, but not blockers……………….230

3 Although maximal rate of dopamine uptake (Vmax) and release are

positively correlated in DAT-tg mice, dopamine release is not

correlated with drug potency…………………………………...233

4 Dopamine release is not correlated with psychostimulant potency

in methylphenidate (MPH) self-administration animals………..235

5 Drug-induced dopamine release does not affect dopamine uptake

inhibition following methylphenidate (MPH) self-administration or

DAT over-expression…………………………………………...237

6 Methylphenidate (MPH) has the release profile of a blocker…..238

Chapter VIII 1 Animals self-administer methylphenidate (MPH) at high rates

when given intermittent access…………………………………259

2 Intermittent methylphenidate (MPH) self-administration leads to

increased stimulated dopamine (DA) release and uptake………261

3 Intermittent methylphenidate (MPH) self-administration causes D2

autoreceptor subsensitivity………………………………...……262

4 Sensitization of the neurochemical effects of methylphenidate

(MPH)…………………………………………………………..264 xiii

5 Enhanced amphetamine (AMPH) potency following

methylphenidate (MPH) self-administration…………………...267

6 Cocaine potency is unaffected by a history of methylphenidate

(MPH) self-administration ……………………………...……...269

7 Stimulated DA release profile of cocaine, methylphenidate (MPH),

and amphetamine (AMPH) following intermittent MPH self-

administration…………………………………………………..272

Chapter X 1 Representative voltammetric dopamine traces highlighting the

effects of cocaine, amphetamine (AMPH), and methylphenidate

(MPH) self-administration (SA) on cocaine potency

…………………………………………………………………288

Appendix I 1 Location of voltammetric recordings in striatal slices from rat,

mouse, and rhesus macaque…………………………………….332

2 Dopamine release from five striatal regions in monkey, rat, and

mouse…………………………………………………………...333

3 Maximal dopamine uptake rate as measured by fast scan cyclic

voltammetry from dorsal striatum through ventral striatum in each

species…………………………………………………………..335

4 Ratio of dopamine release to uptake differs across species…….336 xiv

LIST OF ABBREVIATIONS

[DA]p, dopamine per pulse

2-DG, [14C]-2-deoxyglucose

ACC, anterior cingulate cortex

aCSF, artificial cerebrospinal fluid

ADHD, attention deficit/hyperactivity disorder

Akt, protein kinase B

AMPA, 2-amino-3-(3-hydroxy-5-methyl-isoxazol-4-yl) propanoic acid

AMPH, amphetamine

ANOVA, analysis of variance

App. Km, apparent affinity of drug for the dopamine transporter

CFT, 2 beta-carbomethoxy-3-beta-(4-fluorophenyl)-N-[3H]methyltropane

COC, cocaine

CPP, conditioned place preference

CPu, caudate putamen

C-terminal, carboxy terminal

Ctrl, control

DA, dopamine

DAT, dopamine transporter

DAT-KO, dopamine transporter knock-out

DAT-tg, dopamine transporter overexpressing mice

DC, dorsolateral caudate putamen

ERK, extracellular signal-regulated kinases xv

FSCV, fast scan cyclic voltammetry

GABA, Gamma-Aminobutryic Acid

hDAT, human dopamine transporter

HEK, human embryonic kidney cells

IM, intramuscular

IntA, intermittent-access

IP, intraperitoneal

IV, intravenous

Ki, inhibition constant

Km, Michaelis-Menten constant

LCGU, local cerebral glucose utilization

LgA, long-access

MAPK, mitogen-activated protein kinases

MC, medial caudate putamen

mEPSC, miniature excitatory post-synaptic current

METH, methamphetamine

MPH, methylphenidate

mRNA, messenger ribonucleic acid

NAc, nucleus accumbens

Na(+)/Cl(-)-dependent transporters, neurotransmitter-sodium-symporter

NET, norepinephrine transporter

NMDA, N-methyl-D-aspartate

NOM, nomifensine xvi

N-terminal, amino terminal

PCR, polymerase chain reaction

PFC, prefrontal cortex

PI3k, phosphoinositide 3-kinase

PKA, protein kinase A

PKC, protein kinase C

Pmax, maximal price paid

PR, progressive ratio

PTSD, posttraumatic stress disorder

PVDF, Polyvinylidene fluoride

SA, self-administration

SAMHSA, The Substance Abuse and Methal Health Services Administration

S.E.M., standard error of the mean

SERT, serotonin transporter

ShA, short-access

SHR, spontaneously hypertensive rat

SLC6, solute carrier six family of transporters

SUD, substance use disorder

TH, threshold procedure

TH, tyrosine hydroxylase

Thr, threonine

VM, ventromedial caudate putamen

VMAT2, neuronal vesicular monoamine transporter xvii

Vmax, maximal rate of uptake

VTA, ventral tegmental area xviii

ABSTRACT Calipari, Erin S. UNIQUE PHARMACODYNAMIC PROFILE OF METHYLPHENIDATE: SELF- ADMINISTRATION-INDUCED DOPAMINE SYSTEM ALTERATIONS Dissertation under the direction of Sara R. Jones, Ph.D., Tenured Professor of Physiology and Pharmacology

Methylphenidate (MPH), the active compound in the medication Ritalin, is commonly diverted for off-label use. It is abused at high rates in both the adolescent and adult population; however, until recently, the neurochemical effects of MPH abuse had not been explored in depth. Pharmacologically MPH is a dopamine transporter (DAT) blocker with the same mechanism of action and equivalent potency at the DAT as cocaine. Although MPH is categorized as a DAT blocker, its pharmacological actions are distinct from both blockers and releasers in regards to both its acute effects and the compensatory alterations associated with self-administration of the compound. This work has elucidated the neurochemical consequences of MPH self-administration, whereby MPH administration by a number of paradigms results in consistent neurochemical adaptations characterized by increased maximal rates of uptake (Vmax),

increased DAT levels, increased evoked dopamine (DA) release, and an increased

potency to inhibit the DAT for MPH and releasers, but not blockers. These changes are

opposite from the documented changes that occur following cocaine self-administration,

further suggesting that the neurochemical consequences of MPH are unique, and cannot

be predicted based on previous literature of compounds of the same psychostimulant

class, such as cocaine. The changes directly at the DAT following MPH self-

administration are consistent with microdialysis and behavioral analysis that demonstrate

increased MPH and amphetamine (AMPH)-induced DA overflow, but not cocaine, and xix

increased reinforcing efficacy of AMPH and MPH, but not cocaine. The increases in the reinforcing efficacy of MPH and releasers such as AMPH, suggests that these compounds may having significant abuse liability following MPH abuse in the adolescent and adult populations.

Further, this work has determined the neurochemical mechanism underlying the effects of MPH self-administration. This work shows that MPH self-administration increases DAT levels, driving enhanced potency and drug-seeking for MPH and AMPH, without altering cocaine potency. To corroborate these effects, genetic over-expression of the DAT increased AMPH and MPH potencies, but not cocaine potency as measured by voltammetry, microdialysis, and locomotor analysis. Utilizing transgenic DAT overexpressing mice to study changes in psychostimulant potency, this work has determined a basic mechanism that may predict vulnerability to abuse amphetamines and other dopamine releasers. Namely, increases in dopamine transporter levels are responsible for the increases in AMPH and DA releaser potency. This is important because it suggests that known variability in human DAT expression, particularly in disorders such as attention deficit/hyperactivity disorder (ADHD), post traumatic stress disorder (PTSD), and early life stress, may serve as a marker for vulnerability for substance abuse disorder / addiction. Because these drugs are readily available and are used commonly in the clinic, these results should be considered when treating “at risk” individuals.

Importantly, the effects of MPH resemble those of amphetamines in regards to the effects of DAT levels on its potency, whereas other traditional blockers are unaffected.

This is particularly important when making inferences about the consequences of MPH xx

administration, both therapeutic and abuse relevant, from previous work using other compounds of the same class. Importantly, this work suggests a revision of the current two-category model for psychostimulants beyond the classification as purely blocker or releaser, as compounds such as MPH can exhibit properties of both classes. xxi

PREFACE

This thesis contains work on the neurochemical consequences of methylphenidate abuse as it relates to the larger body of cocaine abuse literature. This thesis was prepared by Erin S. Calipari as a partial fulfillment of the requirements for the degree of doctor of philosophy. This thesis was made under supervision of Sara R. Jones. The works contained within have been either submitted for publication or published previously, and are republished with permission. Publications have been reformatted to fit the guidelines of thesis preparation at Wake Forest School of Medicine. Stylistic variations within the chapters are due to specific requirements for each journal. 1

CHAPTER I

NEUROCHEMICAL AND BEHAVIORAL CONSEQUENCES OF METHYLPHENIDATE (MPH) SELF-ADMINISTRATION: MPH IS UNIQUE IN ITS ACTIONS AT THE DOPAMINE TRANSPORTER

Erin S. Calipari, Mark J. Ferris, and Sara R. Jones

The following manuscript is prepared for submission at Brain Research Reviews. Stylistic variations are due to the requirements of the journal. Erin S. Calipari prepared the manuscript. Drs. Mark J. Ferris and Dr. Sara R. Jones acted in an advisory and editorial capacity.

Abstract:

Pharmacologically, MPH is a dopamine transporter (DAT) blocker with the same mechanism of action and roughly equivalent potency at the DAT as cocaine. Although

MPH is categorized as a DAT blocker, its pharmacological actions are distinct from both blockers and releasers in regards to both its acute effects and the compensatory alterations associated with its self-administration. Importantly, MPH is affected similarly to amphetamines in regards to the effects of DAT levels on its potency, whereas other traditional blockers are not. This is particularly important when making inferences about the consequences of MPH administration, which are different from previous findings using other compounds of the same class.

1. Introduction:

1.1. Methylphenidate (MPH) use and abuse

After marijuana, prescription stimulants are the most commonly abused drugs that

are used to get “high” in teenagers (Johnston et al., 2009, 2010). Methylphenidate

(MPH), the active ingredient in medications (Ritalin® and Methylin®), used in the

treatment of attention deficit/hyperactivity disorder (ADHD) and narcolepsy, is prone to

diversion for non-medical use. In the adolescent and adult populations, MPH abuse in

non-ADHD individuals has become increasingly prevalent, with oral, intranasal or

intravenous (i.v.) routes of administration being most common. 5-17% of college students

are estimated to take 2-10 times the prescribed doses (Teter et al, 2003, 2005, 2006,

2010; McCabe et al, 2004, 2005; Barrett et al, 2005; Klein-Schwartz, 2002; Sepúlveda et

al., 2011; Fone et al., 2005). Recently, increases in MPH prescriptions, and as a result,

increases in both acute and chronic MPH abuse, have been documented (Setlik et al,

2009). The drug is used for cognitive enhancement and to “get high”, causing effects

indistinguishable from cocaine when taken i.v. or intranasally (Morton and Stockton,

2000; Sherman et al, 1987). The emergence of intravenous (i.v.) MPH use is outlined by

a number of case studies; however, currently the neurochemical and behavioral effects of

i.v. MPH use are understudied (Gautschi & Zellweger, 2006; Levine et al, 1986; Parran

& Jasinski, 1991; Sherman et al, 1987; Shaw et al, 2008; Teter et al, 2006). The prevalence of MPH use as a therapeutic agent in adolescents coupled with the high rates of abuse makes it critical to understand the pharmacology of the compound.

1.2. Relevance

MPH is a unique drug that exerts its rewarding and reinforcing effects via

increasing dopamine (DA) levels in brain regions such as the dorsal and ventral striatum.

Although MPH is categorized as a DAT blocker, it has a unique profile that is not like

other psychostimulants in regards to both its acute and chronic effects. Because of

MPH’s unique pharmacological profile, it is difficult to make predictions about the

neurochemical consequences of MPH use and abuse based on the current literature

describing the neurochemical effects of other compounds of the same structural or

functional class. Currently, there are a plethora of reviews on the therapeutic effects of

MPH as it relates to ADHD or the treatment of cocaine dependence (Mariani and Levin,

2013; Grunblatt et al., 2013; Morris et al., 2012; Prommer 2012; Del Campo et al., 2011);

however, there is no review on the effects of abused MPH on the DA system and related

behaviors. This review will comprehensively outline the current pre-clinical studies on

the behavioral and neurochemical consequences of MPH administration as a model of

abuse as it relates to the DA system.

2. MPH use, abuse, and addiction potential

2.1. MPH may facilitate the development of a substance use disorder

Some suggest that MPH use may facilitate the development of a substance use

disorder (SUD) (Lambert and Hartsough, 1998), while others suggest that treatment of

ADHD sufferers with stimulants during childhood and adolescence decreases the

probability of subsequent psychostimulant abuse (Willens, 2004). However, the studies 5

which suggest that therapeutic intervention with MPH reduces the likelihood of future

drug abuse often fail to take into consideration the role of increased academic and social

success in treated vs. untreated ADHD sufferers, which may be protective against later

stimulant abuse (Biederman, 2003; Wilens et al, 2003; Mannuzza et al, 2003). However,

although individuals may be less likely to seek drugs due to improved social interactions,

self-esteem, and scholastic performance, it is possible that neurochemical changes

following chronic low dose MPH treatment may increase the abuse potential of MPH and

other psychostimulants. Even with the improvement of a variety of social factors, there

still may be a subset of individuals treated with MPH who may be susceptible to

addiction if they are in an environment where drugs are readily available. Congruent

with human studies, literature examining the effects of long-term MPH exposure in

rodents is inconsistent, prompting the need to determine the effects of multiple MPH

dosing paradigms on neurochemical outcomes. Brandon et al (2001) showed that MPH administration during adolescence augments the reinforcing properties of other psychostimulants, as seen by increases in cocaine self-administration in adulthood.

However a larger body of preclinical literature suggests that therapeutic MPH administration does not ehance the addiction potential of psychostimulants such as

cocaine. Carlezon et al (2003) found that chronic adolescent MPH administration in rats

caused low doses of cocaine to be aversive and high doses less rewarding in adulthood.

Additionally, a number of epidemiological studies as well as rodent studies have shown

that oral MPH administration at therapeutically relevant doses does not result in changes

to the DA system or to the reinforcing effects of psychostimulants (Calipari et al., 2013a;

Soto et al., 2012; Gill et al., 2012, 2013; Carlezon et al., 2003). 6

Even though MPH is used in the adolescent population for the treatment of

ADHD, the abuse of MPH by normal individuals may be a greater cause for concern.

When abused, individuals take 2-10 times the prescribed doses, as well as often

administering the compound intranasally or intravenously (i.v.), which may result in different neurobiological alterations as compared to low-dose therapeutic usage. Many studies and reviews have outlined the behavioral and neurochemical consequences of therapeutically relevant dosing of MPH; however fewer studies have focused on the effects of high-dose MPH abuse in non-ADHD models (Calipari et al., 2013a, b; Wooters

& Bardo, 2011; Wooters et al., 2011). Because of epidemiological reports that indicate

that MPH administration does not result in increased abuse of psychostimulants, many

people believe that MPH does not have abuse potential and is safe. However, there is

increasing evidence that MPH abuse is occurring at high rates (Teter et al, 2003, 2005,

2006, 2010; McCabe et al, 2004, 2005; Barrett et al, 2005; Klein-Schwartz, 2002;

Sepúlveda et al., 2011; Fone et al., 2005) and may have significant adverse

neurobiological consequences when administered at high doses (Calipari et al., 2013a, b;

Marusich et al, 2010; Botly et al, 2008; Burton et al, 2010; Collins et al, 1984).

2.2. Differential effects of therapeutic and abuse relevant dosing of MPH

When determining the neurochemical effects of MPH, an important distinction

must be made between abuse and therapeutic dosing, due to factors such as contingent versus non-contingent administration and route of administration. The route of administration, which dictates the speed of the onset of drug effects, is the most important 7

factor when considering the abuse potential of drugs as different routes of administration

can cause vastly different subjective effects (Volkow et al., 1999). The ability of

psychostimulants such as MPH and cocaine to elicit a “high” is associated with their

ability to increase DA in striatal sub-regions (Volkow et al., 1999). These drugs act by

blocking the DAT, which is the protein responsible for clearing DA from the synapse and

terminating DA signals. DAT blockade leads to elevated DA levels as well as a

prolonged half-life of DA within the extracellular space, which results in increased

signaling of postsynaptic receptors and enhanced behavioral outputs. It has been demonstrated that the rate at which a drug enters the brain and inhibits the DAT to increase DA levels is the primary factor associated with the perception of “high”, and not just the ability to increase striatal DA levels alone. Volkow et al (1999) demonstrate that while the level of DAT inhibition is important to determine the intensity of the high, where greater than 50% inhibition is needed to produce high, the rate at which the transporters are occupied determines whether the “high” is perceived or not. This is particularly important when thinking about therapeutic administration, as even when more than 60% of DATs are occupied by drug, if the rate at which they are occupied is slow there is no perception of “high”. Thus, it is likely that in therapeutic cases, MPH not only does not result in a “high”, but also results in different neurochemical alterations. Because of this, it is important not to use therapeutic studies to predict the neurochemical consequences of MPH abuse.

2.3. MPH Use in ADHD and normal individuals

Although MPH abuse in all individuals is of concern, MPH use and abuse may

have differential effects in non-ADHD and ADHD sufferers. Sakrikar et al., 2012 found

that a particular coding variant in the DAT which is prevalent in the ADHD population

results not only in differences in normal DAT trafficking but also in differential

responsivity to psychostimulant drugs such as AMPH. Because MPH has been shown in

a number of voltammetry studies to exhibit the pharmacological properties of releasers

(Ferris et al., 2012; Calipari et al., 2013a), it is possible that this mutation also results in differential sensitivity to the effects of MPH in the different populations. This is particularly important, because it suggests that there may be significant differences in the consequences of MPH use/abuse on the DA system in normal populations and ADHD sufferers. Further, this may suggest that while MPH is safe and effective in the ADHD population, it may have neurochemical and behavioral effects that promote the abuse of other psychostimulants in normal people. Additionally, imaging studies using a radiolabeled antagonist of the DAT have shown that DAT binding is higher in subjects with ADHD and this elevation is decreased to control levels after subjects are treated with methylphenidate (Dougherty et al., 1999; Dresel et al., 2000; Krause et al.,

2000; Cheon et al., 2003). This further highlights the importance of choosing a relevant model to study the effects of MPH abuse, as ADHD individuals are likely affected differently by MPH administration than normal individuals.

2.4. MPH has different effects in animal models of ADHD: implications for human use

Consistent with the differences in DA system function and psychostimulant

effects between ADHD and non-ADHD humans, rodent models have shown similar

disparities making it critical to use models that accurately mimic the target human

population for translational studies. It has been shown repeatedly that different strains of

rats exhibit differential acute behavioral activating effects of MPH as well as differential

self-administration behaviors (Dafny & Yang, 2006; Yang et al., 2003; Amini et al.,

2004; dela Peña et al., 2012). The spontaneously hypertensive rat (SHR) is a widely

accepted model of ADHD, and exhibits much of the inattentive phenotype that is observe

in ADHD individuals. These animals have different responses to self-administration in

general, where SHR have increased acquisition and responding for sucrose reinforcement

than both their inbred counter parts (Wistar-Kyoto) and out-bred control strains (Sprague-

Dawley) (Marusich et al., 2011). In addition, MPH self-administration has differential effects in the strains, where prior MPH exposure enhanced fixed ratio 3 MPH self-

administration in Wistar rats, but not SHR. Further, MPH pretreatment reduced

progressive ratio responding in SHR, but not Wistar rats (dela Peña et al., 2012).

Reinstatement of drug seeking is a measure that is used to model relapse in rodents, and

interestingly, MPH exposure greatly increases reinstated responding in Wistar rats as compared to SHR (dela Peña et al., 2012). Taken together, these data suggest that the

SHR rats (ADHD model) may be less susceptible to the rewarding and reinforcing effects of MPH, where MPH treatment either does not affect or reduces responding depending on paradigm. Although there are clear differences in responses to MPH between ADHD 10

and non-ADHD models, the main focus of this review will be on non-ADHD models because MPH abuse most often occurs in normal, non-ADHD individuals.

In addition to the differential behavioral effects, the neurochemical effects of

MPH are also divergent between SHR and other rats. Russel et al., (1998) demonstrated that SHR have reduced stimulated DA release in both prefrontal and striatal slices, as well as significantly reduced MPH potency in SHR animals as compared to Wistar-Kyoto controls. Roessner et al (2010) demonstrated that, at baseline, SHR have increased DAT levels as compared to Wistar-Kyoto and Wistar rats, a difference that was reversed by

MPH treatment. Although the differential DA system dynamics, reinforcement behaviors, and responses to MPH treatment in SHR compared to out-bred strains make

SHR a good model for studying the therapeutic use of the MPH, SHR rats are likely not the optimal strain for modeling MPH abuse. This review will focus on the effects of

MPH abuse on non-ADHD models in order to model MPH abuse in the non-ADHD human population.

2.5. Subjective effects

Growing evidence suggests that MPH has abuse potential, especially via non-oral routes, which produce subjective effects indistinguishable from those of cocaine (Rush and Baker, 2001; Setlik et al, 2009; Teter et al, 2006). In discrimination experiments,

MPH produces full substitution for both cocaine and amphetamine (AMPH) (Rosen et al,

1985; Silverman and Ho, 1980), indicating that the subjective effects of these compounds are indistinguishable. These behavioral similarities are likely due to their shared ability 11

to acutely elevate extracellular DA levels in reward related brain areas, resulting in

similar levels of activation of post-synaptic receptors. The indistinguishable subjective effects suggest that MPH may be administered in place of stimulants such as AMPH and cocaine, as prescription drugs are becoming easier to obtain than illicit drugs, and because people view these drugs as much safer. In addition, a number of measures such as tolerance, withdrawal and sensitization are associated with drugs that may have abuse/addiction potential such as cocaine and AMPH. A number of reports using a range of MPH doses have demonstrated all of these phenomena, suggesting that MPH may pose significant abuse potential and possibly addiction potential when taken via similar routes of administration as cocaine and AMPH (Eckermann et al., 2001; Yang et al., 2000,

2007a, b; Lee et al., 2008; Gaytan et al., 1997).

Additionally, comparison studies with other psychostimulants such as cocaine suggest that MPH may have serious abuse, and possibly addiction potential. Comparing

MPH and cocaine at the most reinforcing doses, which produce similar self- administration behavior (Figure 1), animals acquire MPH self-administration faster than cocaine. In the cocaine literature, faster acquisition rates have been associated with animals that are “drug-use prone” (Deroche-Gamonet et al., 2004, 2008; Belin et al.,

2009, 2011), suggesting that MPH may have significant abuse liability. Currently, in the human population cocaine and MPH are often taken via different routes of administration, with cocaine being primarily intranasal, intravenous, or smoked and MPH being primarily oral or intranasal (Teter et al., 2006). However, reports of intravenous use of MPH are emerging, suggesting that MPH abusers are transitioning to routes of 12

Figure 1. Animals Acquire Methylphenidate (MPH) Self-Administration at Faster

Rates than Cocaine (COC) Self-Administration. (A) Representative traces demonstrating that MPH (0.56mg/kg/inj) and cocaine (1.5mg/kg/inj) result in similar self-administration behavior. Tick marks represent infusions earned on a fixed ratio one schedule of reinforcement. Adapted from Calipari et al., 2013, Addiction Biology. (B)

Escalation of rate of intake does not differ between cocaine and MPH demonstrating that

1.5mg/kg/inj cocaine and 0.56 mg/kg/inj MPH produce comparable self-administration behavior. Adapted from Calipari et al., 2013, Addiction Biology. (C) Group data plotting average time (in sessions) to reach acquisition criteria (>35 injections) with behaviorally equivalent doses of MPH and cocaine. On average, it takes fewer sessions for animals to acquire MPH self-administration as compared to cocaine (D) Group data plotting the percentage of animals that have met acquisition criteria over sessions.

administration comparable to cocaine (Gautschi & Zellweger, 2006; Levine et al, 1986;

Parran & Jasinski, 1991; Sherman et al, 1987; Shaw et al, 2008).

Conditioned place preference (CPP), which is often used as a measure of the

rewarding effects of drugs is produced by MPH in both rats and mice (Chen et al., 2006;

Wooters, Walton and Bardo, 2012). In rats, conditioned preference for MPH occurred

when it was administered (intraperitoneal) i.p. (3 mg/kg); however when administered

orally MPH did not result in preference for the drug-paired chamber (Wooters, Walton,

and Bardo, 2012). The lack of CPP using therapeutic routes of administration (oral) in

rodents is consistent with the human literature demonstrating that when administered

orally at therapeutic doses, that human subjects do not perceive a “high”. Alternatively,

in rodents, i.p. dosing caused preference indicating that the route of administration is an important factor in influencing the subjective effects associated with a particular drug.

This is particularly important to note when considering the clinical implications of the

MPH abuse literature as compared to the therapeutic literature and highlights the importance of using relevant routes of administration in order to model the “high” associated with MPH abuse.

3. Behavioral models of MPH abuse

3.1. Self-administration

The “gold standard” for preclinical drug abuse research is self-administration, where animals respond on a lever in order to contingently administer drug. Most drugs that are abused in the human population are readily self-administered by rodents, and a 15

number of studies have demonstrated that MPH maintains i.v. self-administration in rats

(Marusich et al, 2010; Botly et al, 2008; Burton et al, 2010; Collins et al, 1984). Further,

MPH supports high breakpoints on a progressive ratio (PR) schedule, which are

comparable to cocaine, in both rats and humans that are (Botly et al, 2008; Rush et al,

2001). These studies indicate that MPH is a potent reinforcer, especially when taken i.v., and given that most, if not all, drugs of abuse are self-administered by rodents, there is some cause for concern for MPH abuse in the human population.

Giving further support to the idea that MPH has significant abuse/ addiction potential is the cue-induced augmentation of MPH self-administration. Associations made between drugs and drug-associated cues have often been implicated in relapse, where cues, in the absence of drugs, can trigger drug seeking and drug taking behavior.

Marusich et al. (2011) conducted a study to determine how pairing cues with self- administration affected self-administration behavior. They found that, in the absence of paired cues, MPH functioned as a reinforcer, however, when delivery of MPH was paired with a cue light, animals pressed significantly more to obtain the drug. This demonstrates that MPH is a reinforcer in the absence of environmental stimuli and cues; however, the interplay between environmental cues and MPH reinforcement is synergistic. Because of this strong enhancement of MPH self-administration in the presence of cues, it is possible that once individuals abstain from MPH for extended periods, the cues may trigger drug- seeking behavior and lead to relapse to abuse of the compound. Botly et al., (2008) demonstrated that MPH itself can reinstate extinguished drug seeking; however, it would be interesting to determine if the drug-paired cues were capable of doing so as well. 16

In addition to normal baseline responding for MPH under a number of schedules,

MPH also results in escalation of fixed ratio 1 (FR1) intake over sessions. This escalation is highlighted by an overall increase in total drug intake over sessions as well as an increase in intake within the first hour of each session (Marusich et al., 2010; Figure 1).

An important feature of dependence and addiction is the switch from moderate drug taking to excessive and uncontrolled intake (Koob and Le Moal, 1997). Humans exhibit escalation of intake in extended-access situations (Koob and Kreek, 2007; Gawin and

Ellinwood, 1989) and this has been modeled in rats using long access (LgA, 6 hr/day) self-administration sessions. While daily short access sessions (ShA, 1hr/day) result in stable drug intake, it has been repeatedly shown that LgA produces an escalation in intake for a variety of addictive drugs including COC, AMPH, and MPH (Ahmed and

Koob, 1998, 1999; Johansen et al, 1976; Marusich et al., 2010). It is well accepted that the phenomenon of escalation is a predictor of abuse/dependence potential of drugs in the human population, which suggests that because MPH escalates that when taken via certain routes it may have serious abuse potential. Marusich et al. (2010) demonstrated that long access MPH resulted in escalation of intake at 0.1 mg/kg/infusion as well as at

0.3 mg/kg/infusion. A short-access group (1hr/session) showed no increase in intake

over sessions. This demonstrates that short, controlled access, to MPH, as seen with

therapeutic use, does not result in increases in intake over a session, and may not have

abuse potential. It is likely that longer access and intake of these drugs, as seen with

abuse will more likely result in a dependence/addiction phenotype, which is dangerous,

particularly in the adolescent population, where use in this pattern has been observed.

3.1.1 MPH escalation is due to increased reinforcing efficacy of MPH

Because escalation experiments are done on an FR-1 schedule where one lever

response results in one infusion of drug, it is impossible to determine using this paradigm

if escalation in intake is due to tolerance or an increased motivation to administer the

compound. Koob and colleagues argue that the escalation that occurs with cocaine self- administration is due to a shift in hedonic set point (Ahmed & Koob, 1998; Koob and Le

Moal, 1997; Koob 1996a, b). Because it was only recently determined that MPH results

in escalation, little research has focused on the mechanism of such intake. However,

using a similar LgA paradigm, Calipari et al. (2013a) demonstrated that the reinforcing

efficacy of MPH was increased following LgA self-administration that resulted in first hour escalation, using two independent measures of reinforcing efficacy (Figure 2). As little as five days of extended-access MPH self-administration resulted in increased progressive ratio responding at 0.56mg/kg MPH, the most reinforcing dose of the drug.

This alone indicates that the increase in first hour administration of MPH is not due to tolerance, as tolerance would likely result in decreased PR responding as animals are less motivated to work for the compound when it has less of an effect.

Further, prior MPH self-administration results in increased responding and maximal price paid for MPH, using a “threshold” procedure (Zimmer et al., 2012; Oleson et al., 2009, 2012; Figure 2). The within-session threshold procedure is a behavioral economics approach to assessing drug-taking and drug-seeking by performing a within session dose-response curve. The doses are administered in 12 15-min bins over a session and the doses decrease logarithmically from high to low over the session. Overall

shifts in the entire dose-response curve can be determined by plotting the number of 18

Figure 2. Methylphenidate (MPH) Self-Administration Increases the Preferred

Intake Level and Reinforcing Efficacy of MPH. MPH reinforcement was assessed using a within session threshold procedure. This procedure is a within session dose response curve where doses start high and are reduced throughout the session (every 15 min). Using this procedure the cost [measured as number of responses required to obtain

1mg MPH (resp/mg)] can be assessed for each dose, and the maximal price (Pmax) that an

animal is willing to pay to obtain drug can be assessed. (A) Demand curve plotting the

average intake at each of the doses administered. At high doses (where cost is low)

animals with a history of MPH self-administration administer more MPH. (B) Group

data plotted as responses versus dose. At low doses (where cost is high) animals with a

history of MPH self-administration expend greater effort to maintain MPH blood levels.

Adapted from Calipari et al., 2013, Nature Communications (C) The Pmax is determined

from the peak of the MPH dose-response curve. Boxes highlight the price at which control and MPH self-administration animals respond most for MPH. MPH self- administration increased Pmax for MPH. (D) Group data indicating that the Pmax for MPH is increased following MPH self-administration. Adapted from Calipari et al., 2013,

Nature Communications.

responses that are emitted at each dose, much like a PR dose-response. Second, a measure of the maximal price paid (Pmax) for a drug can be determined before or after a

treatment. The price is expressed as the number of responses necessary to obtain one mg

of drug; thus, as the dose is reduced over the session the price is increased because

animals must respond more to maintain the same level of drug self-administration. The

Pmax is the price at which the animal responds most, and is the apex of the dose-response curve. Using this paradigm Calipari et al. (2013a, b) found that, following extended- access MPH self-administration, there was a shift in the dose-response curve to indicate that MPH was more potent. In addition, the Pmax for MPH was significantly increased,

indicating that animals were willing to work harder to obtain MPH following self-

administration. Further, when plotting the data as a demand curve (intake versus

responses), it can be determined if the animals are titrating their drug intake to a different

preferred blood level. Figure 2A demonstrates that, following MPH self-administration animals take more drug when the cost is low (higher doses). This is in line with escalation experiments, which show that on an FR1 schedule, animals administer more drug in subsequent sessions. Taken together, these data demonstrate that extended-access

MPH self-administration does not cause behavioral tolerance and that animals are, in fact, more motivated to self-administer following prior MPH exposure. This is particularly alarming as it may promote a cycle of drug use in the human population within which individuals that abuse MPH become more motivated to abuse MPH subsequently, which is a cycle that could potentially lead to addiction of the compound. In addition, it is important to determine the effects of MPH administration, not only on MPH, but also on 21

other psychostimulants as they are often used in combination in the adolescent population

(Sepúlveda et al., 2011; See section 3. C.).

3.2. Cross-sensitization

Locomotor sensitization experiments are traditionally used to study the neurochemical alterations that are involved in the addiction process by determining the behavioral consequences of repeated psychostimulant administration. Repeated MPH administration results in robust locomotor sensitization (Wooters and Bardo, 2009); this effect is also characteristic of other commonly abused psychostimulants including cocaine and AMPH (Kalivas and Duffy, 1990, 1993; Parsons and Justice, 1993). It has been demonstrated using a number of paradigms that MPH cross-sensitizes with other psychostimulants, suggesting that MPH use/abuse could affect not only itself, but also the propensity for abuse for these other compounds as well. The locomotor effects of MPH cross-sensitize with AMPH, demonstrating that AMPH-induced behavioral effects can be altered by MPH (Yang et al, 2003, 2011; Burton et al, 2010). This is of interest because

MPH abusers are more likely to abuse other addictive substances (Barrett et al, 2005;

Teter et al, 2006; Wilens et al, 2008). Because sensitization is thought to involve a number of neural circuits including DA and glutamate, this also suggests that MPH exposure may alter other neurotransmitter systems in addition to DA and may have behavioral implications that extend beyond reward and reinforcement (see section 6.3.2.).

3.3. MPH affects the reinforcing efficacy of other psychostimulants

In addition to cross-sensitization, MPH self-administration has been shown to affect the reinforcing efficacy of not only MPH itself, but also other psychostimulants as well. Using two paradigms of self-administration, extended-access (Calipari et al.,

2013a, b) and intermittent access (Calipari et al., unpublished observations), the reinforcing efficacy of MPH, a prototypical releaser (AMPH), and a prototypical blocker

(cocaine) were determined following self-administration using the threshold procedure of reinforcement, described above. The effects of both self-administration paradigms were similar, with MPH self-administration augmenting only AMPH and MPH, but not cocaine reinforcement (Calipari et al., 2013c). These data demonstrate a number of important concepts. First, MPH is capable of altering the reinforcing efficacy of other psychostimulants when taken via multiple patterns of self-administration, an effect that may lead to increased abuse/addiction of these compounds in the human population following MPH abuse. Second, it demonstrates that MPH can class specifically affect the potency of certain compounds. And finally, that MPH, although considered a DAT blocker, may be unique, as its self-administration affects only a releaser and not another compound of the same class. The unique behavioral properties of MPH may be explained by its acute and long-term neurochemical effects, which seem to be unique in comparison to other psychostimulant blockers and releasers.

4. Acute neurochemical effects

4.1. The dopamine system

Although behavior is of high relevance in determining the abuse potential of drugs, it is also important to understand the neurochemical processes underling a drug’s behavioral effects. The DA system plays a critical role in motivated behaviors, goal oriented movement, attention, reward and reinforcement (Carlsson, 1987; Robbins,

2003). Because of this, mutations and dysfunction in the DA system results in a number of pathologies such as Parkinson’s disease (Chase et al., 1998), ADHD (Mazei-Robison et al., 2005), and addiction (Ritz et al., 1987). Dopaminergic innervation of the nucleus accumbens (NAc) is an important mediator of motivated reward-related behaviors (Di

Chiara, 1995; Peoples et al, 1998; Koob, 1996); accordingly, MPH, AMPH, and COC, elevate DA in the rat NAc and enhance dopaminergic signaling (DiChiara and Imperato,

1988; Carboni et al, 1989; Woods and Meyer, 1991; Gerasimov et al, 2000). MPH, a DA and norepinephrine transporter inhibitor, increases accumbal DA levels via DA uptake inhibition directly at the DAT (Volkow et al, 2002; Heal et al, 2009; Han & Gu 2006).

Increased NAc DA levels mediate the reinforcing and rewarding effects of MPH as well as the “high” associated with MPH abuse. MPH rewarding effects have been directly linked to the DAT in studies, which demonstrate that MPH-induced CPP is abolished in mice with mutations of the DAT which reduce the affinity of MPH (Chen et al, 2005;

Tilly & Gu, 2008). Because of the necessary role for the DAT in MPH-induced reward, reinforcement, and therapeutic effects, much of the work on the neurochemical effects of

MPH has focused primarily on the DA system. 24

4.2. MPH pharmacology

Although behaviorally similar, COC, AMPH, and MPH are markedly different in the way in which they acutely interact with the DA system. DAT inhibiting compounds can act by either simply blocking (e.g., cocaine) the transporter or by acting as releasers

(e.g. AMPH), however the net acute effect is increased DA levels in the synapse

(Rothman and Bauman, 2003). Blockers act by binding to the DAT and inhibiting the uptake of DA from the synaptic cleft, while releasers bind to the DAT and are transported into the terminals. Traditionally, releasers act via three major mechanisms: 1) inhibition of DA uptake by competitively binding to the DA DAT, 2) modulation of the pH with in vesicles resulting in the movement of DA into the cytoplasm, and 3) action potential independent DAT-mediated reverse transport of DA into the synapse (Fleckenstein et al.,

2007). Because most releasers must be transported for their effects to occur, blockers can often inhibit the actions of releasers (Rothman and Bauman, 2003; Rudnick and Clark,

1993).

MPH is traditionally classified as an uptake blocker, as cell culture studies have demonstrated that it is not transported into the cell via the DAT, and thus cannot interact with vesicles to cause action-potential independent DA release (Sonders et al, 1997).

Even though MPH is categorized as a blocker, it has been shown to have releasing capabilities at 0.1 mM, suggesting that MPH may share some properties with both blockers and releasers (Sproson et al, 2001; Russell et al, 1998; Heal et al, 1996; Dyck et al., 1980). Since MPH is not a substrate for the DAT, similar to the prototypical blocker cocaine, yet it has release capabilities at high doses, similar to the prototypical releaser

AMPH, MPH may function as an atypical DAT inhibitor, exhibiting pharmacological 25

characteristics similar to AMPH as well as cocaine. The exact molecular mechanisms

responsible for MPH’s unique actions are not yet understood, however.

In addition to MPH being unique in its mechanisms of action, binding studies

demonstrate that MPH interacts with the DAT in a way that is distinct from both AMPH

and cocaine (Wayment et al., 1999; Dar et al., 2005). These studies show that MPH

interacts with the transporter in a manner similar to benztropine, as measured by

displacement of radiolabled CFT (2 beta-carbomethoxy-3-beta-(4-fluorophenyl)-N-

[3H]methyltropane) binding and uptake. In these studies both MPH and benztropine displace radiolabled CFT in a manner that was dissimilar from both blockers and releasers and led the researchers to discuss the interaction of these compounds with the

DAT as a separate pharmacological class of psychostimulants (Dar et al., 2005). This demonstrates that, although MPH is traditionally classified as a blocker, similar to cocaine, MPH is different in the way in which it interacts with the transporter. This difference in DAT-MPH interactions may not have an effect on the observed acute effects of MPH, specifically the ability of MPH to elevate DA; however, the differences in binding properties of MPH may lead to, and explain, some of the observed differences in neurochemical adaptations that occur as a result of chronic MPH administration as compared to traditional blockers.

MPH has been shown to have multiple effects on presynaptic DA terminals. It mobilizes docked vesicles, causing vesicles to be redistributed from membrane-bound to free pools, which may cause the vesicles to be more likely to be released. A 40 mg/kg subcutaneous dose of MPH one hour prior to synaptosomal preparation results in a redistribution of the vesicular monoamine transporter (VMAT)-2 protein from the 26

membrane compartment to the cytosolic compartment. Much work has been done on releasable DA pools, and it is possible that since MPH is capable of redistributing vesicles from membrane-bound forms into the readily releasable pools, it may lead to greater DA release per stimulation. This suggests that although MPH does not enter the cell, it may be able to elevate DA levels in the synapse indirectly, by promoting greater

DA release per action potential (Volz et al., 2007, 2009; Sandoval et al., 2002;

Chadchankar et al., 2012).

In addition to altering vesicle distributions within the terminals, acute MPH injection (40 mg/kg, 1hr prior) results in increased vesicular DA uptake, suggesting that the system is more efficient at repackaging DA, an effect that, like vesicular redistribution, could lead to greater DA release upon each stimulation of the terminal.

Not only is uptake changed, but also release, where the speed and magnitude of release from striatal synaptosomes is increased, lending further support to the fact that MPH may increase DA release independent of its DAT effects (Volz et al., 2009).

Because of these unique properties of MPH, it is difficult to make predictions about the neurochemical consequences of use and abuse, based on previous work with other psychostimulants. As a result, much work needs to be done, not only to further elucidate the mechanism of acute MPH actions on the DA system, but also to determine the effects of chronic MPH abuse.

5. Long-term consequences of MPH administration

5.1. Chronic non-contingent effects

Because of the role of the DA system in reward and reinforcement, and the

DAT’s role as the primary site of action for the euphorigenic effects of psychostimulants,

much focus has been placed on the effects of chronic exposure of these compounds on

the DA system and the DAT. MPH self-administration has previously been shown to be mediated by the DA system, because both D1 and D2 antagonism lead to increased FR1, but decreased PR responding (Botly et al., 2008). These changes are consistent with reduced subjective effects of MPH in the presence of the antagonists, leading to a reduction in reinforcing effects. The same phenomenon is seen with behavioral tolerance, where the reduced effects of a drug lead to an increase in FR1 responding in order to overcome the reduced effects of that drug. Further, animals are not willing to expend as much effort to obtain MPH, which leads to decreases in reinforcing efficacy and a concomitant decrease in PR responding. Studies, such as this, point to the importance of the DA system in the reinforcing effects of MPH. The different interactions with the DA system, more specifically the DAT, are most important in determining the compensatory changes that occur after long-term repeated exposure to the compound. Thus drugs like MPH, which interact with the DAT in a way that is unique from other psychostimulants, must be assessed individually to determine their neurochemical effects. Most work aimed at assessing the neurochemical consequences of

MPH has focused on non-contingent administration of MPH in rodent models. The effects of repeated non-contingent MPH administration on DAT function are unclear, as numerous studies using different dosing paradigms have shown different, sometimes 28

opposite, effects of exposure. It was initially reported that acute 4-day (21 or 50 mg/kg/day) MPH failed to cause changes in tissue DA levels, metabolites, or transporter numbers (Zaczek et al, 1989). Later studies, however, showed that repeated 7-day (44 mg/kg/day) MPH exposure decreased DAT numbers in the caudate putamen, but not the nucleus accumbens or the substantia nigra (Izenwasser et al, 1999). Moreover, administration of MPH at pre- and post-pubertal stages decreased DA transporter density by 25% at day 45 and 50% at adulthood (day 70; Moll et al, 2001). Further, MPH administration results in increased VMAT-2 immunoreactivity, VMAT-2-mediated DA uptake, and increased DA content in a cytoplasmic vesicular fractions in the striatum,

(Volz et al., 2007). Although these studies were important in laying the groundwork for

MPH research on the DA system, the results are unclear and often conflicting. In addition, although these studies use high doses that would constitute abused doses of

MPH, they are administered non-contingently. Non-contingent drug administration can give us insight into the basic neurochemical effects of drugs, however, in regards to drug abuse, in which the neurochemical consequences are dictated by a number of factors, it is particularly important to model the contingency with which humans administer drugs. A number of studies have demonstrated that contingent and non-contingent administration of drug can have vastly different neurochemical effects, thus when attempting to accurately model the effects of drug abuse it is important to use contingent drug administration.

5.2. Neurochemical consequences of MPH self-administration

Self-administration is an ideal method for determining the neurochemical effects of drug abuse, as animals, like humans, choose to administer drug. Because the administration of drug is contingent, this is currently the best working model of human drug abuse that we have in rodents. Although primate work likely more accurately models human drug use, rodents allow for more in-depth probes of the neurochemical and behavioral consequences of drug abuse. Currently, little work has been done to determine the effects of MPH self-administration on DA system neurochemistry. LgA self-administration has been useful for documenting the neurochemical adaptations that occur during the addiction process, and studies have demonstrated that ShA and LgA paradigms differentially alter DA system function as measured by changes in uptake and

DAT density, particularly for drugs such as COC and AMPH (Oleson et al, 2009; Ben-

Shahar et al, 2006).

Long access self-administration of 0.56 mg/kg/infusion MPH for five days resulted in significant DA system alterations. Extended-access self-administration of

MPH results in escalation of first-hour intake, an effect that is thought to signify the switch from abuse to addiction of drugs of abuse (Ahmed & Koob, 1998). In these animals DA system changes were assessed using fast scan cyclic voltammetry (FSCV), an electrochemical technique that allows for real-time recording of DA signals with sub- second time resolution allows for the determination of a number of kinetic parameters.

FSCV in slices containing the NAc core from animals that had previously self- administered MPH exhibited significantly higher stimulated release and maximal rate of uptake (Vmax), indicating significant changes in DA signaling within these animals. 30

These changes are not due to alterations in tissue content levels of DA, or DA synthesis,

as tissue content levels were not elevated following MPH self-administration, and the

levels of tyrosine hydroxylase (TH), the rate limiting enzyme for DA synthesis, remained

unchanged. In addition to the lack of difference in TH levels, there was also no

difference in TH phosphorylation (Calipari et al., 2013b). Therefore, it is likely that

changes in release reflect changes in releasable pools of DA, something that MPH has

been shown to acutely affect by redistributing vesicular pools from membrane-bound into

the readily releasable pool (Volz et al., 2009). Changes in uptake rates in this case were determined to be due to increases in DAT levels, which have previously been shown to alter the potency of psychostimulants (Chen and Reith 2007; Salahpour et al., 2008).

Because two major factors that govern normal DA signaling are DA release and reuptake, the changes in these measures alone at baseline indicate that the DA system may be functioning differently in these animals independent of drug effects. Because DA release is increased, it is possible that phasic activity of DA neurons may be increased as well.

Because phasic firing of DA neurons is associated with goal-reward learning, it is possible that these changes may affect subsequent drug administration and drug-seeking through an enhancement of goal-reward associations.

In addition to assaying the effects of MPH self-administration in an LgA model, we also determined the neurochemical consequences of MPH self-administration using an intermittent-access paradigm that does not result in escalation over sessions.

Intermittent-access was used because human administration of psychostimulant drugs is often not continuous, but rather follows a spiking pattern where people take a bolus of drug and wait a period of time before administering the compound again. Within each 31

session, animals were given unlimited access to MPH (0.56 mg/kg) for 5 minutes with no

timeouts, following a 25-minute time-out period during which the lever is retracted and

the animals cannot respond to obtain drug. This pattern of self-administration repeats for

the six-hour session, resulting in 12 5-minute access periods. Following 14 days of

intermittent MPH self-administration, FSCV was used to determine the DA system

kinetics in NAc core containing brain slices from these animals. Surprisingly, this

different paradigm of self-administration resulted in the same adaptations to DA system

as previous LgA models, characterized by a significant increase in stimulated DA release

as well as an increase in uptake rate. The increased DA release is not due to changes in

D2 auto-receptors, as the functional activity of the receptors was unchanged (Calipari et al., submitted). The fact that two different MPH self-administration paradigms resulted in the same DA changes, suggests that the effects of contingent MPH administration are the same, regardless of paradigm, however, further research would have to be conducted to determine the validity of that hypothesis.

6. Psychostimulant self-administration-induced changes in drug potencies

6.1.1. MPH self-administration effects on psychostimulant potency

The use of FSCV for the assessment of DA signaling, allows not only for the

determination of DA system kinetics and dynamics, but also for determining the potency

of DAT-inhibitor compounds. Using kinetic modeling, we are able to determine the

extent to which drugs such as cocaine, AMPH, and MPH inhibit DA uptake, which can

give us a measure of drug potency following MPH self-administration (Yorgason et al., 32

2011; Ferris et al., 2013). Because other psychostimulants are often used in combination with MPH, it is important to not only determine the potency of MPH. but other compounds as well (Sepúlveda et al., 2011). Following extended-access MPH self- administration, MPH potency was increased, which suggests that MPH may be more rewarding / reinforcing. This theory is supported by the behavioral data discussed previously that indicates that the reinforcing efficacy of MPH is also increased; suggesting that changes in psychostimulant potency within the NAc have behavioral correlates (Calipari et al., 2013a). This is important, as the self-administration other of psychostimulant blockers, such as cocaine, has been shown to result in tolerance, not sensitization, to its neurochemical effects at the DAT, characterized by a reduced DA uptake-inhibition as measured by both FSCV and microdialysis (Mateo et al., 2005;

Ferris et al., 2011, 2012, 2013; Calipari et al., 2013b, c, d, e).

In addition to determining changes in MPH potency following MPH self- administration, MPH self-administration resulted in an increased potency for the releasers

AMPH and methamphetamine (METH), but had no effect on the blockers cocaine and nomifensine. Therefore, MPH self-administration selectively increases the potency of releasers and MPH, and leaves blockers unaffected. Not only was this phenomenon observed following LgA self-administration, but the same trend was observed following intermittent access MPH where AMPH and MPH potency were increased and cocaine potency remained unaffected. This class specific increase in drug potency is important as certain drugs may be more susceptible to abuse in individuals that abuse MPH, while others remain unaffected. 33

Although the previous work was done in vitro using fast FSCV, the results have

also been validated using in vivo microdialysis techniques. Following MPH self-

administration, as predicted by voltammetry studies, there is an increase in MPH- and

AMPH-, but not cocaine-, induced DA overflow, indicating that the effects at the DAT

are directly related to the elevations in DA that are observed following the administration

of these psychostimulants (Calipari et al., 2013a). Further, the increases in

neurochemical potency are accompanied by increases in reinforcement for these

compounds as well, where a history of MPH self-administration results in increased

reinforcing efficacy for AMPH and MPH, but not cocaine, as measured by using the

within session threshold procedure (Described in section 3.1.). The increase in

reinforcement for releaser drugs suggests that these compounds may have an increase in

abuse liability, which is particularly important given the co-abuse of MPH with other

compounds such as amphetamines.

6.1.2. A mechanism for MPH self-administration effects

The changes in psychostimulant potency following MPH self-administration have

been shown to be due to increases in DAT levels (Calipari et al., 2013b). This was

confirmed using transgenic DAT over-expressing mice (DAT-tg) to show that increases

in DAT levels alone, independent of pharmacological manipulations, are capable of

causing the same neurochemical and behavioral effects as MPH self-administration

(Calipari et al., 2013a). DAT-tg mice show the same kinetic and dynamic changes, characterized by increased evoked DA release and increased uptake rates. Further, 34

increasing DAT levels results in increased potency for releasers and MPH, but not

blockers. Additionally the increase in MPH and AMPH potency directly at the DAT are

accompanied by increased AMPH- and MPH-induced DA overflow and increased locomotor activating effects of the compounds (Salahpour et al., 2008; Calipari et al.,

2013a). These data demonstrate that increasing DAT levels is sufficient replicate the effects that are observed following MPH self-administration, validating this as a mechanism for the neurochemical and behavioral effects. Further, this demonstrates that the acute effects of MPH are affected by DAT levels in a similar fashion to releaser compounds, but not blockers, further demonstrating that MPH is unique in regards to its behavioral effects and its interactions with the DA system.

Increased potency of releasers and MPH in the presence of high Vmax/DAT levels

may be important in clinical treatment settings, as individuals with ADHD have well-

documented increases in DAT levels ranging from 17-70% (Madras et al., 2005). These

findings may explain in part the high frequency of drug abuse in untreated ADHD

sufferers (Biederman et al., 1999), and these individuals may be more susceptible to the neurochemical, behavioral, and neurotoxic effects of MPH, AMPH and other releasers like methamphetamine and “bath salts”. Also, models of PTSD (Hoexter et al., 2012), early life stress (Yorgason et al., 2012), and repeated stress (Kohut et al., 2012) all result in similar increases in DAT levels; therefore, many individuals fall into this category,

making the relevance of these results extend far beyond the drug abuse field.

6.2. The effects of MPH self-administration are different from AMPH and cocaine

self-administration

6.2.1. Cocaine self-administration

Calipari et al., (2013b) demonstrated that although MPH self-administration

caused an increase in the measures of DA release and uptake, and an increase in MPH

potency, the effects of cocaine self-administration were very different. Cocaine self- administration resulted in decreased DA release and uptake, effects that were both opposite from MPH self-administration. In addition, the effect of the self-administration of each drug on potency was different, where cocaine self-administration resulted in decreased cocaine potency, but no affect on MPH potency, and MPH self-administration resulted in increased MPH potency, without effecting cocaine potency. The opposite compensatory changes that occur in the DA system following the self-administration of two traditional DAT blockers are surprising, but highlight the unique properties of MPH, not only acutely, but also in long-term self-administration paradigms.

6.2.2. Amphetamine self-administration

It was initially hypothesized that the effects of MPH self-administration were opposite of cocaine because MPH is structurally similar to releasers, thus, its effects would likely resemble the changes that occur following AMPH self-administration.

However, MPH effects were different from the previous reports of the effects of AMPH self-administration. AMPH self-administration resulted in no change in baseline DA kinetics or on psychostimulant potency of either blockers or releasers (Ferris et al., 2011). 36

This demonstrates that although MPH effects are different from traditional blockers, they are also different from releasers, suggesting that MPH may have properties of both classes of drugs. This further supports the idea that inferences on the effects of MPH on the DA system cannot be made based on previously published work on either blockers or releasers.

6.2.3. Pattern of self-administration alters the compensatory changes associated with cocaine, but not MPH self-administration

Further supporting the idea that the effects of MPH self-administration are unique is data indicating that MPH is unaffected by pattern of self-administration, which is different from the literature on cocaine self-administration. The cocaine literature demonstrates that LgA and intermittent access cocaine administration result in different changes in DA system kinetics and psychostimulant potency (Calipari et al., 2013c, d, e).

Specifically, tolerance to the DAT-inhibiting effects of cocaine is dictated by intake pattern, where continuous high-dose cocaine intake results in tolerance to cocaine effects, while intermittent cocaine intake results in sensitization where cocaine is more potent at inhibiting the DAT (Calipari et al., 2013c). This is different from MPH self- administration, which results in the same DA kinetic and MPH potency effects for both intermittent and continuous access paradigms (Calipari et al., submitted).

6.3. What is different about MPH?

The unique properties of MPH in regards to its chronic effects make it impossible

to make generalizations based on the effects of other drugs. Although the compensatory

changes associated with MPH self-administration do not resemble those of blockers, they

also do not resemble those of a releaser, amphetamine, which had no effect on DA dynamics or kinetics. Although in vitro studies have shown that MPH exhibits the

properties of both blockers and releasers, it is clear that MPH does not fit neatly into

either category. Additionally, this work highlights that it is likely that the compensatory changes that occur within the DA system following repeated administration of MPH are driven by the way in which it interacts with the DAT, and not just its ability to elevate

DA, as both cocaine and AMPH elevate DA to a similar extent. The fact that MPH causes compensatory changes that are different from both a prototypical blocker and a prototypical releaser demonstrates that not only does MPH have functional properties of both classes, but rather that it belongs in a class of its own.

6.3.1. MPH has limited serotonin transporter affinity

In addition to the unique acute effects of MPH in regards to binding to the DAT,

MPH is different than cocaine in regards to its affinity for the serotonin transporter.

While cocaine binds with high affinity to the norepinephrine, DA, and serotonin

transporters, MPH binds with high affinity only to the norepinephrine and DATs (John

and Jones, 2007). MPH has low affinity for the serotonin transporter, so that at

physiologically relevant concentrations, MPH does not elevate serotonin levels. 38

Although the acute effects of the drug at the DAT are independent of these differences, it

is possible that the differences between the chronic effects of MPH and cocaine, as

assayed following self-administration studies, are due to the lack of affinity of MPH for the serotonin transporter. In mice is has been shown that repeated MPH administration

results in changes in the connectivity between the serotonin and dopamine systems,

whereby, following MPH administration, serotonin reuptake inhibitors such as fluoxetine

are able to increase DA-mediated behaviors (Brookshire & Jones, 2012). Thus, it is

possible that changes such as this are happening within the self-administering animal,

which leads to differential compensatory changes as compared to cocaine self-

administration.

6.3.2. MPH modulates the glutamate system

Extensive work from the Dafny group has demonstrated that many of MPH’s

effects, especially in regards to behavioral sensitization and modulation of VTA receptor

excitability, depend on activation of glutamate receptors (Yang et al., 2000a, b; Gaytan et

al., 2000; Sripada et al., 1998; Gaytan et al., 2001; Prieto-Gómez et al., 2004; Prieto-

Gómez et al., 2005). Gaytan et al., (2000) showed that the non-selective NMDA receptor

antagonist, MK-801, is able to block MPH-induced locomotor sensitization

demonstrating that the glutamate system is necessary for the development of

sensitization. This is particularly relevant to the differential effects observed with MPH

self-administration as MPH and AMPH have differential effects on glutamatergic

transmission in VTA DA neurons (Prieto-Gómez et al., 2005). Pretreatment with AMPH 39

increased both the frequency and amplitude of miniature excitatory post-synaptic currents

(mEPSCs), while pre-treatment with MPH increased only the frequency (Prieto-Gómez et al., 2005). Additionally, MPH and AMPH had differential acute effects on the type of mEPSC with MPH only modulating NMDA receptor mediated mEPSCs and AMPH modulating both NMDA and AMPA receptor mediated mEPSCs. The differential effects of MPH on the glutamate system could potentially play a role, at least in part, in the differential effects of AMPH, cocaine, and MPH self-administration on the DA system.

7. MPH is a unique drug

7.1. MPH does not act like other blockers following cocaine self-administration

MPH does not fit cleanly into either the blocker or releaser class, as cocaine self- administration studies have demonstrated that MPH is affected in a manner that is significantly different from other psychostimulant blockers. Extended-access cocaine self-administration has been demonstrated repeatedly to result in pharmacodynamic tolerance, whereby cocaine is less effective at inhibiting DA uptake in the NAc core

(Mateo et al., 2005; Calipari et al., 2013b, c, d, e; Ferris et al., 2011, 2012, 2013). In a recent publication, Ferris and colleagues (2012) determined the potency of a number of blocker and releaser compounds following cocaine self-administration. Of all the blockers tested, MPH, was the only one that was unaffected by cocaine self- administration. Even more surprising, was the fact that none of the releasers tested were affected by cocaine self-administration, therefore, in this study, MPH seemed to fit into the same category as releaser compounds. 40

7.2. DAT levels affect MPH potency in a similar fashion to releasers

MPH is unique not only in structure or function but also in the neurochemical alterations that influence its effects. Previous work by Salahpour et al., (2008) has demonstrated that over-expression of the DAT results in an increase in AMPH, but not blocker, potency as measured by microdialysis or locomotor behavior. This was further confirmed using FSCV, where AMPH, but not cocaine, potency was increased following transgenic DAT over-expression (Calipari et al., 2013a). Because MPH is a DAT blocker, one would hypothesize that it would be unaffected by changes in DAT levels, however, MPH’s potency is increased with increasing DAT levels, both in uptake inhibition and in locomotor activity. One caveat is that Salahpour et al (2008) showed no difference in MPH-induced locomotor responding in the DAT-tg animals at the 20 mg/kg dose. Calipari et al. (2013a) also show no difference at this dose; however 20 mg/kg dose is on the descending limb of the dose-response curve for MPH, thus the groups are no longer significantly different. Regardless, this illustrates both behaviorally and neurochemically that MPH is unique as it is a DAT blocker that has pharmacological actions that mimic those of releasers.

In addition, many neurochemical manipulations that increase transporter levels at baseline as measured by western blot and functionally by FSCV also increase the potency of MPH. This has been illustrated with a number of models including DAT-tg mice,

MPH self-administration, social isolation (Yorgason et al., in preparation) and intermittent access cocaine self-administration (Calipari et al., 2013c). These paradigms result in increases in Vmax at baseline that results in increases in releaser and MPH potency. One advantage to using Vmax measurements as a functional measure of DAT 41

levels, is that dose response curves for drugs can be preformed within the same subject,

thus, allowing for correlations between uptake rates and drug potency. Previously we

correlated our measure of uptake inhibition (app. Km) with a functional measure of DAT

levels (Vmax). Correlation analysis of data from both MPH SA and DAT-tg show that

DAT levels are positively correlated with potency measurements for AMPH, MPH, and

to a lesser extent cocaine. Although there was a positive correlation between uptake rates

and cocaine potency, the shift in cocaine potency across increasing Vmax values was substantially less robust than MPH and AMPH, and the effect size for cocaine was so small that no difference in app. Km was found between fast and slow Vmax based on a

median split of Vmax values (Calipari et al., 2013a). This further supports the idea that

DAT density increases affect MPH in a similar fashion to releasers.

The proposed mechanism for the increased potency of releasers in scenarios

where there are elevated DAT levels is outlined in Figure 3. It is possible that because

releasers enter the cell through the DAT that when there are more transporters that more

drug can enter the cell leading to enhanced drug effects and increased releaser potency.

Further, because the release of DA into the cytoplasm is via DAT-mediated reverse

transport, when DAT levels are elevated more DA can be released into the synapse. It

has been shown previously that MPH does not enter the cell (Sonders et al., 1997);

however, it is possible that MPH is causing release effects via a DAT mediated

mechanism. For example, a number of kinases have been shown to participate in DAT

signaling cascades (Beaulieu et al., 2005; Beom et al., 2004; Brami-Cherrier et al., 2002;

Burgering and Coffer, 1995; Chen et al., 2010; Giros and Caron, 1993; Guptaroy et al., 42

Figure 3. Increased Dopamine Transporter (DAT) Levels Increase the Potency of

Psychostimulant Releasers. Schematic demonstrating the proposed mechanism for elevated releaser potency in dopamine (DA) neurons when DAT levels are elevated.

(Left) The naïve state when there are normal DAT levels. Amphetamine (AMPH) enters the cell via the DAT (blue arrow), followed by entry into the vesicle via the vesicular monoamine transporter (VMAT). AMPH releases DA into the cytoplasm, which is released into the synapse via DAT-mediated reverse transport (red arrow). (Right)

Elevated DAT levels following methylphenidate (MPH) self-administration (SA) or in

DAT over-expressing mice. Because DAT levels are elevated, more AMPH can enter the cell and enter vesicles. AMPH releases more DA into the cytoplasm, which is released into the synapse via DAT-mediated reverse transport. Because DAT levels are elevated more DA can be released into the synapse from the cytoplasm, which leads to elevated synaptic DA levels and augmented post-synaptic receptor signaling as compared to the naïve state.

2008, 2010; Neve et al., 2004), and it is possible that MPH is causing changes to these

signaling pathways, which leads to enhanced DAT-mediated release (Ferris et al., 2013).

8. Conclusions A high potential for MPH abuse in the human population is predicted by the

behavioral and neurochemical profile of MPH in translational studies, which have

demonstrated high rates of self-administration, escalation of intake over sessions, and

high break-points on a progressive ratio schedule of reinforcement (Marusich et al., 2010;

Calipari et al., 2013b). Relatively little work has been conducted on the neurochemical

consequences of MPH abuse, however, it has been shown that MPH self-administration,

under a number of reinforcement schedules, increases the potency of amphetamines and

MPH, both in drug effects at the DAT and in reinforcement behavior (Calipari et al.,

2013a). Although there are many similarities between the effects of MPH and cocaine both behaviorally and neurochemically, indicating that MPH may have abuse/addiction potential, the neurochemical consequences of binge self-administration of the two compounds are vastly different, making it impossible to make inferences on the neurochemical consequences of MPH based on the previous cocaine literature. Because

MPH abuse in both the adolescent and adult population has been on the rise over the past decade, and will likely continue to increase, further understanding of the effects of high dose MPH on cognition, impulsivity, as well MPH effects on many brain systems is important to predict the clinical outcomes of MPH abuse.

9. Summary

In conclusion, this dissertation uses psychostimulant (cocaine and MPH) self- administration in combination with a variety of behavioral and neurochemical techniques including locomotor analysis, FSCV, and microdialysis to 1.) determine the consequences of cocaine self-administration on the DA system (Chapters 1-4), 2.) compare the effects of MPH self-administration on the DA system to previous work using cocaine (Chapter 5) 3.) determine the consequences of MPH self-administration on

DA system function and psychostimulant reward and reinforcement (Chapters 5-8), and

4.) determine a mechanism for the MPH self-administration-induced increases in releaser, but not blocker, neurochemical and behavioral potency using DAT transgenic overexpressing mice (Chapters 6-7). 46

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CHAPTER II

EXTENDED ACCESS COCAINE SELF-ADMINISTRATION RESULTS IN TOLERANCE TO THE DOPAMINE-ELEVATING AND LOCOMOTOR STIMULATING EFFECTS OF COCAINE

Erin S. Calipari, Mark J. Ferris and Sara R. Jones

The following manuscript was published in The Journal of Neurochemistry, in press, 2013, and is reprinted with permission. Stylistic variations are due to the requirements of the journal. Erin S. Calipari performed all self-administration, microdialysis and behavioral experiments, data analysis, and prepared the manuscript. Dr. Mark J. Ferris performed select voltammetry experiments. Drs. Sara R. Jones and Mark J. Ferris acted in an advisory and editorial capacity. 60

Abstract:

Tolerance to the neurochemical and behavioral effects of cocaine after repeated

use is a hallmark of cocaine addiction in humans. However, comprehensive studies on

tolerance to the behavioral and neurochemical effects of cocaine following contingent

administration in rodents are lacking. We outlined the consequences of extended access

cocaine self-administration as it related to tolerance to the psychomotor, dopamine (DA)

elevating, and DA transporter (DAT) inhibiting effects of cocaine. Cocaine self-

administration (1.5 mg/kg/inj; 40 inj; 5 days), which resulted in escalation of first hour intake, caused reductions in evoked DA release and reduced maximal rates of uptake through the DAT. Further, we report reductions in cocaine-induced uptake inhibition as measured by fast scan cyclic voltammetry, and a corresponding increase in the dose of cocaine required for 50% inhibition of DA uptake (Ki) at the DAT. Cocaine tolerance at

the DAT translated to reductions in cocaine-induced DA overflow as measured by

microdialysis. Additionally, cocaine-induced elevations in locomotor activity were

reduced. Here we demonstrate both neurochemical and behavioral cocaine tolerance in an extended-access rodent model of cocaine abuse, which allows for a better understanding of the neurochemical and psychomotor tolerance that develops to cocaine during the human addiction process.

Introduction:

Cocaine is a DAT blocker that inhibits the uptake of dopamine (DA), thus

increasing extracellular DA levels and augmenting postsynaptic DA receptor activation.

The ability of cocaine to inhibit the DAT is essential for its rewarding effects, which is

highlighted by the fact that transgenic mice with cocaine-insensitive DATs do not develop conditioned place preference for the drug (Chen et al., 2008). Further, the potency of stimulants for inhibiting the DAT is strongly correlated with self- administration behavior (Ritz et al., 1987, Roberts et al. 1977), suggesting that changes in cocaine potency at the DAT have important behavioral implications. In rodents, tolerance to the pharmacological DAT-inhibiting effects of cocaine has been reported previously following a variety of fixed-ratio and progressive-ratio cocaine self- administration paradigms (Calipari et al., 2012, 2013; Ferris et al., 2011, 2012, 2013;

Mateo et al., 2005). Tolerance has also been reported to the DA elevating and locomotor activating effects of cocaine (Hurd et al., 1989; Lack et al., 2008). Although tolerance has been demonstrated to these different aspects of cocaine effects, the results are from a wide range of different self-administration paradigms, and a comprehensive understanding of the tolerance induced by the extended-access, defined-intake (5 days, 40 inj/day, 1.5 mg/kg/inj) model is lacking.

Tolerance to the euphorigenic and DA elevating effects of cocaine has been reported consistently in human cocaine addicts (Dackis and O’Brien, 2001; Mendelson et al., 1998; Reed et al., 2009; Volkow et al., 1997a, b; Volkow et al., 1996), and is thought to mediate some aspects of continued drug taking. Tolerance has been suggested to modulate cocaine intake behavior, specifically escalation of intake that occurs after 62

repeated use that has been reported in both human addicts and rodent self-administration studies (Ahmed et al., 2002, 2003; Ahmed and Koob, 2005; Barrett et al., 2004; Dackis and O’Brien, 2001; Koob and Le Moal, 2001). Therefore, we aimed to define cocaine self-administration induced tolerance in rodents. We found that the extended-access, defined-intake self-administration model (Calipari et al., 2012; Ferris et al., 2011, 2012) mimics important aspects of the tolerance reported in humans, which is characterized by deficits in baseline DA functioning, reduced cocaine potency, escalated self- administration behavior, and reduced cocaine-induced locomotor behaviors.

Here we show that a history of cocaine self-administration resulted in reduced DA system function characterized by reductions in baseline DA release and uptake, as well as reduced psychomotor and neurochemical potencies of cocaine. These data highlight that self-administration results in tolerance to DA uptake inhibition by cocaine at the DAT that is concomitant with reduced cocaine-induced DA elevations as well as reduced behavioral activation. In addition, because of the integral role that the DA system plays in learning and motivated behaviors, it is possible that the documented changes could have implications for many different types of behavior such as learning and the execution of goal oriented behaviors in the absence of drug.

Materials and Methods

experimental protocol was approved by the Institutional Animal Care and Use Committee

at Wake Forest School of Medicine.

Self-Administration: Rats were anesthetized with ketamine (100 mg/kg) and xylazine (10 mg/kg), implanted with chronic indwelling jugular catheters, and trained for i.v. self-

administration as previously described (Calipari et al., 2013). Following surgery, animals

were singly housed, and all self-administration sessions took place in the home cage.

Each animal was maintained on a reversed light cycle (3:00 am lights off; 3:00 pm lights on), and all self-administration procedures occurred during the active/dark cycle.

Sessions were six hours in length and were terminated at the end of the six hours or after

40 injections of drug. Animals self-administered cocaine (1.5 mg/kg/inj over 4 sec) on a fixed-ratio 1 schedule of administration. Concurrent with the start of each injection, the lever retracted and a stimulus light was activated for 20 seconds to signal a time-out

period. Under these conditions, animals acquired a stable pattern of intake within 1 to 5

days. For self-administering animals, acquisition (Day 1) was counted when the animal

reached 35 or more responses. Following acquisition, the animals were given access to

40 injections per day for a period of 5 consecutive days. In this study all animals took the

maximum number of injections (40) on each of the self-administration days. Control animals were naïve rats housed under the same reversed light-dark light cycle for at least one week prior to neurochemical analysis.

Fast Scan Cyclic Voltammetry in Brain Slices: Fast scan cyclic voltammetry was used to characterize presynaptic DA signaling in the NAc. Voltammetry experiments were conducted during the dark phase of the light cycle, 24 hours after commencement of the final self-administration session. 400 µm thick coronal brain sections containing the NAc 64

core were cut using a vibrating tissue slicer (Leica Microsystems Inc.; Buffalo Grove,

IL). A carbon fiber electrode was placed approximately 75 µm below the surface of the slice in close proximity to a bipolar stimulating electrode in the NAc core. DA release was evoked by a single electrical pulse (300 μA, 4 msec, monophasic) applied every 5 minutes. Extracellular DA was recorded by applying a triangular waveform (−0.4 to +1.2 to −0.4 V vs. silver/silver chloride, 400 V/sec) to the electrode every 100 msec.

Locomotor Analysis: Locomotor analysis was performed, as previously described (Lack et al. 2008.), the day following completion of cocaine self-administration. On the test day, prior to locomotor recording, animals were allowed to habituate in the testing room, in their home cages, for 60 minutes. Following habituation to the room, rats were placed in the locomotor chamber (MedAssociates; St. Albans, VT) and baseline activity recorded for 30 min. Rats then received an IP injection of saline, and activity was recorded for 90 min. Lastly, rats were injected with 15 mg/kg cocaine i.p., and locomotor response was measured again. Locomotor recordings were performed in two separate groups (control and cocaine self-administration) for between-subject comparisons.

Microdialysis: Microdialysis surgery was performed the day following locomotor activity analysis. Microdialysis guide cannulae (CMA/Microdialysis AB, Stockholm,

Sweden) were stereotaxically implanted above the NAc core (anteroposterior, + 1.2 mm; lateral, 2.0 mm; ventral, 6.0 mm). Concentric microdialysis probes (2 mm membrane length, CMA/Microdialysis) were inserted the day before recording and approximately

16 h prior to the beginning of sample collection. Probes were implanted in animals the day following locomotor testing and then microdialysis experiments were conducted the following day. Thus, rats were tested ≈ 72 h following their final SA session. The probes 65

were continuously perfused at 0.8 μl/min with artificial cerebrospinal fluid (aCSF; pH

7.4): NaCl 148 mM, KCl 2.7 mM, CaCl2 1.2 mM, MgCl2 0.85 mM. Once stable baselines

were established, animals received a cocaine (15 mg/kg) i.p. challenge and DA was

monitored at 15 minute intervals until DA levels returned to baseline.

High Performance Liquid Chromatography: The HPLC (ESA/Thermo Scientific,

Chelmsford, MA) consisted of a syringe pump, a glassy carbon working electrode, a

reference electrode, and an electrochemical detector. A 2 × 50 mm (3 µm particle)

reverse-phase column (Luna, Phenomenex, Torrance, CA) was used to separate compounds. The applied potential was +650 mV as referenced to an Ag/AgCl electrode.

The mobile phase (75 mM NaH2PO4, 1.7 mM 1-octanesulfonic acid sodium salt, 100

µL/L triethylamine, 25 µM EDTA, 10% acetonitrile v/v, pH=3.0) was pumped at a rate of

170 µL/min, with a detection limit for DA of 10 pM. DA quantification was achieved by

comparing dialysate samples with DA standards of known concentration.

Statistics: Graph Pad Prism (version 5, La Jolla, CA, USA) was used to statistically

analyze data sets and create graphs. Self-administration data was subjected to a one-way

analysis of variance (ANOVA), and differences across sessions were tested using a

Tukey post hoc test. Baseline voltammetry data was compared using a two-tailed

Student’s t-test. Locomotor data was subjected to a two-way ANOVA with experimental

group and time as the factors. Differences between groups were tested using a Bonferroni

post hoc test.

Results:

Cocaine self-administration results in escalation of first-hour intake over sessions.

Animals self-administered cocaine (1.5 mg/kg/inj) for five consecutive days in 6

hour sessions with a maximum of 40 total injections. Injections were limited in order to

ensure that animals all had the same intake over the 5 self-administration sessions, to

control for total intake as a factor in differences in neurochemical effects. Because of the

limit on the total number of injections, animals did not escalate in total intake over the

entire session. However, traditional long-access self-administration paradigms use

increases in first-hour intake as a marker of escalation (Ahmed and Koob, 1998, 1999;

Marusich et al., 2010). ANOVA revealed a main effect of session on first hour intake

(F4, 10 = 9.515, p < 0.0001, Fig. 1). Tukey post hoc analysis revealed a significant

increase in rate of intake on sessions 3 (p < 0.01), 4 (p < 0.001), and 5 (p < 0.001) versus

session 1.

Stimulated DA release and uptake are reduced following cocaine self-

administration.

Using fast scan cyclic voltammetry, we assessed presynaptic DA signaling

parameters in the NAc core to determine the effects of cocaine self-administration on DA release and uptake when drug is not present. We found significant reductions in DA release elicited by single pulse electrical stimulations after cocaine self-administration

(Fig. 2A). Stimulated release was reduced by 44% versus controls (t45 = 2.915, p <

0.001; Fig. 2B). In addition to stimulated release, we also found reductions in the

maximal rate of DA uptake (Vmax; Fig 2C). Vmax was reduced by 32% versus controls (t42 67

Figure 1. Cocaine self-administration results in escalation of first-hour cocaine intake. Group data presented as cocaine injections within the first hour of the self- administration session over consecutive sessions. The graph demonstrates that first-hour cocaine intake increases over session, indicating escalation over days. **, p < 0.01; ***, p < 0.001

Figure 2. Reduced dopamine (DA) release and uptake following cocaine self- administration. (A) Representative data indicating that stimulated DA release is reduced following cocaine self-administration in the nucleus accumbens core. Plots are represented as DA concentration over time. (B) Group changes in μM DA released upon stimulation of the terminal. Cocaine self-administration results in a decrease in stimulated DA release relative to control animals. (C) Representative traces, overlaid to match for concentration, to highlight differences in maximal rate of DA uptake in the nucleus accumbens core. (D) Group data indicate that cocaine self-administration results in reduced maximal rate of uptake as compared to control animals. **, p < 0.01; SA, self-administration; Vmax, maximal rate of dopamine uptake

= 3.123, p < 0.001; Fig. 2D). These reductions in presynaptic DA measures demonstrate

that DA signaling and DAT function is reduced following cocaine self-administration.

DAT sensitivity to cocaine is reduced following self-administration.

Because the DAT is the main site of action of cocaine for elevating DA, and for producing reinforcement, we aimed to determine if the effects of cocaine at the DAT were altered following extended-access, defined-intake cocaine self-administration. We found a reduction in cocaine-induced DA uptake inhibition in the NAc core region by a number of potency measures (Fig. 3). A two-way repeated measures ANOVA revealed a main effect of dose (F4, 14= 231.3, p < 0.0001) indicating that cocaine dose-dependently

inhibits DA uptake (Fig. 3A). In addition there was a main effect of group (F1, 14 = 38.35,

p < 0.0001; Fig. 3B) indicating that the DAT was less sensitive to cocaine-induced DA

uptake inhibition following cocaine self-administration. Bonferroni post hoc analysis revealed significant effects at the 10µM (p < 0.01) and 30 µM (p < 0.001) concentrations.

Ki is the drug concentration that results in 50% uptake inhibition. This

measurement can determine relative potencies between drugs in naïve animals as well as

potency changes following drug self-administration. The Ki for cocaine was significantly

higher in animals with a history of cocaine self-administration (t14 = 5.312, p < 0.0001;

Fig. 3C), indicating that cocaine potency was reduced.

Cocaine-induced DA overflow was reduced following a history of cocaine self- administration.

In order to determine if the changes in DA kinetics following cocaine self-administration translated to reductions in extracellular DA levels, we performed microdialysis in freely- 70

moving animals approximately 72 hrs following the last self-administered cocaine

infusion (Fig. 3D). There were no statistically significant differences in basal DA levels

across groups. Systemic administration of a challenge dose of cocaine (15 mg/kg, i.p.)

markedly increased DA levels in naïve rats (t7 = 5.654, p < 0.001) but failed to produce significant changes in DA in cocaine self-administering rats. In addition, a two-way repeated measures ANOVA revealed a main effect of cocaine self-administration cocaine-induced DA overflow as compared to control animals (F1, 12 = 16.39, p < 0.01).

Bonferroni post hoc analysis revealed significant differences at the 40 (p < 0.001), 60 (p

< 0.001), 80 (p < 0.01), 100 (p < 0.01), and 120 (p < 0.05) minute time points. These

differences indicate that extended-access cocaine self-administration results in neurochemical tolerance to the DA elevating effects of systemically administered cocaine.

Behavioral analysis showed no differences in basal locomotor activity, but tolerance to cocaine effects following self-administration.

We used locomotor analysis to determine the effects of prior cocaine self-administration on the psychomotor activating effects of a cocaine challenge (15 mg/kg i.p.; Fig. 4).

Figure 5A illustrates the time course of locomotor activity, with habituation to the chamber (30 min) followed by saline-induced locomotion (90min) and finally cocaine- induced locomotion. Saline-induced locomotion was not significantly different across groups (Fig. 4 A, inset), demonstrating that differences in cocaine-induced locomotor activity are not due to differences in response to injection. As expected, cocaine resulted in increased locomotion in all groups [Cocaine self-administration (F6, 18 = 5.114, p <

0.0001); Control (F6, 18 = 6.641, p < 0.0001)]. A repeated measures ANOVA revealed a 71

Figure 3. Cocaine self-administration results in tolerance to the dopamine transporter (DAT)-inhibiting and dopamine (DA)-elevating effects of cocaine. (A)

Representative traces normalized to peak height and plotted over time highlighting differences in 10μ cocaine-induced DA uptake inhibition in the nucleus accumbens core.

Data indicate that cocaine is less effective at inhibiting DA uptake following a history of cocaine self-administration. (B) Group data of cocaine potency as plotted as apparent Km over cocaine concentration. Cocaine potency is reduced over a dose-response (0.3-30

μM) following cocaine self-administration. (C) The Ki for cocaine was significantly increased following cocaine self-administration. Increased Ki values indicate that higher concentrations of drug are needed, relative to controls, to achieve the same degree of DA uptake inhibition. (D) DA overflow in the NAc was measured by freely moving microdialysis. Pre-drug baselines were determined, animals were injected with 15 mg/kg cocaine i.p., and cocaine-induced elevations in DA overflow were monitored. *, p < 0.05;

**, p < 0.01; ***, p < 0.001; SA, self-administration 73

Figure 4. Cocaine self-administration results in tolerance to the locomotor activating

effects of acute cocaine administration. (A) Group data of locomotor activity as measured in cm over time plotted in five-minute bins. Data indicate that a history of

cocaine self-administration results in reduced cocaine (15mg/kg; i.p.)-induced locomotor

activity. (A, inset) Saline-induced locomotion was not different between controls and

animals with a history of cocaine self-administration. (B) Cocaine-induced locomotor

activity as represented as percent control. (C) Stereotypy as represented as average

stereotypy counts per five-minute bin over the 90-minute session. (D) Vertical activity as

represented as average vertical counts per five-minute bin over the 90-minute session. *,

p < 0.05; **, p < 0.01; ***, p < 0.001; SA, self-administration 74

main effect of cocaine self-administration on cocaine-induced locomotor activity (F1, 12 =

27.49, p < 0.0001 Fig. 4 A, B) and a significant Time×Self-Administration interaction

(F17, 12 = 4.055, p < 0.0001). Bonferroni post hoc analysis revealed significant differences at time points 130–165 minutes post-injection (Fig. 4 A). Further, locomotor activity was significantly different between groups when it was presented as total distance traveled in the first 30 min (t12 = 2.665, p < 0.05), 90 min (t12 = 1.925, p < 0.05) or as percent baseline (t12 = 3.388, p < 0.01; Fig. 5 B). Thus, cocaine is less effective at stimulating locomotor activity following cocaine self-administration, which is indicative of tolerance to the psychomotor activating effects of cocaine.

In order to assess changes in activity, in addition to distance traveled we assessed stereotypy behavior and vertical activity following a cocaine challenge. Student’s t-test revealed that cocaine self-administration animals had lower stereotypy counts as compared to controls (t12 = 5.206, p < 0.0001; Fig. 5 C). In addition, cocaine self- administration animals had higher vertical counts as compared to controls (t12 = 7.640, p

< 0.0001; Fig. 5 D). These results, taken with the lack of difference in distance traveled, highlight a change in spontaneous locomotor activity, distinct from forward activity.

Discussion:

Here we demonstrate that a history of extended-access, defined-intake cocaine self- administration results in robust tolerance to the neurochemical and psychomotor activating effects of cocaine. In the absence of drug, at baseline, DA system deficits, characterized by reductions in DA release and uptake in the NAc were also observed.

The sensitivity of the DAT to cocaine-induced DA uptake inhibition was reduced, which translated to reduced cocaine-induced overflow, indicating neurochemical tolerance. The 75

neurochemical data was supported by behavioral data that demonstrated an attenuated cocaine-induced locomotor activating response. Psychomotor effects are hypothesized to predict the rewarding effects of drugs, suggesting that cocaine-induced reward may be reduced following cocaine self-administration (Wise and Bozarth, 1987). Because of the critical role of the DA system in reward, reinforcement, goal-reward associations, and motivated behaviors, the changes observed here could have profound inhibitory effects on goal-directed behavior in the absence of cocaine as well as increased cocaine-related behaviors, such as cocaine seeking/intake in order to normalize DA deficits.

Because of the critical role of the NAc core in cue-reward association, assignment of motivational value, goal oriented behaviors, and the reinforcing properties of psychostimulant drugs, it was important to determine the effects of cocaine self- administration on this region (Willuhn et al., 2010). Here we show decreased DA function, expressed as reduced DA release and uptake. These DA deficits could result in reduced emphasis on, and engagement in, normal behaviors associated with obtaining and processing rewards as well as an increased focus on drug seeking in order to

“normalize” DA levels. Although previous work has demonstrated reduced basal DA levels as measured by microdialysis following cocaine self-administration (Ferris et al.,

2011; Hurd et al., 1989; Mateo et al., 2005; Maisonneuve et al., 1995; Weiss et al., 1992) here we found no difference in basal DA concentrations. This may be explained by differences in the time of microdialysis measurements relative to the final cocaine self- administration session, where measurements for the current study occurred 72 hours post self-administration as compared to 24 hours for previous work. This suggests that within this time period changes in baseline DA are normalized; however, tolerance to cocaine, 76

both neurochemical and behavioral, remains. This further demonstrates that differences

in baseline DA functioning are not driving the cocaine tolerance, but rather they are two

completely separate phenomena, which could both potentially affect drug-seeking

behavior in cocaine addicts.

Only recently was it discovered that the effects of cocaine on the DA transporter were

reduced following extended access cocaine self-administration (Calipari et al., 2012,

2013; Ferris et al., 2011, 2012, 2013). Here we replicate the reduced sensitivity of the

DAT to cocaine, and demonstrate that this neurochemical tolerance at the DAT is also

observed with DA overflow as measured by microdialysis, where cocaine failed to

significantly increase DA levels following cocaine self-administration. This is consistent with previous work demonstrating reductions in cocaine-induced DA release as a

function of cocaine experience under various paradigms (Ferris et al, 2011; Hurd et al,

1989; Mateo et al., 2005; Meil et al., 1995). The decreased DA overflow elicited by cocaine administration is likely due to the decreased ability of the compound to block the

DAT. This is consistent with human studies, which have demonstrated a reduced ability of cocaine to elevate DA levels following a history of cocaine abuse (Dackis and

O’Brien, 2001; Volkow et al., 1997a, b; Volkow et al., 1996). The ability of cocaine to

elevate DA in the NAc is essential for its rewarding and reinforcing effects, thus

reductions in cocaine-induced DA increases following this paradigm would be

hypothesized to reduce the subjective effects of cocaine. There are numerous human

reports supporting this idea, where there are reduced positive subjective effects of

cocaine in heavy users (Mendelson et al., 1998; Reed et al., 2009). In addition, human

cocaine addicts often increase their intake in order to compensate for reductions in the 77

rewarding effects of cocaine (Dackis and O’Brien, 2001). These clinical findings are consistent with the current study, where we find increased intake rates for cocaine over sessions and decreased cocaine-induced locomotor activity.

We report here that animals escalate the rate of cocaine intake over sessions.

Although this paradigm is different from traditional long-access models (LgA) due to the fixed injection maximum, animals still escalate in first hour intake, which is the same escalation that is often reported in LgA studies (Ahmed and Koob, 1998, 1999; Marusich et al., 2010). Escalation is thought to be associated with the switch from abuse to addiction in humans (Ahmed and Koob, 1998, 1999), and has been suggested to be due to tolerance to the rewarding effects of cocaine (Ahmed et al., 2002, 2003; Ahmed and

Koob, 2005; Barrett et al., 2004; Koob and Le Moal, 2001). The observed changes, where animals consume more drug in shorter periods of time, mimic changes in the patterns of self-administration when a lower dose of cocaine is substituted for a higher one, which would be consistent with reduced cocaine effects, or tolerance (Carelli and

Deadwyler, 1996). A similar escalation in cocaine dosing also commonly occurs during bingeing in humans (Dackis and O’Brien, 2001), and humans self-report tolerance to the euphorigenic effects of cocaine following repeated use (Mendelson et al., 1998; Reed et al., 2009). It is possible that the DAT tolerance, and concomitant reduction in cocaine- induced DA overflow, results in reduced rewarding effects, leading to an increase of cocaine intake to compensate.

Further, locomotor analysis also revealed an altered pattern of cocaine-induced activity, with decreases in forward locomotion and stereotypical behaviors and increases in vertical activity. Elevations in DA levels mediate forward locomotion, thus, decreases 78

are consistent with the reductions in cocaine potency at the DAT as well as cocaine-

induced DA overflow. Additionally, D2 receptor activation is critical for stereotyped

behaviors, thus it is possible that D2 activity is reduced following cocaine self- administration. Indeed, Mateo et al., (2005) demonstrated that D2 receptors are subsensitive following 10 days of cocaine self-administration. In addition, the reduction in D2 activity was observed at both one and 7 days after self-administration, indicating that some of the changes that occur following this self-administration paradigm may persist well into the withdrawal period. In addition to DA system changes, serotonin levels are inversely related to vertical activity (Brookshire and Jones, 2009); thus, it is possible that the serotonin system may also be affected by self-administration. Studies of whole brain functional activity after this self-administration paradigm have observed reduced dorsal raphe activity (Calipari et al., 2013). This is not surprising as cocaine has direct effects on the serotonin transporter, so it is possible that tolerance to the serotonin elevating effects also develops.

Both tolerance and sensitization can develop to the neurochemical effects of cocaine.

The development of tolerance is dependent on cocaine intake, where high sustained cocaine levels over a session result in reduced cocaine potency. Alternatively, cocaine sensitization at the DA terminal occurs following intermittent patterns of self- administration and seems to be independent of intake (Calipari et al., 2013). Much work has been aimed at outlining the consequences and causes of neurochemical sensitization as a model of cocaine addiction (Brown et al., 2011; Cornish and Kalivas 2001; Thomas et al., 2008), and yielded important information, especially on changes in glutamate neurotransmission (Cornish and Kalivas 2001). However, sensitization of cocaine 79

pharmacology has been difficult to demonstrate in humans. Only recently was

sensitization in humans demonstrated with amphetamine administration; however, it only

occurs in drug naïve individuals and is not present in heavy users (Bolieau et al., 2006).

It is possible that sensitization occurs with intermittent exposure to drug during the early

stages of the addiction process, but later stages, with higher and more continuous drug

intake, result in tolerance. As a result, animal models which produce tolerance have

more face validity for studying the neurochemical changes that occur within addicted

individuals. In fact, similar extended access paradigms, which result in neurochemical

tolerance, still show measures of sensitized drug seeking and relapse which are

characteristics of human addicts (Koob 1996; Koob and Le Moal, 1997; Orio et al, 2009;

Patterson and Markou, 2003). As a result, when studying the DA system, it is important to choose a model that has translational validity, such as extended access paradigms that result in DA system deficits and cocaine tolerance.

Acknowledgements: This work was funded by NIH grants R01 DA021325, R01

DA030161, P50 DA06634 (SRJ), K99 DA031791 (MJF), T32 DA007246 and F31

DA031533 (ESC).

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CHAPTER III

WITHDRAWAL FROM EXTENDED-ACCESS COCAINE SELF- ADMINISTRATION RESULTS IN DYSREGULATED FUNCTIONAL ACTIVITY AND ALTERED LOCOMOTOR ACTIVITY IN RATS

Erin S. Calipari, Thomas J.R. Beveridge, Sara R. Jones and Linda J. Porrino

The following manuscript was published in European Journal of Neuroscience, in press, 2013, and is reprinted with permission. Stylistic variations are due to the requirements of the journal. Erin S. Calipari performed all self-administration experiments, data analysis for self-administration studies, and prepared the manuscript. Dr. Thomas Beveridge performed all functional activity experiments. Drs. Sara R. Jones and Linda Porrino acted in an advisory and editorial capacity. 85

Abstract:

Much work has been focused on determining the consequences of cocaine self- administration on specific neurotransmitter systems, thus neglecting the global changes that occur. Previous imaging studies have focused on the effects of cocaine self- administration in the presence of high blood levels of cocaine, and do not determine the effects of cocaine self-administration on baseline functional activity. Extended access cocaine self-administration, where animals administer cocaine for 6 hours each day, results in escalation in the rate of cocaine intake and is believed to model the transition from recreational use to addiction in humans. We aimed to determine the functional changes following acute (48 hours) withdrawal from animals that have undergone extended access self-administration for 5 days, a time point when behavioral changes are present. Using the 2-[14C]deoxyglucose method to measure rates of local cerebral glucose metabolism, an indicator of functional activity, we found reductions in circuits related to learning and memory, attention, sleep, and reward processing, which have important clinical implications for cocaine addiction. Additionally, lower levels of functional activity were found in the dorsal raphe and locus coeruleus, suggesting that cocaine self-administration may have broader effects on brain function than previously noted. These widespread neurochemical reductions were concomitant with substantial behavioral differences in these animals, highlighted by increased vertical activity and decreased stereotypy, which would be predicted based on the alterations in the dopaminergic and serotonergic nuclei. These data demonstrate that behavioral and neurochemical impairments following cocaine self-administration are present at baseline and persist after cocaine has been cleared. 86

Introduction:

The neuroadaptations that occur following cocaine administration have been

studied extensively in an effort to determine both the consequences of cocaine abuse and

to find potential targets for addiction treatment. Previous work using non-contingent

cocaine exposure has shown significant neuroadaptations in gene expression, protein

function, neurotransmitter release and uptake, and concomitant behavioral changes

(Vanderschuren & Pierce, 2010; Mu et al., 2010). However it is important to choose a

model that accurately mimics human drug taking (Hemby et al., 1994, 1997; Porrino

1993; Lecca et al., 2007). Rodent self-administration is a translational model of human

cocaine abuse, and much of the current literature on cocaine self-administration has

focused on extended access self-administration, during which animals have access to

cocaine self-administration for 6 hours (h) per day (Ahmed & Koob, 1998). This

paradigm allows animals to administer consistent high levels of cocaine over the session

and has been reported to accurately model the pattern by which human addicts administer

cocaine (Dackis and O’Brien, 2001). Extended access cocaine self-administration has been shown previously to have many of the neurochemical hallmarks of cocaine addicts and is characterized by reduced basal dopamine levels (Mateo et al., 2005; Ferris et al.,

2011), behavioral and neurochemical tolerance to cocaine (Ferris et al., 2011, 2012:

Calipari et al., 2012), and increased motivation to administer cocaine (Zimmer et al.,

2012).

Most of the current literature on the effects of chronic cocaine self-administration on the brain has focused on the striatal dopamine system, thus neglecting the contribution from other neurotransmitters and circuits. Neuroimaging techniques allow for a global 87

view of the effects of cocaine self-administration on the brain. Previous work has demonstrated that immediately following 21 days of self-administration, while blood levels of cocaine are still high, there are reductions in functional activity in a number of brain regions, including striatal regions (Macey et al., 2004); however, the question of whether these changes persisted beyond the self-administration session remained. Most functional activity studies determine the effects of a drug challenge; however, the present study focused on rates of local cerebral glucose utilization in the absence of drug, in order to determine the effects on brain function. These data are important because determining the persistent effects of cocaine self-administration on baseline functional activity can point to changes in specific brain regions and circuits which may be predictive of behavioral deficits in cocaine-addicted individuals.

We show that cocaine self-administration results in functional reductions in brain regions involved in reward, learning, and memory that are present 48 h after the final cocaine session. We also see reduced function of the dorsal raphe and locus coeruleus, which has implications for global brain function as these nuclei have an extensive network of projections. Using behavioral activity analysis after cocaine self- administration we report alterations which would be predicted based on decreased serotonergic and dopaminergic functioning, demonstrating that these neural changes have behavioral implications. The reduced functional activity in selected regions suggests that a 5-day cocaine binge is capable of producing reductions in regional brain activity that may have adverse consequences for normal functioning.

Materials and Methods

Animals: Male, Sprague-Dawley rats (375–400 g; Harlan Laboratories, Frederick, MD)

were maintained according to the National Institutes of Health guidelines in Association

for Assessment and Accreditation of Laboratory Animal Care accredited facilities. The

experimental protocol was approved by the Institutional Animal Care and Use Committee

at Wake Forest School of Medicine.

Self-Administration: Rats (n = 14) were anesthetized with ketamine (100 mg/kg) and

xylazine (10 mg/kg), implanted with chronic indwelling jugular catheters, and trained for

i.v. self-administration as previously described (Liu et al., 2005). Following surgery,

animals were singly housed, and all self-administration sessions took place in the home

cage. Each animal was maintained on a reverse light cycle (3:00 am lights off; 3:00 pm

lights on), and all self-administration procedures occurred during the active/dark cycle.

Sessions were six hours in length and were terminated at the end of the six hours or after

40 injections of drug. Animals self-administered cocaine (1.5mg/kg/inj over 4 sec) on a fixed-ratio 1 schedule of administration. Concurrent with the start of each injection, the lever retracted and a stimulus light was activated for 20 seconds to signal a time-out

period. Under these conditions, animals acquired a stable pattern of cocaine self-

administration within 1 to 5 days. For self-administering animals, acquisition (Day 1)

was counted when the animal reached 35 or more responses. Following acquisition, the

animals were given access to 40 injections per day for a period of 5 consecutive days.

Control animals were naïve rats housed under the same reverse light-dark light cycle for

at least one week prior to all experimental manipulations. 89

Locomotor Analysis: Locomotor analysis was performed as previously described (Läck

et al. 2008) the day following completion of cocaine self-administration. Locomotor analysis was performed on a different group of animals from the functional activity experiments. On the test day, prior to locomotor recording animals were allowed to habituate in the testing room, in their home cages for 60 minutes. Following habituation to the room, rats (control, n=7; cocaine self-administration, n=7) were placed in the locomotor chamber (MedAssociates) and baseline activity recorded for 30 min. Rats then received an intraperitoneal (IP) injection of saline, and activity was recorded for 90 min.

Locomotor recordings were performed in two separate groups (control and cocaine self- administration) and data was compared across groups.

Measurement of local cerebral glucose utilization: Twenty-four h after their final self- administration session, animals underwent femoral artery catheterization surgeries, as previously described (Macey et al., 2004). Animals were allowed 24 h to recover from surgery. Rates of local cerebral glucose utilization (LCGU) in rat brain were quantified

48 h after their last cocaine self-administration session according to the method of

Sokoloff et al. (1977), as adapted for use in freely moving animals (Crane and Porrino

1989). As part of a separate study, both cocaine self-administration animals (n=7) and controls (n=6) were administered saline (1 ml/kg, IP) 30 min prior to initiation of the

[14C]-2-deoxyglucose (2DG) procedure. One control animal was dropped from analysis

due to an occluded femoral catheter. Control animals consisted of both naïve controls

and animals that had undergone surgery but did not self-administer cocaine. Three of the

six controls were animals that failed to self-administer/ acquire, thus, they underwent

exactly the same surgical procedures as the cocaine self-administering animals, as well as 90

housing conditions, light/ dark cycle and handling. Rates of local cerebral glucose utilization in the brains of these three animals in response to saline injections were no different from the other controls, which were housed in similar conditions and handled in the same fashion. The 2DG procedure was conducted in the animal’s home cage and was initiated by means of an intravenous infusion of a pulse of 2-[14C]DG (75 μCi/kg; specific activity 55 mCi/mmol; New England Nuclear, Boston, MA) through the jugular venous catheter (via which self-administration had previously occurred). Timed femoral arterial blood samples were collected over the next 45 minutes and immediately centrifuged. Rates of LCGU in cocaine self-administering rats were compared with those obtained from drug-naïve rats. These control animals underwent jugular vein and femoral artery catheterization surgeries in the same fashion as self-administering rats, 24 h prior to the 2DG procedure. Plasma concentrations of 2-[14C]DG were determined by liquid scintillation counting (Beckman Instruments, CA), while plasma glucose levels were determined by means of a Beckman Glucose Analyzer II (Beckman Instruments,

CA). Immediately after the 45-minute sample, animals were killed by administration of intravenous pentobarbital (100 mg/kg). Brains were rapidly removed, frozen in isopentane at -45°C, and stored at -80°C until sectioned. Brains were sectioned coronally

(20μm) in a cryostat maintained at -20°C, collected on glass coverslips and immediately transferred to a hot plate (60°C) to dry. Coverslips were opposed to Kodak EMC film for

13-17 days along with a set of calibrated [14C]methylmethacrylate standards (Amersham,

IL) previously calibrated for their equivalent wet weight 14C concentrations. Films were developed in GBX developer (Kodak, NY). 91

Autoradiograms were analyzed by quantitative densitometry with a computerized image analysis system (MCID, Imaging Research, Ontario). Tissue 14C concentrations were determined from densitometric analysis of autoradiograms of the calibrated standards. Rates of glucose utilization were then calculated using the optical densities and a calibration curve obtained from local 14C tissue concentrations, time-courses of the plasma glucose and 14C concentrations, and the constants according to the operational equation of the 2DG method (Sokoloff et al. 1977). Glucose utilization measurements were determined for 20 discrete brain regions according to the rat brain atlas of Paxinos and Watson (Paxinos and Watson 1998). Each brain region was analyzed bilaterally in a minimum of five brain sections per animal.

Statistics: Graph Pad Prism (version 4, La Jolla, CA, USA) was used to statistically analyze data sets and create graphs. Locomotor data was subjected to a two-way ANOVA with experimental group and time as the factors. Differences between groups were tested using a Bonferroni post hoc test. Rates of local cerebral glucose utilization were analyzed in specific functional groups of brain regions (cortex, basal ganglia, limbic-related and brainstem) using 2-way analyses of variance (ANOVA), brain region group X treatment

(control vs. cocaine self-administration) with brain region group as a repeated measure.

These were followed by planned Bonferroni’s tests for multiple comparisons. Statistical significance was considered as p < 0.05.

Results:

Extended access to cocaine self-administration results in escalation in the rate of daily intake. Animals self-administered cocaine (1.5 mg/kg/inj) for five consecutive days 92

with a maximum of 40 total injections (all animals self-administered the maximum each day). Injections were limited to ensure that all animals had the same intake over each self-administration session in order to control for total intake as a factor in the functional effects of cocaine. Because of the limit on total injections, therefore, animals cannot escalate their total intake, but rather escalate the rate of intake over the sessions (Figure

1), similar to previous studies (Mateo et al., 2005; Calipari et al., 2012; Ferris et al.,

2012). One way ANOVA revealed a main effect of session (F4, 14 = 14.93, p < 0.001).

Tukey post hoc analysis revealed a increase in rate versus the first session on sessions two (q = 4.216, p < 0.05), three (q = 5.843, p < 0.01), four (q = 8.734, p < 0.001), and five (q = 9.673, p < 0.0001).

Behavioral analysis shows a differential baseline locomotor profile following 48 h withdrawal from cocaine self-administration. Following cocaine self-administration, behavioral activity was assessed using automated monitors. We ran the analysis based on a priori hypothesis that locomotor activity in response to a novel environment would be reduced following cocaine self-administration. Two-way ANOVA revealed a main effect of cocaine self-administration on the response to a novel environment (F(1, 13) = 4.04, p <

0.05). In addition, there was a main effect of time (F(5, 13) = 73.53, p < 0.0001) as

animals habituated to the activity chamber. Bonferroni post hoc analysis was performed

to compare across treatment group, and a reduction in locomotor activity was observed at

the 15 minute time point in animals that had undergone cocaine self-administration (t =

3.219, p <0.05; Figure 2). Alternatively, we found no effect of treatment or time on

saline-induced locomotion indicating that normal forward locomotion was not impaired

by a prior cocaine self-administration history (Figure 3). 93

Figure 1. Cocaine self-administration results in escalation of rate of cocaine intake.

(A) Event record of a representative cocaine self-administration animal. Each line

represents a daily self-administration (SA) session. Each tick mark represents an injection

of cocaine (1.5 mg/kg/inj). Animals are allowed 40 injections or 6 hours, whichever

comes first. Animals demonstrate regular inter-injection intervals, and while injections stay constant, they take less time over sessions to complete the 40 injections. (B) The animals showed escalation of drug intake by self-administering 40 injections each day in successively shorter time periods. (*p < 0.05, **p < 0.01, ***p < 0.001; SA, self-

administration) 94

Figure 2. Cocaine self-administration results in reduced locomotor response to a novel environment. Animals were placed in automated locomotor activity monitors and their behavior on the first exposure to the environment and the subsequent habituation was monitored for 30 minutes. (A) Locomotor activity, represented as distance traveled over time. Cocaine self-administration animals (open circles) habituated to the novel environment faster than their control counterparts (closed circles). (B) Total locomotor distance traveled in the novelty session. Animals with a history of cocaine self- administration have significantly reduced responses to a novel environment. (*p < 0.05;

SA, self-administration)

Figure 3. Cocaine self-administration does not alter baseline locomotion. Animals were placed in automated locomotor activity monitors and their behavior following a saline injection to determine the effects of cocaine self-administration on forward locomotor activity. (A) Locomotor activity, represented as distance traveled over time.

Cocaine self-administration animals (open circles) were not significantly different in their response to a saline injection than control animals (closed circles). (B) Total locomotor distance traveled during the saline session. No differences were observed in normal baseline forward locomotion following cocaine self-administration. (SA, self- administration)

In order to assess changes in locomotor behavior, in addition to distance traveled

we assessed stereotypy behavior and vertical activity. Student’s t-test revealed that

cocaine self-administration animals had higher vertical counts as compared to controls

(t12 = 7.604, p < 0.0001; Figure 4). In addition, cocaine self-administration animals had lower stereotypy counts as compared to controls (t12 = 3.988, p < 0.0001; Figure 4).

These results, taken with the lack of difference in distance traveled, highlight a change in

spontaneous locomotor activity, distinct from forward activity.

Rates of local cerebral glucose utilization are lower following 48 h withdrawal from

cocaine self-administration. Baseline plasma glucose concentrations prior to the

initiation of the 2DG procedure were not different between drug-naïve controls and

cocaine-experienced animals (controls, 144.2 ± 6.7 mg/mL; 48 h withdrawal from

cocaine, 153.4 ± 17.0 mg/mL). Rates of local cerebral glucose metabolism were

measured in 20 brain regions and data are shown in Table 1. These rates were globally

lower in animals with a history of cocaine self-administration measured 48 h after the

final self-administration session as compared to drug-naïve controls (84.5 ± 4.7

μmol⁄100 g⁄min controls versus 74.6 ± 4.4 μmol⁄100 g⁄min cocaine-withdrawal, p < 0.05).

This pattern was observed in all 20 of the regions in which glucose utilization rates were

measured. In the cortex, two-way analysis of variance revealed a main effect of

treatment (F(1, 11) = 5.95, p <0.05) and brain region (F(2, 20) = 151.9, p <0.001), but no

interaction. In the basal ganglia, there was a main effect of treatment (F(1, 11) = 8.10 p

<0.05) and brain region (F(5, 55) = 125.67, p < 0.001), but no interaction. In limbic brain

areas, there was a main effect of treatment (F(1, 11) = 6.10 p <0.05) and brain region (F(7, 97

Figure 4. Altered locomotor activity following cocaine self-administration. Animals were placed in automated locomotor activity monitors and their behavior following a saline injection to determine the effects of cocaine self-administration on stereotypy and vertical activity (A) Stereotypy as represented as average stereotypy counts per five minute bin over the 90 minute session. Cocaine self-administration animals (blue) had reduced stereotypy counts as compared to controls (black). (B) Vertical activity as represented as average stereotypy counts per five minute bin over the 90 minute session.

Cocaine self-administration animals (blue) had increased vertical counts as compared to controls (black). (*** p < 0.001; SA, self-administration)

Figure 5. Cocaine self-administration results in reduced functional activity in a number of brain regions. Pseudocolor enhanced autoradiograms showing rates of local cerebral glucose metabolism in the striatum (top row) and hippocampus (bottom row) of a representative control rat (panel A) and a rat 48 h following cocaine self-administration

(panel B).

Table 1. Effect of 48 h withdrawal from a five-day binge cocaine self-administration on rates of local cerebral glucose utilization in rat brain.

Brain Region Drug-naïve Cocaine-exposed Controls (n = 6) (n = 7)

Cortex

Medial prefrontal 76.2 ± 1.9 67.7 ± 3.2

Anterior cingulate 105.9 ± 2.9 93.1 ± 4.2 *

Motor 108.9 ± 2.9 97.3 ± 5.7

Basal Ganglia

Dorsal caudate 111.0 ± 5.9 93.7 ± 4.0 *

Ventral caudate 96.8 ± 3.5 85.7 ± 4.7

Nucleus accumbens 94.4 ± 4.1 79.7 ± 3.8 **

Globus pallidus 53.8 ± 3.7 45.2 ± 2.8

Substantia nigra pars compacta 65.2 ± 2.8 58.7 ± 4.0

Substantia nigra pars reticulata 56.2 ± 3.3 50.1 ± 2.7

Limbic

Basolateral amygdala 81.3 ± 4.5 68.1 ± 3.4 *

Central amygdala 42.9 ± 3.5 39.8 ± 2.1

Lateral thalamus 95.1 ± 6.2 83.0 ± 5.9

Medial thalamus 97.7 ± 4.2 84.8 ± 3.7 *

Ventromedial hypothalamus 56.6 ± 5.9 46.1 ± 3.0

Hippocampal CA1 region 78.6 ± 7.2 60.0 ± 3.9 *

Hippocampal CA3 region 81.2 ± 6.9 66.6 ± 3.7

Dentate gyrus 64.5 ± 6.6 52.4 ± 2.4

Brainstem 100

Dorsal raphe 117.5 ± 2.3 96.4 ± 7.5 *

Locus coeruleus 73.8 ± 2.0 64.0 ± 2.8 *

Cerebellum 70.6 ± 3.7 60.3 ± 2.4 *

Values are local rates of glucose utilization expressed as mean (μmol/100g/min) ± S.E.M. * P<0.05, ** P<0.001 versus drug-naïve controls.

101

77) = 110.3, p < 0.001), and an interaction (F(7,70) = 3.041 p <0.05) . Finally, in the brainstem, there was a main effect of treatment (F(1, 11) = 12.48 p <0.01) and brain region

(F(2, 22) = 75.21, p < 0.001), but no interaction. Planned multiple comparisons showed that 48 h after cocaine self-administration functional activity was lower in the anterior cingulate cortex (– 12%), dorsal caudate putamen (– 16%), nucleus accumbens (– 16%), basolateral amygdala (– 16%), medial nucleus of the thalamus (– 12%), hippocampal

CA1 region (– 24%), dorsal raphe (– 18%), locus coeruleus (– 13%) and cerebellum (–

15%), when compared to controls.

Discussion:

Here we demonstrate that there are functional and behavioral reductions present

48 h after 5-day cocaine self-administration. The functional alterations were characterized by reduced brain activity, as indicated by lower rates of cerebral glucose utilization, in circuits involved in learning and memory, attention, sleep, and reward processing. These data are consistent with human studies that have demonstrated marked reductions in functional brain activity, in particular prefrontal cortical and striatal regions, following cocaine abuse (Volkow et al., 1992, 1993). Previously, we have shown that cocaine self-administration resulted in reductions in functional activity, but these effects were measured immediately following the final infusion at a time when cocaine levels were still high (Macey et al., 2004). The present study extended these findings and demonstrated that there were functional alterations 48 hours following the final self- administration session, indicating that neuroadaptations associated with cocaine administration may persist and result in reduced activity. In addition, we found that there 102

were also behavioral changes, as indicated by increased vertical and reduced stereotypical

behavior, suggesting that these functional alterations may have direct behavioral

consequences even in the absence of drug. These results highlight the fact that even a

relatively short (five day) exposure to cocaine, which resulted in escalation of the rate of

daily intake, can lead to neurochemical (Mateo et al., 2005; Calipari et al., 2012; Ferris et

al., 2012), functional and behavioral changes that can be detected during withdrawal.

While previous reports have focused on the neurochemical changes that occur

when drug is still present or in response to a challenge dose of cocaine (Macey et al.,

2004; Kornetsky, Huston-Lyons, & Porrino, 1991; Zocchi, Conti, & Orzi, 2001), the

present study focused on measuring functional activity 48 hours after the last self-

administration session. At this time point, we found that functional activity was lower

than controls in the nucleus accumbens, anterior cingulate cortex, basolateral amygdala,

hippocampus, dorsal caudate, medial thalamus, dorsal raphe, and locus coeruleus – brain

areas involved in vital processes such as learning, memory, reward and reinforcement. In contrast to these data, our previous work has examined the effects of five days of cocaine self-administration on functional activity, while cocaine was present, and found no changes in any of these regions. In fact, most of the regional differences from controls were higher, not lower, levels of functional activity (Macey et al., 2004). Macy et al.,

(2004) also compared the five-day group to a 30-day self-administration group that was different in duration from the current study, but similar in intake. In the current study, animals administered ≈100mg cocaine over the five days, while animals in the 30 -day group administered ≈150mg cocaine. The animals with the 30 -day self-administration history had similar changes to what was observed in the present study, suggesting that 103

intake, not duration, determines the adaptations that occur. This observation is consistent

with previous work from our lab indicating that total intake, not the length of the self-

administration history, is responsible for neurochemical changes that occur following

cocaine self-administration (Calipari et al., 2013). Because the 30-day self-administration group from Macey et al., (2004) was imaged with cocaine present, it suggests that not only are the circuits depressed in the absence of cocaine, but cocaine does not produce sufficient effects to ‘normalize’ circuits. Continued drug-taking in addicted individuals has been suggested to occur as compensatory behavior to “normalize” a baseline dysregulated state (Koob, 2009; Koob and Le Moal, 1997). It is important to differentiate the effects of cocaine-induced alterations of neural networks with those of cocaine self-administration on functioning in the absence of drug, as they have very different implications for the functioning of the brain at baseline.

The mesocorticolimbic DA system mediates many of the reinforcing and rewarding effects of cocaine (Pierce and Kumaresan, 2006), and because neuroadaptations resulting from chronic drug exposure are often opposite from the acute effects, it is not surprising that there were reductions in the activity of these regions following cocaine self-administration. Previous work has demonstrated reduced function of the striatal DA system at a similar time point following cocaine self-administration, as well as the development of tolerance to the neurochemical effects of cocaine (Ferris et al.,

2011). Further, these functional reductions are present 18 hours following the final cocaine self-administration session (Mateo et al., 2005; Ferris et al., 2011, 2012; Calipari et al., 2012), and persist for up to two weeks following cocaine exposure (Ferris et al.,

2012). These reductions in DA function have been observed using both fast scan cyclic 104

voltammetry and microdialysis where it was found that 18-24 hours of withdrawal from

cocaine self-administration resulted in reduced DA release and uptake, as well as reduced

baseline DA overflow, respectively (Ferris et al., 2011, 2012; Calipari et al., 2012, 2013;

Maisonneuve et al., 1995; Weiss et al., 1992; but see, Hooks et al., 1994; Meil et al.,

1995). The current data agree with these observations in that functional activity was

significantly reduced in the terminal fields of the VTA, namely the nucleus accumbens

and caudate putamen (Koeltzow and White, 2003). Moreover, the neurochemical

changes previously reported concur with the behavioral data, which demonstrated a

decreased locomotor response to a novel environment following withdrawal from cocaine

self-administration.

Previous studies have demonstrated the influential role of striatal DA levels on the

locomotor response to a novel environment; for example, animals can be separated into

two groups (high and low response) according to their locomotor activity in reaction to a

novel environment. Ferris et al., (2013) recently demonstrated that high and low

response to novelty can predict both the tolerance that develops to cocaine directly at the

dopamine transporter as well as the rate of acquisition of cocaine self-administration.

Low novelty responders have been shown to have lower extracellular DA levels, in line

with the present data where we observed reduced functional activity in dopaminergic

regions following withdrawal from cocaine self-administration (Verheij and Cools, 2008;

Verheij et al., 2008). Previous work on withdrawal from cocaine self-administration has found depression of locomotor activity during similar time-points, an effect that is indicative of reductions in DA levels and VTA cell firing (Koeltzow and White, 2003;

Gauvin et al., 1997). The lower locomotor activity then would be predicted based on the 105

reduced functional activity in dopaminergic nuclei. These alterations suggest that there could be changes in reward processing at baseline, which could play an important role in the reinstatement of cocaine-seeking (Schmidt and Pierce, 2010). Because these regions are involved in the processing of salient stimuli, these data also suggest that the processing of other alternate rewards, such as food, may also be impaired at baseline

(Carelli 2002; Schultz, 2010). In addition, there may be differential effects of cocaine on dopaminergic systems involved in motor and reward processing, an effect that was highlighted in the behavioral data indicating that there was no difference in baseline forward locomotion following cocaine self-administration. It is important to note that there were reductions in stereotypic behaviors, indicating that although forward locomotion does not differ between groups, there may be inherent differences in motor control following cocaine self-administration, although it is not clear as to the meaning of these results. Together, these data suggest that the alterations in functional activity are not general changes that occur in all dopaminergic terminal fields, but rather are specific to those associated with reward and reinforcement and specific aspects of motor control.

In line with reductions in functional activity in dopaminergic regions 48 hours following cocaine self-administration, electrophysiological recordings have demonstrated reduced action potential firing in nucleus accumbens neurons both in vitro and in vivo after withdrawal from cocaine self-administration (Dong et al., 2006; Ishikawa et al.,

2009; Kourrich and Thomas, 2009; Mu et al., 2010; White et al., 1995). The lower rates of glucose metabolism in the brain regions reported here, together with the reductions in cell firing could suggest a reduced/depressive state following acute withdrawal from self- administration. Indeed, Markou and Koob (1991) have demonstrated elevations in 106

intracranial self-stimulation thresholds in rats, indicating a depressed or anhedonic state in animals following self-administration. The elevated thresholds were reversed by a DA

D2 receptor agonist, suggesting that the effects were due, at least in part, to reduced DA system activity following a cocaine self-administration history (Markou & Koob, 1992).

A similar phenomenon has also been demonstrated in mice, where withdrawal from cocaine delivered via osmotic mini-pump also resulted in elevated reward thresholds 72 hours following treatment (Stoker & Markou, 2011). Because functional activity measurements were made 48 hours following the final cocaine self-administration session, these modifications may be indicative of the changes that occur during early withdrawal periods and may coincide with the alterations in reward thresholds. Further, it is well documented that, similar to the anhedonic behavior seen in rodents, human addicts going through early withdrawal from cocaine exposure also report depression and anhedonia (Markou & Kenney, 2002). It is possible, therefore, that the widespread decreased functional activity may be associated with depression and anhedonia during the early withdrawal periods. Although it is possible that these changes may also underlie the neuroadaptations that occur during later stages of withdrawal, the time points that we measured in this study can only confirm that this state is present 48 hours following cocaine self-administration. Future studies that look at the time course of both the functional and behavioral effects of cocaine withdrawal are necessary to confirm whether the effects observed here are persistent.

Although reward and reinforcement are an essential part of the early stages of the addiction process, drug addiction is dependent on neural plasticity associated with drug- induced reward learning mechanisms (Jones and Bonci, 2005). Here we observe 107

functional reductions in brain regions involved in this type of learning. Specifically, the reductions in the prefrontal cortex (PFC) and nucleus accumbens activity suggest that there may be suppression of cortico-striatal loops. Goal-directed learning is reliant on the dorsomedial striatum through loops that project from the cortex to the striatum

(Alexander et al. 1986; Lawrence et al. 1998; Haber and Calzavara 2009; McFarland and

Haber 2002). Here we show reductions in functional activity in these areas, implying that this type of learning may also be impaired. These data suggest that 1.) individuals may be less able to learn new goal-directed behaviors, and 2.) that they also may be less able to replace already formed associations. Replacing associations that occurred during the development of drug addiction is a process that is essential for continued abstinence and the prevention of relapse in abstinent individuals. In addition, the motivational loop, comprised of the ventral striatum, orbitofrontal and anterior cingulate cortex, hippocampus, and amygdala (Lawrence et al. 1998), seemed to be particularly affected.

These reductions in regional functional activity may also potentially lead to drug-taking in order to restore these brain areas to the functional state that was present before the drug-taking was initiated (Koob and Le Moal, 1997).

In additions to reductions in areas involved in reward learning and motivational behaviors, there were also reductions in regions involved in learning and memory.

Reductions in functional activity were observed in the hippocampus, medial thalamus, and basolateral amygdala. Reduced activity in these regions has important implications for normal functioning and the learning capacity at baseline after the cessation of drug consumption. Even more important for cocaine abusers is the role that learning plays in cue-reinforcement pairings during drug abuse. It is well established that cue conditioning 108

plays a role in the effects of drugs and on relapse, where cues alone are sufficient to reinstate drug taking/seeking after periods of prolonged abstinence (Lu et al., 2004;

Shaham et al., 2003; Schmidt and Pierce, 2010). The basolateral amygdala has also been shown to be a major modulator of the extinction of conditioned place preference, further suggesting that the reductions in functional activity, and perhaps learning, may lead to a decreased ability to replace associations between drugs and cues (Schroeder & Packard,

2003, 2004). In addition to extinction of conditioned preference, the basolateral amygdala has been shown to be integral to the neural circuits involved in fear conditioning (Berlau & McGaugh, 2006; LaLumiere et al., 2003; Sacchetti et al, 1999;

Vazdarjanova & McGaugh, 1999), thus reductions in the region have implications for associative learning in general, and not just reward based learning.

Here we demonstrate that there are large reductions in the functional activity of the dorsal raphe and locus coeruleus following withdrawal from cocaine self- administration. Our previous study, which investigated the effect of cocaine self- administration while cocaine was still on board, found no differences in the locus coeruleus and actually found higher levels of metabolism in the dorsal raphe (Macey et al., 2004). Because these areas are cell body nuclei for catecholamine projections that are widespread throughout the brain, these data demonstrate that cocaine self-administration affects a broad expanse of the brain, certainly well beyond the DA system that is typically investigated. Our data of alterations of functional activity in the dorsal raphe are particularly intriguing, since the 5-HT system has been shown to play a role in locomotor activity. Specifically, 5-HT levels have been shown to be inversely related to vertical activity (Brookshire and Jones, 2009); thus, it is tempting to speculate that reduced 109

serotonergic activity (as indicated by the lower levels of functional activity in the dorsal

raphe) may have had direct behavioral consequences (increased vertical activity at

baseline). In addition, if the alterations in raphe activity that we see in rodents are also

present in human users, these may account for some of the sleep disturbances that are

often reported by addicts following cocaine abuse (Morgan & Malison, 2007;

Schierenbeck et al., 2008). Also, dysfunction of both the dorsal raphe and locus

coeruleus has been directly related to anxiety and depression during withdrawal

(Carrasco and Van de Kar, 2003; Graeff et al., 1996; Itoi and Sugimoto, 2010). Further,

the locus coeruleus system has been shown to mediate shifts in attention, thus in addition

to stress and anxiety, these reductions could have effects on basic attention, which could

in turn lead to additional learning and memory deficits (Aston-Jones et al., 1999;

Rajkowski et al., 1994; Usher et al., 1999). These functional alterations could be due to

the ability of cocaine to inhibit both the norepinephrine and serotonin transporters

(Rothman and Baumann, 2003), thus, these changes during withdrawal may be

compensatory effects due to the sustained elevated levels of these transmitters during

cocaine self-administration. Taken together, these data demonstrate that the alterations

that occur following cocaine self-administration are clearly not limited to just the DA system, but include other neurotransmitter systems as well, and suggest that cocaine has a widespread influence on the brain even when the drug is no longer present.

In summary, the present study demonstrated that cocaine self-administration resulted in robust alterations in both functional and behavioral activity long after cocaine has been cleared. These data suggest that there are reductions in the functionality of a number of critical circuits involved in reward processing, memory, attention, sleep, and 110

stress processing. The reductions in these areas have important implications for

individuals that abuse cocaine as these data indicate that even a short (five-day) self-

administration history can result in functional reductions in activity that are present up to

48 h later. These deficits were accompanied by behavioral changes as well, indicating

that these metabolic changes are functionally relevant in the behaving animal. It is

important to determine the functioning of neural networks after cocaine self-

administration, as it is possible that the reductions in some of these regions persist for

longer periods of time and could facilitate the continued use of drugs in the face of

negative consequences, and facilitate continued drug administration in the face of robust

tolerance, as well as potentiate drug seeking after periods of prolonged abstinence.

Acknowledgements: The authors wish to thank Mr. Mack Miller for his assistance conducting the 2-DG experiments. This work was funded by NIH grants R01 DA09085

(LJP), P50 DA06634, R01 DA024095 (SRJ), R01 DA03016 (SRJ), T32 DA007246 and

F31 DA031533 (ESC). The authors have no conflicts to declare.

Abbreviations: LCGU, local cerebral glucose utilization; 2-DG, [14C]-2-deoxyglucose;

ACC, anterior cingulate cortex; NAc, nucleus accumbens; DA, dopamine; IP, intraperitoneal

111

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CHAPTER IV

TEMPORAL PATTERN OF COCAINE INTAKE DETERMINES TOLERANCE VS SENSITIZATION AT THE DOPAMINE TRANSPORTER

Erin S. Calipari, Mark J. Ferris, Benjamin A. Zimmer, David C. S. Roberts, and Sara R. Jones

The following manuscript was published in Neuropsychopharmacology, in press, 2013, and is reprinted with permission. Stylistic variations are due to the requirements of the journal. Erin S. Calipari performed most self-administration and voltammetry experiments, data analysis, and prepared the manuscript. Dr. Mark J. Ferris performed select voltammetry experiments. Benjamin A. Zimmer generated a small number of self- administration animals. Dr. Sara R. Jones acted in an advisory and editorial capacity. Dr. David C. S. Roberts acted in an editorial capacity. 118

Abstract:

The dopamine transporter (DAT) is responsible for terminating dopamine (DA) signaling

and is the primary site of cocaine’s reinforcing actions. Cocaine self-administration has been shown previously to result in changes in cocaine potency at the DAT. To determine whether the DAT changes associated with self-administration are due to differences in intake levels or temporal patterns of cocaine-induced DAT inhibition, we manipulated cocaine access to produce either continuous or intermittent elevations in cocaine brain levels. Long-access (LgA, 6 hr) and short-access (ShA, 2 hr) continuous self- administration produced similar temporal profiles of cocaine intake that were sustained throughout the session; however, LgA had greater intake. ShA and Intermittent-access

(IntA, 6 hr) produced the same intake, but different temporal profiles, with “spiking” brain levels in IntA compared to constant levels in ShA. IntA consisted of 5 min access periods alternating with 25 min time-outs, which resulted in bursts of high responding followed by periods of no responding. DA release and uptake, as well as the potency of cocaine for DAT inhibition, were assessed by voltammetry in nucleus accumbens slices following control, IntA, ShA, and LgA self-administration. Continuous access protocols

(LgA and ShA) did not change DA parameters, but the “spiking” protocol (IntA) increased both release and uptake of DA. In addition, high continuous intake (LgA) produced tolerance, while “spiking” (IntA) produced sensitization, relative to ShA and naïve controls. Thus, intake and pattern can both influence cocaine potency, and tolerance seems to be produced by high intake, while sensitization is produced by intermittent temporal patterns of intake.

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Introduction

A substantial literature has documented the effects of cocaine on the dopamine

(DA) system and its involvement in the addiction process (Roberts et al., 1977;

Izenwasser 2004; Stuber et al., 2011; Blum et al., 2012). Cocaine exerts its reinforcing and neurochemical effects by inhibiting the dopamine transporter (DAT), which leads to augmented DA signaling (Ritz et al., 1987; Kristensen et al., 2011). DA elevations in the nucleus accumbens (NAc) core region are critically involved in self-administration behaviors, reinstatement, cue-reward association, assignment of motivational value, and goal oriented behaviors (for review see Wheeler et al., 2005; Kalivas and McFarland,

2003; Aragona et al., 2009; Willuhn et al., 2010).

Both tolerance and sensitization can develop to the neurochemical effects of cocaine; however, the nature of these changes appears to depend on the dosing parameters used. An extensive literature, primarily using daily experimenter- administered intraperitoneal (IP) injections has documented neurochemical sensitization associated with the mesolimbic DA system (Kalivas and Duffy, 1990, 1993; Parsons and

Justice, 1993; Addy et al., 2010). Sensitization of cocaine-induced increases in extracellular DA has been linked not only to alterations in the regulation of DA release and reuptake (Jones et al., 1996, Addy et al. 2010), but also to influences such as glutamate (for review see Vanderschuren and Kalivas, 2000), GABA (for review see

Steketee, 2005; Filip et al., 2006) and serotonin (Neumaier et al., 2002; Filip et al., 2010).

By contrast, studies using self-administration procedures have generally shown tolerance to cocaine’s DA-elevating and DAT-inhibiting effects of cocaine, as measured by microdialysis (Hurd et al., 1989; Mateo et al., 2005; Lack et al., 2008; Ferris et al., 2011). 120

It is possible that cocaine tolerance is due to a reduced ability of cocaine to inhibit the

DAT, which has been reported in a number of paradigms where cocaine levels are high

and sustained over daily extended-access self-administration sessions (Mateo et al., 2005;

Ferris et al., 2011, 2012; Calipari et al., 2012).

Therefore, experimenter-delivered and self-administration protocols produce distinctly different effects on the DA system. There are many differences between these protocols including contingency, temporal pattern of intake, total consumption, and route of administration, which may influence the divergent neurochemical consequences. For example, experimenter-administered injections result in an intermittent pattern of drug administration, whereas intravenous (IV) self-administration procedures result in high rates of responding and high levels of administration for many hours (i.e. for the duration of the self-administration session).

In the present study, we investigated the contribution of 1) pattern of consumption and 2) total intake of cocaine on rapid DA signals in the NAc and the ability of self-

administered cocaine to either sensitize or induce tolerance to the pharmacological effects

of cocaine on the DAT. Self-administration paradigms were used in order to control for

the contribution of contingency and route of administration on the effects of the DA

system. A long-access (LgA) procedure was used in which cocaine levels were sustained

for 6 hours each day (Ahmed et al., 2003; Martin et al, 2011; Peraile et al., 2010). This

was compared to an intermittent access (IntA) self-administration procedure in which cocaine was available during a 6 hr session but only during 5 min trials, which were separated by 25 min time-outs. This protocol allows animals to "load up" during each trial but ensures that cocaine levels cannot be maintained. The IntA procedure, which 121

results in a “spiking” pattern of intake, has recently been shown to produce a greater augmentation of the reinforcing effects of cocaine compared to the long access (LgA) procedure (Zimmer et al., 2012). We also included a short access (ShA) group in which cocaine levels were matched to the IntA group but were maintained during a two-hour session similar to LgA. Here we demonstrate that intake and pattern can both influence cocaine potency at the DAT; while tolerance seems to be dictated by total intake, sensitization appears to be determined by pattern.

Methods and Materials:

Animals: Male Sprague-Dawley rats (375–400 g; Harlan Laboratories, Frederick,

Maryland), maintained on a 12:12 hour reverse light/dark cycle (3:00 am lights off; 3:00 pm lights on) with food and water ad libitum. All animals were maintained according to the National Institutes of Health guidelines in Association for Assessment and

Accreditation of Laboratory Animal Care accredited facilities. The experimental protocol was approved by the Institutional Animal Care and Use Committee at Wake Forest

School of Medicine.

Self-Administration: Rats were anesthetized and implanted with chronic indwelling jugular catheters as previously described (Liu et al., 2007). Animals were singly housed, and all sessions took place in the home cage during the active/dark cycle (9:00 am–3:00 pm). After a 2-day recovery period, animals underwent a training paradigm within which animals were given access on a fixed ratio one (FR1) schedule to a cocaine-paired lever, whereby a single lever press initiated an intravenous injection of cocaine

(0.75mg/kg, infused over 4s). After each response/infusion, the lever was retracted and a 122

stimulus light was illuminated for a 20 second timeout period. Training sessions were

terminated after a maximum of 20 infusions or 6h, whichever occurred first. Acquisition

occurred when an animal responded for 20 injections for two consecutive days and a

stable pattern of infusion intervals was present. Following training, animals were

assigned to either ShA, IntA, or LgA groups. All self-administration was 14 consecutive sessions, after which animals were sacrificed and brains were prepared for voltammetric

recordings.

Control: Controls were naïve rats housed in the same conditions as animals undergoing self-administration.

LgA Group: Subjects completed daily 6h sessions during which they had unlimited access to cocaine (0.75 mg/kg; infused over 4s) on an FR1 schedule for 14 consecutive days. Upon each infusion, the lever was retracted, and a stimulus light signaled a 20-s

timeout period.

ShA Group: Subjects were given access to cocaine (0.75 mg/kg; infused over 4s) on an

FR1 schedule during 2-h daily sessions for 14 consecutive days. At the start of each

infusion, a stimulus light signaled a 20-s timeout period during which the lever was

retracted.

IntA Group: Subjects were given access to cocaine on an intermittent schedule of administration described previously (Zimmer et al., 2012). Briefly here, during each 6h session animals had access to cocaine for 12 five minute trails separated by 25-minute

timeout periods. Within each five-minute session, there were no timeouts other than 123

during each infusion, and the animal could press the lever on an FR1 schedule to receive

a 1-sec infusion of cocaine (0.375 mg/kg/inf).

In Vitro Voltammetry: Fast scan cyclic voltammetry (FSCV) was used to characterize

presynaptic DA system kinetics and the ability of psychostimulants to inhibit DA uptake

in the NAc. Voltammetry experiments were conducted during the dark phase of the

light/dark cycle 18 hours after commencement of the final self-administration session. A

vibrating tissue slicer was used to prepare 400 µm thick coronal brain sections containing

the NAc. The tissue was immersed in oxygenated artificial cerebrospinal fluid (aCSF)

containing (in mM): NaCl (126), KCl (2.5), NaH2PO4 (1.2), CaCl2 (2.4), MgCl2 (1.2),

NaHCO3 (25), glucose (11), L-ascorbic acid (0.4) and pH was adjusted to 7.4. Once sliced, the tissue was transferred to the testing chambers containing bath aCSF (32°C), which flowed at 1 ml/min. A carbon fiber microelectrode (100–200 μM length, 7 μM

radius) and bipolar stimulating electrode were placed into the core of the NAc, which was

selected because of its role in the reinforcing and rewarding actions of cocaine. DA

release was evoked by a single electrical pulse (300 μA, 4 msec, monophasic) applied to

the tissue every 5 minutes. Extracellular DA was recorded by applying a triangular

waveform (−0.4 to +1.2 to −0.4V vs Ag/AgCl, 400 V/s). Once the extracellular DA

response was stable cocaine (0.3–30 μmol/L) was applied cumulatively to the brain slice.

Data Analysis: Demon Voltammetry and Analysis Software was used for all analyses of

FSCV data (Yorgason et al., 2011). To evaluate DA kinetics and drug potency, evoked

levels of DA were modeled using Michaelis-Menten kinetics. Apparent Km (app. Km)

was used as a measure of the ability of cocaine to inhibit DA clearance, and to evaluate

changes in cocaine potency. As app. Km increases, the affinity of DA for the DAT 124

decreases. Increasing concentrations of cocaine linearly decrease the affinity of DA for

the DAT, such that shifts in app. Km across treatment groups indicate shifts in the ability

of cocaine to inhibit DA uptake. Recording electrodes were calibrated by recording

responses (in electrical current; nA) to a known concentration of DA (3 μM) using a

flow-injection system.

Calculating Ki Values: Inhibition constants (Ki) were determined by plotting the linear

concentration-effect profiles and determining the slope of the linear regression. The Ki

was calculated by the equation Km/slope. Ki values are reported in µM and are a measure

of the drug concentration that is necessary to produce 50% uptake inhibition. Ki is a

measure of the drug affinity for the DAT, reported in concentration of drug, while app.

Km is a DA related parameter that estimates DA uptake inhibition.

Statistics: Graph Pad Prism (version 5, La Jolla, CA, USA) was used to statistically

analyze data and create graphs. Baseline voltammetry data and Km values were compared

using a one-way analysis of variance (ANOVA). When main effects were obtained

(P < 0.05), differences between groups were tested using Tukey post hoc tests. Release data and data obtained after perfusion of cocaine were subjected to a two-way ANOVA with experimental group and concentration of drug as the factors. Differences between groups were tested using a Bonferroni post hoc test. Given the lack of a Gaussian distribution for Ki values, non-parametric tests (Kruskal-Wallis and Neuman Keuls) were

used to compare inhibition constants.

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Results:

ShA and LgA result in similar pattern of self-administration that is different from

IntA (Fig 1A). Figure 1 A contains representative behavioral plots demonstrating the different patterns of self-administration behavior between ShA, LgA, and IntA. We demonstrated that ShA results in high and consistent rates of responding for cocaine over a 2hr self-administration session (Fig 1A, top panel). IntA results in an intermittent pattern of responding for cocaine, characterized by high rates of responding followed by

time-out periods within which no responding occurs (Fig 1A, middle panel). LgA results

in high and consistent rates of responding, similar to responding for ShA, for cocaine

over a 6hr self-administration session (Fig 1A, bottom panel).

LgA results in greater cocaine intake as compared to ShA and IntA (Fig 1B). One-

way ANOVA revealed a main effect of intake between groups (F2, 11 = 39.28, p <

0.0001). Tukey post hoc analysis indicated that there was a significant increase in intake

for the LgA group versus both the ShA group (p < 0.0001) and IntA group (p < 0.0001).

Further, although the pattern of self-administration differed, the total cocaine intake between the ShA and IntA groups did not significantly differ. Because ShA results in similar intake to the IntA group and similar pattern of estimated cocaine brain levels to the LgA group, it was used as a comparator group to determine if effects were due to total intake or temporal pattern of cocaine self-administration.

IntA, but not LgA or ShA, increases stimulated DA release and Vmax. FSCV was used to assess presynaptic baseline DA system kinetics. ANOVA indicated a main effect of 126

127

Figure 1. Intermittent (IntA), long-access (LgA), and short access (ShA) cocaine self-

administration result in different patterns of self-administration. (A) Plots

demonstrating representative self-administration behavior throughout each session for individual rats self-administering cocaine. Tick marks represent infusions/responses on the lever earned on a fixed ratio one schedule of reinforcement. (A, Top) ShA results in high, consistent rates of responding over the two hour session. (A, Middle) IntA is achieved by giving 5 minutes access followed by 25 minute forced time-outs. This results in bursts of high responding followed by no responding. The spacing between clusters of tick marks is due to a forced time-out period. (A, Bottom) LgA results in high consistent rates of responding over the six hour session. (B) Group data plotting total intake over the 14 days of self-administration for each paradigm. ***, p <0.001 vs ShA;

###, p <0.001 vs IntA. 128

Figure 2. Differential effects of intermittent (IntA), short-access (ShA) and long-

access (LgA) self-administration on presynaptic dopamine system kinetics. (A)

Representative traces from control (left), IntA (center, left), LgA (center, right), and ShA

(right) animals. Traces are represented as concentration (µM) in dopamine (DA) over

time. (B) Stimulated DA release in µM across LgA, IntA, ShA, and control groups. (C)

Maximal rate of DA uptake (Vmax) across groups. (D) Group data indicating that the Km of DA for the dopamine transporter is unchanged following all self-administration paradigms. **, p < 0.01 vs control; ***, p < 0.001 vs control; &&&, p < 0.001 vs LgA.

129

paradigm on stimulated DA release (F3, 63 = 4.020, p < 0.05; Fig 2A, B) and Vmax (F3, 63 =

8.397, p < 0.0001; Fig 2 A, C). Tukey post hoc analysis revealed that stimulated release

(p < 0.05; Fig 2 B) and Vmax (p < 0.05; Fig 2 C) were both elevated in the IntA group as compared to controls. In addition, Vmax was also elevated as compared to LgA (p < 0.001;

Fig 2 B). Both LgA and ShA resulted in no significant change in either DA release or

Vmax as compared to control animals. There were no changes in any groups in regards to

the affinity of DA for the DAT (Km; Fig 2D). This indicates that pattern of cocaine

interaction with the DAT has differential effects on the compensatory mechanisms

associated with baseline functioning.

Differences in intake (LgA versus ShA) results in decreased cocaine potency, while

differences in temporal pattern of cocaine intake (IntA versus ShA) results in

increased cocaine potency at the DAT. FSCV in brain slices was used to determine

cocaine potency over a concentration-response curve. ANOVA revealed a main effect of

paradigm on cocaine potency (F3,68 = 3.21, p < 0.01; Fig 3). ShA resulted in no changes

in cocaine potency as compared to controls (Fig 3A, C, black vs. green lines). When

temporal pattern of cocaine self-administration was kept the same, but there were

differences in intake, cocaine potency was reduced (ShA vs LgA). This was expressed as

a significant reduction in cocaine potency as measured by apparent Km at the 30 µM

concentration in LgA (p <0.001) versus ShA (Fig 3C, Green vs. Red curve). Conversely,

when intake was kept the same, but there were differences in temporal pattern of self-

administration, cocaine potency was increased (IntA vs ShA). This was expressed as an

increase in cocaine’s ability to inhibit the DAT in the IntA group (p < 0.0001) as 130

131

Figure 3. Intermittent access (IntA) self-administration results in sensitization to

the neurochemical effects of cocaine while long-access (LgA) results in tolerance. (A)

Representative traces highlighting the uptake inhibition induced by 10 µM cocaine in control (Black) and short-access (ShA, Green) animals. Traces are represented as concentration (µM) in dopamine (DA) over time and smaller signals were shifted to the right in order to match the peak-height of the small signal to equivalent concentration of the larger signal. This allows for direct comparison of dopamine uptake in signals with different peak-heights. (B) Representative traces highlighting the uptake inhibition induced by 10 µM cocaine in control (Black), IntA (blue) and LgA (Red) animals. (B)

Cumulative cocaine (0.3-30 µM) dose response curves in slices containing the nucleus accumbens core. Cocaine potency is decreased following LgA, unchanged following short-access (ShA), and increased following IntA. (D) Group data of Ki values for

cocaine in control, LgA, ShA, and IntA groups. Ki values are a measure of the

concentration of drug at which 50% inhibition is achieved. *, p < 0.5 vs control **, p <

0.01 vs control; # p < 0.01 vs ShA.

132

compared to ShA (Fig 3C, Green vs. Blue curve). A similar trend was present when

groups were compared to control animals where LgA resulted in decreased cocaine

potency at the 30 µM concentration (p < 0.01), and IntA resulted in enhanced potency for

cocaine at the same concentration (p < 0.01) (Fig 3C, Red and Blue curves vs. Black curve).

Ki is a measure of the drug concentration that results in 50% uptake inhibition.

This measurement can determine relative potencies between drugs at baseline as well as

potency changes following drug self-administration. Kruskal-Wallis non-parametric

2 analysis revealed a significant main effect of paradigm on Ki (Chi 4=10.94, p < 0.05 =

10.53; Fig 3 D; Supplementary Fig 1). Mann Whitney analysis revealed that Ki was

increased in LgA animals (p < 0.05) and reduced following IntA (p < 0.05) when

compared to ShA. Further, Ki was increased in LgA animals (p < 0.05) and reduced

following IntA (p < 0.05) when compared to control animals.

Cocaine-induced increases in peak-height was assessed across all three groups to

determine if this aspect of cocaine effects on DA was changed by self-administration.

There were no significant differences between any of the groups tested (Fig 4).

Discussion

The present results demonstrate that the compensatory changes in DAT sensitivity to

cocaine produced by self-administration are influenced by both the temporal pattern of

cocaine consumption and the total amount of drug intake. When there was a sustained

consumption pattern and intake was high (LgA), tolerance to cocaine’s effects at the 133

Supplementary Figure 1. Intermittent access (IntA) self-administration results

increased potency, while long-access (LgA) results in decreased potency versus short-access (ShA). Linear concentration-response curves for cocaine. The slope of the concentration-response curve for cocaine was significantly increased following IntA, and decreased following LgA, as compared to both control and ShA. Ki values across groups

were calculated based off of the linear dose-response curve for cocaine in each group.

***, p < 0.001 vs control. 134

Figure 4. Cocaine-induced increases in DA did not differ across groups. Stimulated

DA release was measured across a dose-response curve for cocaine, and expressed as a

percent pre-cocaine stimulated DA release. There were no differences in cocaine-induced

DA elevations between control, intermittent-access (IntA), long-access (LgA), or short- access (ShA) cocaine self-administration groups.

135

DAT developed. Conversely, when intake was low and patterns of consumption were intermittent (IntA) sensitization of the DAT to cocaine occurred. Differences were also observed in baseline (pre-drug) DA measures, wherein IntA cocaine administration

resulted in increased Vmax and stimulated DA release, and LgA and ShA did not produce

any changes. This is the first comparison of the effects ShA and LgA on cocaine potency

directly at the DAT. Previous work showed increased measures of drug seeking,

motivation to administer cocaine, and craving in LgA versus ShA animals (Koob 1996;

Koob and LeMoal 1997; Orio et al., 2009; Patterson and Markou 2003); however, these

measures are probably not due to the pharmacological effects of cocaine at the DAT,

which we demonstrate are reduced. Further, we found that IntA cocaine self-

administration produced a sensitized cocaine response at the DAT, demonstrating that

pattern of self-administration plays an integral role in the compensatory effects of the

DAT to cocaine effects following extended use.

Here we show that LgA results in reduced cocaine potency, indicative of a

neurochemical tolerance to cocaine at the DAT, in comparison to both ShA and naïve

control animals. The decreased cocaine potency following LgA is consistent with

previous reports demonstrating similar changes following a number of different

extended-access paradigms. In our hands and others, LgA results in neurobiological

compensations characterized by decreased cocaine effects and blunted DA system

function in the NAc (Hurd et al., 1989; Meil et al., 1995; Macey et al., 2004; Ferris et al.,

2011, 2012; Calipari et al., 2012; but see Hooks et al., 1994; Zapata et al., 2003). Also,

immediately following 21-day LgA cocaine self-administration while cocaine is still present, there are decreases in functional activity in the ventral and dorsal striatum, as 136

well as a number of other brain regions, indicating that cocaine is less efficacious at

activating these circuits (Macey et al., 2004). Previously we examined a number of self- administration protocols, manipulating both frequency and duration of access, and regardless time, animals given continuous cocaine access exhibited robust behavioral and neurochemical tolerance. Animals that administered cocaine for only 1 day of 40 injections and animals that underwent extended-access self-administration for five days

(40 inj. per day) both exhibited the same effects as LgA self-administration (6 hrs/day, 14 days, Ferris et al., 2011, 2012; Calipari et al., 2012). All of the previously tested procedures shared the property that animals could administer large amounts of cocaine for the duration of the session. Regardless of duration of testing, each of these groups that maintained high rates of responding over 5-6 hr session showed neurochemical tolerance at the DAT when tested 24 hrs after the last self administration session (Ferris et al., 2011; 2012; Calipari et al., 2012). Although ShA animals have a similar pattern of self-administration, and can administer large amounts of drug, they can only do so for 2 hr. This results in significantly less drug consumption, leading to no change in cocaine potency. This suggests that total intake within sessions, and not pattern, is what is driving the tolerance to the pharmacological effects of cocaine at the DAT.

In contrast, here we show that the IntA cocaine self-administration procedure enhances cocaine potency, indicative of a sensitized neurochemical response to cocaine, at the DAT relative to both ShA and naïve controls. The IntA results are opposite to the well-documented decrease in cocaine potency after LgA shown here and in previous research (Hurd et al., 1989; Ferris et al., 2011, 2012; Calipari et al., 2012). Although behavioral sensitization to cocaine has been reported previously (Schmidt and Pierce, 137

2010), to our knowledge, this is the first demonstration of a sensitized cocaine response

directly at the DAT following cocaine self-administration. It is possible that the increased

potency may promote increased rewarding and reinforcing effects of cocaine as well as

an increase in motivation to self-administer the drug, potentially leading to greater risk of

compulsive or addictive-like cocaine intake. Indeed, Zimmer et al. (2012) showed that

motivation to self-administer cocaine is significantly increased following IntA as

compared to LgA and ShA cocaine self-administration.

The marked differences between ShA and IntA cannot be attributed to intake, as

the animals administer similar amounts of drug over sessions. In addition, the session

length was different between IntA (360 min) and ShA (120 min); however, we do not

think that effects are due to session length differences, because LgA and IntA both had

360 min sessions. These groups exhibited opposite effects on DAT pharmacology,

therefore it seems that session time is not a contributing factor to the neurochemical

effects. The increased effects of cocaine at the DAT seem to be due to the intermittent

intake pattern of cocaine that likely leads to intermittent cocaine-DAT interactions. The

LgA and IntA groups differ substantially in the total cocaine self-administered over the course of the current experiment; however, we would predict that LgA would still produce tolerance when total intake is limited to equal the IntA condition. In fact, we have shown that a single day of LgA (60 mg total), which approximates the IntA group’s total intake of cocaine (70 mg total), produced robust tolerance (Ferris et al., 2011). Thus, the sensitized response was only seen in the group with intermittent cocaine access (IntA) and not in the matched intake groups that experienced sustained drug levels examined here (i.e., ShA) and in previous work (i.e. LgA, Ferris et al., 2011). 138

Cocaine has been demonstrated to result in changes in DA release that are

dependent on vesicular exocytosis (Venton et al., 2006), therefore we wanted to confirm

that changes in this process were not driving the observed changes in cocaine effects.

DA release over the concentration-response curve for the compound was not changed in

any of the groups, suggesting that it was cocaine-induced DAT inhibition, not

increased/decreased DA release, causing the change in potency following IntA/LgA. It is

possible that allosteric modifications to the DAT protein itself are mediating the

decreased potency following LgA and the increased potency following IntA. Indeed, the

DAT has been shown to undergo glycosylation and phosphorylation (Foster et al, 2008;

Chen et al, 2009). Therefore, it is possible that changes in the interaction of the DAT

protein with downstream effectors responsible for these post-translational modifications

are altered following self-administration in a way that changes the ability of ligands to

bind to the DAT and inhibit the clearance of DA. Additionally, the DAT has been shown

to form oligomer complexes (Hastrup et al., 2003) and be modulated by receptors such as

the D2 autoreceptor (Chen et al., 2013), which are two additional mechanisms that could

play a role in the observed changes in cocaine potency.

There appear to be many neurochemical adaptations that occur following cocaine

exposure, and how they interact to influence cocaine-induced DA overflow and behavior is as yet unclear. In addition to the sensitized effect at the DAT reported here, other systems appear to play a role in DA system sensitization, including glutamate (for review see Vanderschuren and Kalivas, 2000), GABA (for review see Steketee, 2005; Filip et al.,

2006) and serotonin (Neumaier et al., 2002; Filip et al., 2010). Due to the convergence of these systems and factors, which lead to the expression of behavioral sensitization, it 139

remains to be determined whether increased DA overflow and behavioral effects, such as locomotor sensitization, would be seen after IntA self-administration. Further, demonstrations of sensitized DA overflow are more robust after 1-2 weeks of drug abstinence (Kalivas and Duffy, 1990, 1993) thus it is possible that the changes observed here could be more robust following acute and prolonged withdrawal.

Here we demonstrate that whether tolerance or sensitization develops to specific effects of cocaine appears to depend on access conditions and the intake or pattern of administration, respectively. Pattern, total dose, and abstinence periods need to be taken into account when modeling the behavioral and neurochemical processes involved in addiction. Cocaine sensitization has been difficult to demonstrate in humans, suggesting that either sensitization does not occur in humans, or that it occurs during a part of the addiction process that has not been studied extensively (Leyton & Vezina, 2013). It is possible that early in the drug abuse process administration of cocaine is intermittent, leading to a sensitized cocaine response that facilitates continued drug use, while after long-term use there is tolerance to acute drug effects, an effect that has been reported in human subjects (Mendelson et al, 1998; Reed et al, 2009). It is suggested that in humans, drug use may be based on limited availability, which may lead individuals to administer drug in an intermittent pattern (Ahmed et al., 2013). However, it has also been suggested that LgA self-administration is a model of the escalation that is reported with long-term abuse of the compound in humans (Dackis and O’Brien, 2001). Here we demonstrate tolerance to the neurochemical effects of cocaine following LgA, suggesting that LgA may result in neurochemical changes consistent with human studies. In our previous work and currently accepted cocaine self-administration models, much emphasis has 140

been placed on maximizing an animal’s intake, with the thought that more intake results

in greater neurochemical effects. Here we demonstrate that greater intake is not

necessary to produce robust neurochemical effects, and in fact, continuous high intake

early in the animal’s self-administration history may produce marked tolerance to the

drug. Thus, we highlight the importance of mimicking human patterns of administration

in rodent models, as compensatory mechanisms associated with drug exposure are not

only dependent on the drug and total intake, but also the pattern in which the drug is

taken.

Acknowledgements: This work was funded by NIH grants R01 DA024095, R01

DA03016 (SRJ), R01 DA14030 (DCSR), P50DA006634 (SRJ and DCSR), T32

DA007246 and F31 DA031533 (ESC), K99 DA031791 (MJF). 141

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146

CHAPTER V

METHYLPHENIDATE AND COCAINE SELF-ADMINISTRATION PRODUCE DISTINCT DOPAMINE TERMINAL ALTERATIONS

Erin S. Calipari, Mark J. Ferris, James R. Melchoir, Kristel Bermejo, Ali Salahpour, David C.S. Roberts and Sara. R. Jones

The following manuscript was published in Addiction Biology, in press, 2012, and is reprinted with permission. Stylistic variations are due to the requirements of the journal. Erin S. Calipari performed all voltammetry, tissue content, and self-administration experiments, as well as western blot hybridization for the dopamine transporter. Kristel Burmejo performed western blot hybridization for tyrosine hydroxylase as well as the polymerase chain reaction experiments. Erin S. Calipari prepared the manuscript and Drs. Mark J. Ferris, Ali Salahpour, and Sara R. Jones acted in an advisory and editorial capacity. 147

Abstract

Methylphenidate (MPH) is a commonly abused psychostimulant prescribed for the treatment of attention deficit hyperactivity disorder. MPH has a mechanism of action similar to cocaine (COC) and is commonly characterized as a dopamine transporter

(DAT) blocker. While there has been extensive work aimed at understanding dopamine

(DA) nerve terminal changes following COC self-administration, very little is known about the effects of MPH self-administration on the DA system. We used fast scan cyclic

voltammetry in nucleus accumbens core slices from animals with a five-day self- administration history of 40 injections/day of either MPH (0.56 mg/kg) or COC (1.5 mg/kg) to explore alterations in baseline DA release and uptake kinetics as well as alterations in the interaction of each compound with the DAT. Although MPH and COC have similar behavioral effects, the consequences of self-administration on DA system parameters were found to be divergent. We show that COC self-administration reduced

DAT levels and maximal rates of DA uptake, as well as reducing electrically stimulated release, suggesting decreased DA terminal function. In contrast, MPH self-administration increased DAT levels, DA uptake rates, and DA release, suggesting enhanced terminal function, which was supported by findings of increased metabolite/DA tissue content ratios. Tyrosine hydroxylase mRNA, protein and phosphorylation levels were also assessed in both groups. Additionally, COC self-administration reduced COC-induced

DAT inhibition, while MPH self-administration increased MPH-induced DAT inhibition, suggesting opposite pharmacodynamic effects of these two drugs. These findings suggest that the factors governing DA system adaptations are more complicated than simple DA uptake blockade. 148

Introduction

Methylphenidate (MPH), the active ingredient in medications (Ritalin®,

Methylin®, Focalin®) used in the treatment of attention deficit/hyperactivity disorder

(ADHD) and narcolepsy, is prone to diversion for non-medical use. MPH abuse in non-

ADHD individuals has become increasingly prevalent through oral, intranasal or intravenous (i.v.) routes of administration (Teter et al., 2006; Sherman et al, 1987). The drug is used for cognitive enhancement and to “get high”, causing effects indistinguishable from cocaine (COC) when taken i.v. or intranasally (Morton and

Stockton, 2000; Sherman et al, 1987; Teter et al., 2006; Rush and Baker, 2001). In 2008,

4.8 million people reported abusing MPH in the past year, compared to 5.3 million for

COC, suggesting that both of these drugs pose a significant threat to public health

(SAMHSA, National Survey on Drug Use and Health, 2008).

From a behavioral standpoint, MPH and COC share a very similar preclinical profile. In rats, the discriminative stimulus effects of MPH and COC are nearly identical as seen by MPH’s ability to fully substitute for COC (Li et al., 2006). Several i.v. self- administration studies in rats have demonstrated that COC and MPH have similar reinforcing effects. Both compounds maintain high rates of operant responding, and extended access to MPH results in an escalation of intake similar to COC self- administration (Ahmed & Koob, 1998; Marusich et al, 2010). With regard to reinforcing efficacy, doses of MPH or COC at the peak of their respective progressive ratio dose response curves engender similar break-points, indicating that the motivation to take each 149

drug is comparable (Marusich et al., 2010; Roberts et al., 2007; Calipari et al.

unpublished).

Like many psychostimulants, COC and MPH exert their rewarding and

reinforcing properties primarily via their ability to bind to dopamine transporters (DATs)

and inhibit dopamine (DA) uptake, elevating DA in the nucleus accumbens (DiChiara

and Imperato, 1988; Woods and Meyer, 1991; Gerasimov et al., 2000). For example, a

triple mutation in the second transmembrane domain of the DAT, which reduces affinity

for MPH and COC, also abolishes conditioned place preference (Chen et al, 2005, 2006;

Tilley et al, 2008a, b), highlighting the role of DAT inhibition in their rewarding

properties. Acute inhibition of DA uptake by psychostimulants consistently results in

enhanced DA signaling, but repeated or prolonged exposure to such drugs can lead to

compensatory changes in presynaptic DA terminal function as well as alterations in the

pharmacological actions of the drugs themselves (Biederman and Spender, 2002;

Bouffard, 2003; Cadet et al., 2009).

The neurobiological effects of MPH self-administration on the DA system remain

to be elucidated; however, COC effects on the DA system have been well characterized

and we hypothesized that MPH, a DAT blocker with a similar mechanism of action,

would produce similar changes. In previous studies, COC self-administration resulted in lower basal levels of DA, decreased stimulated DA release and modestly decreased maximal rate of uptake (Vmax) (Mateo et al., 2005; Ferris et al., 2011). In addition to baseline DA system alterations, COC self-administration also resulted in a decreased potency of COC in the nucleus accumbens, producing a marked tolerance to its DA- 150

elevating and DAT-inhibiting effects (Hurd et al., 1989; Mateo et al., 2005; Ferris et al.,

2011). These data, taken together, suggest an overall hypodopaminergic and less

responsive DA state following COC self-administration.

Because MPH is increasingly becoming a drug of abuse (Marusich et al, 2009,

2010; Burton et al., 2010; Botly et al, 2008), but the neurochemical alterations following contingent administration have yet to be characterized, we chose to compare the behavioral and neurochemical effects of MPH self-administration with self- administration of an extensively studied DA uptake blocker, COC. The purpose of this study was to systematically evaluate the neurochemical consequences of MPH and COC self-administration by evaluating baseline presynaptic DA system parameters such as release and uptake rate, as well as the ability of COC and MPH to inhibit the reuptake of endogenous DA. Surprisingly, MPH produced a distinctly different pattern of results from COC, suggesting that MPH does not behave as a prototypical dopamine uptake blocker. The present results suggest that the factors governing DA system adaptations are more complicated than simple DA uptake blockade.

Materials and Methods

Animals: Male, Sprague-Dawley rats (375–400 g; Harlan Laboratories, Frederick, MD) were maintained according to the National Institutes of Health guidelines in Association for Assessment and Accreditation of Laboratory Animal Care accredited facilities. The experimental protocol was approved by the Institutional Animal Care and Use Committee at Wake Forest School of Medicine. 151

Self-Administration: Rats were anesthetized with ketamine (100 mg/kg) and xylazine (10

mg/kg), implanted with chronic indwelling jugular catheters, and trained for i.v. self-

administration as previously described (Roberts and Goeders 1989). Following surgery,

animals were singly housed, and all self-administration sessions took place in the home cage. Each animal was maintained on a reverse light cycle (3:00 am lights off; 3:00 pm

lights on), and all self-administration procedures occurred during the active/dark cycle.

Sessions were six hours in length and were terminated at the end of the six hours or after

40 injections of drug. Animals self-administered either COC (1.5mg/kg/inj over 4 sec) or

MPH (0.56 mg/kg/inj over 4 sec) on a fixed-ratio 1 schedule of administration.

Concurrent with the start of each injection, the lever retracted and a stimulus light was

activated for 20 seconds to signal a time-out period. Under these conditions, animals

acquired a stable pattern of COC or MPH self-administration within 1 to 5 days. For self-administering animals, acquisition (Day 1) was counted when the animal reached 35 or more responses. There was no significant difference between groups in the injections received before acquisition criteria was met. Following acquisition, the animals were given access to 40 injections per day for a period of 5 consecutive days for both the COC and MPH self-administration experiments.

Fixed ratio self-administration allows animals to titrate drug intake by spacing injections to maintain a preferred brain concentration of drug (Norman & Tsibulski,

2006). We compared doses of MPH and COC that were behaviorally equivalent. Due to the significant difference in half-life of MPH, which is approximately two times longer than COC (Huff and Davies, 2002; Weikop et al, 2004), we compared 0.56 mg/kg MPH and 1.5 mg/kg COC, doses which produce maximal responding on a progressive ratio 152

schedule of reinforcement (Richardson and Roberts 1996; Marusich et al., 2010). To

confirm behavioral equivalence we also measured the time to complete session, inter- dose interval and rate of intake.

Control animals were naïve rats housed under the same reverse light-dark light cycle for at least one week prior to neurochemical analysis.

Fast Scan Cyclic Voltammetry in brain slices: Animals were sacrificed 24 hours after commencement of the last session, during the dark phase of the light cycle. 400 µm thick coronal brain sections containing the nucleus accumbens core were cut using a vibrating tissue slicer. A carbon fiber electrode was placed approximately 75 µm below the surface of the slice in close proximity to a bipolar stimulating electrode in the nucleus accumbens core. DA release was evoked by a single electrical pulse (300 μA, 4 msec, monophasic) applied every 5 minutes. Extracellular DA was recorded using fast-scan cyclic voltammetry (FSCV) by applying a triangular waveform−0.4 ( to +1.2 to −0.4 V vs. silver/silver chloride, 400 V/sec) to the electrode every 100 msec. Once the extracellular DA response was stable for three consecutive stimulations, individual brain slices were treated with either COC or MPH (0.3–30 μM), with increasing concentrations cumulatively added after stable responses were recorded, approximately every 45 minutes.

Western Blot Hybridization: Tissue sections were dissected 24 hours after commencement of the last self-administration session, and homogenized in ice-cold lysis buffer (10mM Tris, 2% SDS, 1mM EDTA) and spun in a centrifuge at 13,000g for 20 153

minutes to remove cellular debris. Bicinchoninic acid (BCA) protein assays (Thermo

Scientific, Rockford, IL) were used to determine the protein content of each sample.

Proteins were separated on 10% reducing SDS-PAGE gels (Invitrogen, Carlsbad, CA) and transferred to hydrophobic polyvinylidene difluoride membranes (Bio-Rad, Hercules,

CA). For estimation of the molecular weight of the protein bands, Precision Plus protein standards (10–250 kDa, Bio-Rad) were run in parallel with the samples on gels.

Nonspecific binding was blocked by incubation with blocking buffer (5% non-fat milk in

tris-buffered saline with tween-20) for 30 minutes before incubation with primary antibodies: rabbit anti-DAT antibody (Millipore, Temecula, CA; 1:5,000 dilution), rabbit anti-phosphorylated tyrosine hydroxylase (TH) Ser19, Ser31, Ser40 (PhosphoSolutions,

Aurora, CO; 1:2000) and mouse anti-TH (Millipore; 1:5000) at 4°C overnight.

Membranes were then incubated with either secondary goat anti-rabbit HRP-conjugated antibody (Millipore; 1:10,000, Rockland, Gilbertsville, PA; 1:5000) or donkey anti- mouse antibody (Invitrogen; 1:5000). Immunoreactive products were visualized by either chemiluminescence (Pico chemiluminescent substrate, Thermo Scientific) or by infrared detection using the Odyssey LI-COR Infrared Imaging System and quantified using Image J (NIH). Protein loading was visualized by incubation with either a

monoclonal antibody to β-actin (Abcam, Cambridge, MA; 1:10,000) or mouse anti-

GAPDH (Sigma; 1:6000).

Tissue Content: The striatum was dissected, snap-frozen, and samples (10-30 mg/sample

wet weight) were homogenized in 250 μL of 0.1 M HClO4 and analyzed for protein

concentration by the BCA method (Thermo Scientific). Extracts were centrifuged and

the supernatants removed and analyzed for DA and its metabolites 3,4- 154

dihydroxyphenylacetic acid (DOPAC) and homovanillic acid (HVA) using high

performance liquid chromatography (HPLC) coupled to electrochemical detection at

+220 mV (ESA Inc., Chelmsford, MA) and separated on a Luna 100 x 3.0 mm C18 3 µm

HPLC column (Phenomenex, Torrance, CA). The mobile phase consisted of 50 mM

citric acid, 90 mM sodium dihydrogen phosphate, 1.7-2.0 mM 1-octanesulfonic acid, 50

μM ethylenediaminetetracetic acid, 10-12 % acetonitrile and 0.3 % triethylamine in a

volume of 1 L (pH 3.0). Analytes were quantified using PowerChrom software (eDAQ

Inc, Colorado Spring, CO) and a calibration curve.

Quantitative Polymerase Chain Reaction (PCR): To obtain RNA from tissues, snap-

frozen ventral tegmental area (VTA) tissue sections were homogenized in cold TRI-

Reagent (BioShop Canada Inc) as described previously (Hu et al., 2009). Optical density readings at 260/280 nm were used to determine the quality and concentration of the resuspended RNA. 1µg of RNA was used for reverse-transcriptase PCR (RT-PCR) to obtain cDNA using SuperScript III Reverse Transcriptase (Invitrogen) following the manufacturer’s instructions. Relative quantification of gene targets was obtained using the GoTaq® qPCR Master Mix (Promega, Fitchburg, Wisconsin) on the Applied

Biosystems 7500 Real-Time PCR System. Phosphogycerlate kinase 1 (PGK1) was used as the reference gene (forward primer: ACCAAAGGATCAAGGCTGCTGTC; reverse primer: GACGGCCCAGGTGGCTCATA). Dopamine transporter (DAT) (forward primer: CCTGGTTCTACGGCGTCCAGC; reverse primer:

GCCGCCAGTACAGGTTGGGT) and TH (forward primer:

TTGAAGGAGCGGACTGGCTTCCA; reverse primer:

TGGCCAGAAAATCACGGGCGG) were used as the target genes. Target genes were 155

relatively quantified using the ΔΔCt method, and are represented as % control normalized to PGK-1.

Data Analysis: DA current was converted to concentration by calibration with 3 μM DA at the end of each experiment. For all analyses of FSCV data, DEMON voltammetry software was used (Yorgason et al., 2011). To evaluate the effects of MPH and COC self-administration on baseline DA system kinetics, evoked levels of DA were modeled using Michaelis-Menten kinetics, as a balance between release and uptake (Yorgason et al., 2011). For COC and MPH dose-response curves, apparent Km, a measure of apparent affinity of DA for the DAT, was used to determine changes in ability of the psychostimulants to inhibit DA uptake in the nucleus accumbens core relative to baseline.

Statistics: Graph Pad Prism (version 4, La Jolla, CA) was used to statistically analyze data sets and create graphs. Baseline voltammetry, western blot hybridization, and PCR data were compared across groups using a two-tailed Student’s t-test. Data obtained after perfusion of COC or MPH was subjected to a two-way analysis of variance with experimental group and concentration of COC or MPH as the factors. When significant interactions or main effects were obtained (p < .05), differences between groups were tested using Bonferroni post hoc tests. Behavioral data were subjected to a two-way analysis of variance with experimental group and hours to complete self-administration session as the factors.

156

Results

COC and MPH intake increases over time. Each self-administration session was six hours in length and consisted of 40 injections per session. Time to complete 40 injections of COC (n = 8) significantly decreased over the five sessions (F (4, 7) = 8.858, p < 0.01,)

(Fig. 1A, Top). In addition, the inter-infusion interval was also significantly decreased across sessions, demonstrating an escalation in rate of intake over sessions (F (4, 7) =

8.180, p < 0.01).

MPH self-administration resulted in nearly identical changes in behavior. MPH self-administration (n = 11) engendered an increase in rate of lever pressing over self-

administration sessions (F (4, 10) = 7.956, p < 0.01) (Fig. 1A, Bottom). The same trend

was observed with inter-infusion interval, demonstrating that the rate of intake also

escalates across MPH self-administration sessions (F (4, 10) = 7.041, p < 0.01).

Thus, the effects of MPH (n = 11) and COC (n = 8) self-administration on

behavioral responding for drug were not significantly different as the two compounds

produced the same inter-dose intervals and the same escalation (decreases in time to

complete sessions) over days (Fig. 1B).

Opposite effect of MPH and COC self-administration on baseline DA system kinetics.

Baseline DA system kinetics were measured using FSCV and DAT levels were

determined using western blot hybridization. COC self-administration (n=11)

engendered a decrease in electrically stimulated DA release as compared to naïve control 157

158

Figure 1. Escalation in rate of cocaine (COC) and methylphenidate (MPH) self- administration. (A) Representative self-administration plots from individual animals; each tick mark represents an infusion that was obtained. Five sessions with a maximum of 40 injections of either COC (1.5 mg/kg/inj) or MPH (0.56 mg/kg/inj) resulted in significant increases in rate of intake in over sessions. (B) The increase in rate of intake of was not significantly different between COC (•) and MPH (•).

159

animals (n=22) (t31 = 2.348, p < 0.05, Fig. 2A, Center; Fig. 2B). Also, after COC self-

administration there was a significant decrease in maximal rate of DA uptake (t30 = 2.719, p < 0.05) (Fig. 2A, Center; Fig. 2C). This decrease in maximal rate of uptake was accompanied by a decrease in DAT density in the COC group (n=5) compared to controls

(n=3), as measured by western blot hybridization (t6 = 2.182, p < 0.05) (Fig. 3A, Center;

Fig. 3B). Relative expression levels of DAT mRNA as measured by quantitative PCR in

the VTA (n = 12) were not significantly different from controls (n = 18).

Conversely, MPH self-administration resulted in increases in all DA system measurements. Stimulated DA release in the MPH group (n = 11) was increased compared to controls (n = 22) (t31= 2.076, p < 0.05) (Fig. 2A, Right; Fig. 2B). Maximal rate of DA uptake was also significantly increased in MPH (n = 7) versus control animals

(n = 22) (t24 = 2.719, p < 0.05) (Fig. 2A, Right; Fig. 2B). Total DAT levels were

significantly increased following MPH self-administration (n = 4) compared to controls

(n = 5) (t7 = 3.532, p < 0.01) (Fig. 3A, Right; Fig. 3B). In addition, DAT mRNA levels

were assessed in the VTA. MPH group levels (n = 18) were not significantly different

than control animals (n = 18), suggesting that the increases in protein expression are not

due to increased synthesis of new protein.

Differential Effects of COC and MPH SA on Tissue Content of DA and Metabolites.

Post mortem tissue content of DA and its metabolites DOPAC and HVA were assessed in

the striatum following COC and MPH SA (Fig. 4A). COC SA (n = 5) had no effect on

DA or any of its metabolites as compared to controls (n = 6) (Fig. 4A). MPH SA (n = 9) 160

Figure 2. Baseline dopamine (DA) system kinetics following methylphenidate (MPH) and cocaine (COC) self-administration. (A) Representative traces of electrically- evoked DA signals in nucleus accumbens core slices from control, MPH self- administration or COC self-administration animals. Traces show decreased maximal rate of uptake (rate of return to baseline) and DA release (peak height max) following COC self-administration and increased uptake and release following MPH self-administration.

Insets: Background-subtracted cyclic voltammograms indicate signal is DA. (B)

Grouped data showing that stimulated DA release is reduced after COC self- administration and increased after MPH self-administration. (C) Grouped data showing that the maximal rate of DA uptake was decreased after COC self-administration and increased after MPH self-administration. *p < 0.05 versus control animals.

161

resulted in a significant decrease in DA tissue content as compared to control animals (n

= 6) (t13 = 3.598, p < 0.01) (Fig 4A). While DA tissue content was significantly decreased, there was no significant difference between control and MPH SA in the metabolites HVA or DOPAC (Fig. 4A).

Metabolite to monoamine ratios were assessed in the striatum to determine changes in functional activity of the DA neurons in this region (Fig. 4B). COC SA (n =

5) did not produce significant differences in either DOPAC/DA or HVA/DA ratios as compared to controls (n = 6) (Fig. 4B). MPH SA (n = 9) resulted in a significant increase in the DOPAC/DA ratio as compared to control animals (n = 6) (t13 = 2.852, p < 0.01), and although not significant, there was a trend towards an increased HVA/DA ratio (t13 =

2.144, p = 0.0515) (Fig. 4B).

No effect of MPH or COC SA on Tyrosine Hydroxylase Protein, mRNA, or

Phosphorylation Levels. To determine if changes in stimulated DA release could be due to differences in TH, mRNA levels of TH were assessed in the VTA of COC and MPH groups using quantitative PCR. COC SA (n = 18) resulted in a significant increase in TH mRNA levels as compared to controls (n = 12) (t28 = 5.704, p < 0.0001) (Fig 5A). MPH

SA (n=18) also significantly increased levels of TH mRNA in the VTA versus controls (n

= 18) (t34 = 2.480, p < 0.05) (Fig 5A), although the levels were higher in COC (n = 12) than MPH groups (n = 18) (t28 = 4.475, p < 0.0001) (Fig. 5A). However, this difference was not reflected in protein levels (see below; Fig. 5 B, C, D), highlighting the well known complex translational regulation of this protein (Tank et al., 2008). 162

Figure 3. Western blot hybridization for the dopamine transporter (DAT) after

cocaine (COC) or methylphenidate (MPH) self-administration. (A) Representative photographs of Western blots on tissue from the nucleus accumbens core region of control, COC self-administration, and MPH self-administration groups. (B) COC self- administration reduced DAT levels while MPH self-administration increased DAT levels in the nucleus accumbens. Protein expression levels were determined as the ratio of DAT to the level of β-actin and are reported as percent control values. *p < 0.05 versus control group. 163

164

Figure 4. Tissue content of dopamine (DA) and metabolites (A) in the striatum of

cocaine (COC) and methylphenidate (MPH) self-administration groups. The MPH

group had significantly lower DA tissue content levels with no differences in metabolite

levels. Tissue content levels of DA and metabolites were unaffected by COC self- administration. (B) Metabolite/monoamine ratios, a measure of functional activity, in

MPH and COC groups as compared to controls. COC self-administration did not affect ratios, while MPH increased DOPAC/DA ratio. *p < 0.05 versus control group.

165

166

Figure 5. Quantification of tyrosine hydroxylase (TH) mRNA levels, protein levels,

and phosphorylation by western blot hybridization and quantitative PCR. (A) TH

mRNA expression levels in the ventral tegmental area (VTA) of methylphenidate (MPH)

and cocaine (COC) self-administering rats. TH mRNA levels were significantly increased

in both groups as compared to controls. The COC group had significantly higher

expression levels as compared to the MPH group. TH mRNA levels were normalized to

phosphogycerlate kinase 1 (PGK-1) and expressed as a percent of control group. (B)

Representative western blot images for total TH and two phosphorylation sites (Serine

19, 40) in the striatum (left) and VTA (right). (C) There were no differences in TH or its

phosphorylation sites in the striatum or (D) VTA in any of the groups tested. Protein levels were determined as the ratio of DAT to the level of GAPDH and are reported as percent control values. *** p < 0.001 versus control group, # p < 0.0001 versus MPH group.

167

TH protein levels as well as two phosphorylation sites were quantified via western

blot hybridization (Fig 5B). COC SA (n = 5) did not change total TH levels or

phosphorylation at either serine 40 (THp Ser40) or 19 (THp Ser19) in the striatum (Fig.

5B, left; 5C) or VTA (Fig. 5B right; 5D) as compared to controls (n = 6). Serine 31 was

not quantifiable in any samples. Similarly, MPH SA (n = 7) also resulted in no changes

in TH, THp Ser40, or THp Ser19, in either the striatum (Fig. 5B, left; 5C) or the VTA

(Fig. 5B; 5D) as compared to controls (n = 6).

MPH self-administration resulted in increased MPH potency, while COC potency

remained unchanged. Cumulative dose-response curves of COC and MPH were collected to determine changes in the compounds’ ability to inhibit DA uptake following

MPH self-administration. The Michaelis-Menten measure of DA affinity for the transporter, apparent Km, was used to measure changes in the ability of a drug to inhibit

DA uptake relative to baseline. Following MPH self-administration (n = 4), there was a

significant main effect of MPH treatment as compared to controls (n = 4) (F (4, 1) = 23.74,

p < 0.001), with significant increases in the maximal apparent Km of MPH self- administration groups at 30uM (p < 0.001) (Fig. 6D). MPH self-administration resulted in a leftward shift in the dose-response curve, indicating that MPH potency is increased following MPH self-administration.

Cumulative COC dose response curves were performed to determine if there was a shift in the potency of COC following MPH self-administration. There was no change in the dose response curve for COC (n = 3) as compared to controls (n = 3), indicating 168

that COC’s ability to inhibit DA uptake in the nucleus accumbens core remained

unchanged after MPH self-administration (Fig. 6E).

COC self-administration resulted in decreased COC potency, while MPH potency

remained unchanged. COC self-administration resulted in an overall group effect (F (4, 1)

= 13.85, p < 0.01) and a rightward shift in the dose response curve for COC (n = 3) as

compared to controls (n = 4), signifying a significant decrease in COC-induced DA uptake inhibition (Fig. 7E). Bonferroni analysis demonstrated a significant effect at

30uM (p < 0.001).

Conversely, following 5 days of COC self-administration, there was no significant change in MPH’s DA uptake-inhibiting effects (Fig. 7D), indicating that MPH (n = 5) potency remained unaltered as compared to controls (n = 3) following repeated administration of COC.

Discussion

MPH and COC are both DAT inhibitors and produce similar acute DA-elevating effects. Despite the close similarities in self-administration behavior, the current study demonstrates that MPH and COC intake can produce strikingly different effects on DA system kinetics and drug potency. Consistent with previous studies, 5 days of high-dose

COC self-administration resulted in decreased DAT density, maximal rate of uptake

(Vmax), and stimulated DA release (Mateo et al., 2005; Ferris et al., 2011). In contrast, 169

170

Figure 6. Significantly greater dopamine (DA) uptake inhibition by

methylphenidate (MPH), but not cocaine (COC), after MPH self-administration.

The effect of COC and MPH applied to nucleus accumbens core slices on representative

electrically-evoked (one pulse) DA signals is shown in (A) Pre-drug (B) 10µM MPH and

(C) 10 µM COC from control and MPH self-administering rats. Representative plots are shown as percent peak height; control and MPH self-administration animals are overlaid.

MPH-induced DA uptake inhibition is present in naive animals but significantly increased in MPH self-administering rats as depicted by a longer time course of the signal to return to baseline; there is no effect of MPH self-administration on COC uptake inhibition. Group data showed that MPH inhibited DA uptake to a greater extent (D), and that COC uptake is unaffected (E) following 5 days of MPH self-administration (•) compared with control rats (•),with uptake inhibition measured as apparent Km (***p <

.001 171

172

Figure 7. Significant reduction in dopamine (DA) uptake inhibition by cocaine

(COC), but not methylphenidate (MPH), after COC self-administration. The effect of COC and MPH on representative electrically evoked (one pulse) DA signals in nucleus accumbens core slices is shown. (A) Pre-drug (B) 10µM MPH and (C) 10 µM COC from control and cocaine self-administering rats. Representative plots are represented as percent peak height; control and COC self-administration animals are overlaid. COC- induced DA uptake inhibition is significantly reduced in cocaine self-administering rats as evidenced by a shorter time course of the signal’s return to baseline; there is no effect of COC self-administration on MPH uptake inhibition. Group data showed that MPH uptake is unaffected (D) but DA uptake inhibition by COC is reduced (E) following 5 days of COC self-administration (•) compared with control rats (•), measured as apparent

Km (***p < .001).

173

MPH self-administration increased DAT density, Vmax, and stimulated DA

release. In addition to robust differences in baseline DA nerve-terminal kinetics, COC self-administration resulted in a decreased potency of COC to inhibit DA uptake, with no

change in potency of MPH. Conversely, MPH self-administration resulted in increased potency of MPH and no change in COC potency. Overall, COC self-administration seems to result in sub-sensitive DA terminals while MPH self-administration produces super-sensitive terminals. These profound differences in the neurobiological effects of two DA uptake inhibitors provide evidence that the DA-elevating effects of psychostimulants are not solely, or even primarily, responsible for altered DA system function after repeated exposure.

The goal of this study was to compare DA system alterations that occurred following 5 days of COC or MPH self-administration. One challenge was to select comparable doses of these two drugs with different time courses and binding affinities.

The doses we chose for MPH (0.56 mg/kg) and COC (1.5 mg/kg) are at the peak of the respective PR dose response curves, indicating that these are the maximally reinforcing dose of each drug. The selected doses of these two drugs produced similar inter-injection intervals within a session and produced escalation in rates of intake across sessions, indicating that these doses are behaviorally equivalent. Therefore, although there are differences in half-life and potency, we were able to equate the behavioral responses to these drugs in order to accurately compare the neurochemical consequences of MPH and

COC self-administration. 174

Despite almost identical behavioral profiles, baseline changes in maximal DA

uptake rate (Vmax) and stimulated DA release following MPH and COC self- administration were found to be opposite. COC self-administration resulted in a decreased Vmax and decreased stimulated release, effects that have been observed

previously with the same paradigm (Ferris et al., 2011). DAT density was found to be decreased following COC self-administration, suggesting that the observed decrease in uptake rate was due to reduced numbers of DA transporters. The alterations in DAT density following self-administration are most likely due to differences in protein processing as there were no observed changes in mRNA levels in COC or MPH self- administration groups. In the literature, there are reports of increased, decreased and unaltered DA uptake rates following COC self-administration (Ferris et al., 2011;

Ramamoorthy et al., 2010; Mateo et al., 2005; Wilson and Kish, 1996), and clearly, different self-administration paradigms produce different neurobiological effects, emphasizing the need for equating doses as well as injection frequency, timing and duration. Self-administration of MPH resulted in an increase in Vmax and DAT density as

well as an increase in stimulated DA release in the nucleus accumbens core,

demonstrating that two drugs which cause identical self-administration behavior are

capable of causing opposite neurobiological adaptations.

To address the differences in stimulated DA release between COC and MPH

groups, various markers of presynaptic function were evaluated. DA tissue content was

found to be decreased in the MPH group, with corresponding increases in metabolite/DA

ratios, indicating increased functional activity, consistent with the increased DA release

in this group. No changes were found in the COC group. A number of factors could be 175

responsible for the observed difference between COC and MPH, for example, MPH has

been shown to redistribute vesicular DA pools (Volz et al., 2008) and may alter both

release and tissue content directly. Also, MPH has a longer half-life of uptake inhibition than COC, which in combination with the increased release and ability to mobilize DA vesicles, could lead to a reduced ability to refill vesicular stores and explain the difference in tissue content between the two groups. These findings further emphasize the differential impact of these two psychostimulant blockers on the DA system.

We initially postulated that the MPH-induced DA release and tissue content changes might be explained by alterations in TH, the rate-limiting enzyme in DA synthesis, but no differences were found in protein or phosphorylation levels, indicating that TH is most likely not driving the changes. There were, however, increases in TH mRNA levels in both self-administration groups, indicating that either post-translational processing or protein degradation may be altered.

With regard to the interaction of stimulants with the DAT, previous work found reduced pharmacological effects of COC in the nucleus accumbens after high-dose COC self-administration (Hurd et al., 1989; Mateo et al., 2005; Ferris et al., 2011). In order to determine if the effects of COC self-administration were unique to cocaine or common to all psychostimulants, Ferris et al. (2011) determined that the effects of amphetamine

(AMPH) on DA uptake in nucleus accumbens core slices remained unchanged following

COC self-administration. The same study also showed that self-administration of AMPH had no effect on either COC or AMPH potency in slices, suggesting that COC self- administration produced COC-specific pharmacological changes. We hypothesized that 176

AMPH did not alter the pharmacology of the DAT because it was recognized as a

substrate/releaser, while COC, a pure uptake blocker, induced allosteric modifications

resulting in altered pharmacology. Next, it was reasonable to test whether self-

administration of a structurally dissimilar uptake inhibitor, MPH, would also produce

altered DAT pharmacology. The current results demonstrate that MPH self-

administration produces opposite effects from COC self-administration, with increased

MPH potency on slices but no change in COC effects. Thus, it appears that DAT pharmacology is altered according to individual drug interactions with the DAT and not according to drug class, such as blocker or releaser.

While MPH and COC are both classified as uptake blockers, they have different chemical structures, which may account for the disparate neurochemical changes that occur following self-administration. MPH is structurally related to amphetamine, while

COC is a tropane (Uhl et al., 2002; Volkow et al, 2002; Heal et al, 2009; Han & Gu

2006). MPH, although typically categorized as a DAT blocker, has unique properties

that are distinct from both releasers and blockers. Studies using cell culture and striatal

tissue preparations have shown that MPH exhibits binding properties of both blockers

and releasers (Dar et al, 2005; Wayment et al, 1999). MPH is not a DAT substrate, as it

is not transported into cells (Sonders et al, 1997); however, some studies have shown that

MPH has the ability to promote reverse-transport of DA through the DAT at very high

doses (Sproson et al, 2001; Russell et al, 1998; Heal et al, 1996). It is clear that DAT

inhibition-induced increases in extracellular DA levels do not explain the distinct

adaptations produced by the two drugs studied here, and we hypothesize that drug

interactions with specific regions of the DAT may explain the differences observed. 177

Changes in DAT density and Vmax do not explain the potency changes found with

MPH and COC. With regard to COC self-administration, in the present study we show decreases in DAT protein levels and Vmax for DA uptake after COC self-administration.

However, in previous studies with COC self-administration, Vmax was either increased or

unchanged, with the same reduction in potency for DA uptake inhibition in slices (Mateo

et al., 2005; Ferris et al., 2011). With regard to MPH self-administration, to our

knowledge this is the first study examining neurochemical changes and thus we cannot

compare to other regimens; however, the Michaelis-Menten based kinetic model used to

fit the DA release and uptake profiles takes into account any changes in baseline uptake

rate using the pre-drug electrically stimulated DA overflow curves, and this allows the

effects of uptake inhibition to be separated from changes in maximal uptake rate. This

indicates that the maximal DA uptake rate (Vmax), which is correlated with DA

transporter number, cannot account for the observed alterations in DA uptake inhibition

by both COC and MPH. Thus, these effects are most likely due to allosteric alterations in

the DA transporter, making it more or less sensitive to inhibition by specific drugs.

These DA system alterations induced by self-administration of COC or MPH have important implications for the subsequent abuse or co-abuse of other psychostimulants. MPH and COC are dependent upon their actions at the DAT for their reinforcing effects, and changes that occur to the DA system would be expected to affect the reinforcing potency or efficacy of other psychostimulant drugs (Chen et al, 2005,

2006; Tilley et al, 2008 a, b). Because psychostimulants that are DA releasers rely on

DATs to have their reverse-transport effects, the present results from MPH self- administering animals would predict greater behavioral potency. Consistent with this 178

prediction, previous studies have already demonstrated that MPH self-administration, as well as increasing DAT levels by transgenic overexpression, results in increased AMPH- induced locomotor activity (Burton et al., 2010; Salahpour et al., 2008; Yang et al.,

2003). In addition, epidemiological studies have provided evidence that individuals who abuse MPH are more likely to abuse other substances and to have problems with drug use

(Barrett et al, 2005; Teter et al, 2006; Wilens et al, 2008). Given the widespread abuse of

MPH and the potential risk for greater stimulant effects of other drugs, further studies of the consequences of MPH self-administration will be important.

Acknowledgements

This work was funded by NIH grants R01DA024095, RO1DA03016 (SRJ),

R01DA014030 (DCSR), T32DA007246 (MJF), Institutional NRSA T32DA007246 and

Individual NRSA F31 DA031533 (ESC), and a Canadian Institutes of Health Research

(CIHR) grant (AS).

179

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CHAPTER VI

METHYLPHENIDATE AMPLIFIES THE POTENCY AND REINFORCING EFFECTS OF AMPHETAMINES BY INCREASING DOPAMINE TRASNPORTER EXPRESSION

Erin S. Calipari, Mark J. Ferris, Ali Salahpour, Marc G. Caron and Sara. R. Jones

The following manuscript was published in Nature Communications, in press, 2013, and is reprinted with permission. Stylistic variations are due to the requirements of the journal. Erin S. Calipari performed the experiments and prepared the manuscript and Drs. Mark J. Ferris, Ali Salahpour, and Sara R. Jones acted in an advisory and editorial capacity. 185

Methylphenidate (MPH) is commonly diverted for non-clinical use, but the

neurobiological consequences of exposure to MPH at high doses are not well defined.

Here we show that MPH self-administration increases dopamine transporter (DAT)

levels, driving enhanced potency and drug-seeking for MPH and amphetamine (AMPH),

without altering cocaine potency. To corroborate these effects, genetic over-expression of

the DAT increased AMPH and MPH potencies, but not cocaine potency, suggesting that

individuals with elevated DAT levels, such as ADHD sufferers, may be more susceptible

to the addictive effects of amphetamine-like drugs.

Methylphenidate (MPH), the active compound in Ritalin®, is commonly used off-

label, with up to 17% of college students reporting abusing MPH, alone and in

combination with other stimulants, for its cognitive enhancing or euphoric effects1. MPH is taken orally, intranasally or intravenously, and is one of the prescribed drugs most diverted onto the illicit market worldwide2. There are a limited number of studies of

MPH self-administration in rats, and little is known about the neurobiological

consequences of exposure to high doses. While comparable cocaine self-administration

paradigms have produced marked tolerance to cocaine’s effects3, here we show

sensitizing effects of MPH. These experiments reveal a mechanism whereby increased

DAT levels drive enhanced potency and motivation to administer MPH and dopamine

(DA) releaser drugs such as AMPH. One implication of these findings is that individual

variations in DAT levels (e.g. ADHD sufferers4) may predict susceptibility to abuse of

compounds such as MPH, AMPH and methamphetamine.

Rats self-administered MPH (0.56 mg/kg/infusion, i.v.) on a fixed-ratio one

schedule for five days. This resulted in escalation of first-hour intake (F (4, 10) = 20.00, p 186

< 0.001) as well as overall rate of intake (F (4, 10) = 7.956, p < 0.001; Fig 1 A, B). To

examine the motivation to administer MPH, we measured reinforcing efficacy using a

progressive ratio paradigm and found an increase in breakpoint (t12 = 2.068, p < 0.05; Fig

1 C) following MPH self-administration. The reinforcing and rewarding effects of many

drugs of abuse are related to their ability to elevate DA in the nucleus accumbens (NAc)

5. While the NAc shell is involved in the acute rewarding effects of drugs and acquisition

of self-administration, the NAc core plays a critical role in cue-reward learning as well as continued responding for drugs after repeated administration as in the current paradigm6.

We found DA uptake in the NAc core to be supersensitive to MPH inhibition following

MPH self-administration (F (1, 9) = 25.11, p < 0.05; Fig 1 D, E). The proposed mechanism

for augmented MPH potency is increased DAT levels, which has been suggested to

modulate the potency of DA releasers, although not MPH 7. After MPH self- administration, the maximal rate of DA uptake was increased (Vmax; t60 = 2.719, p < 0.01)

(Fig 1 G, H), due to increased total DAT levels8.

To further understand the impact of MPH self-administration on psychostimulant

potencies, we examined a number of DAT blockers and DA releasers. We found that

MPH self-administration had no effect on blocker potency, but enhanced the potency of

releasers. Thus, the ability of the blockers cocaine (Fig 2 A, B) and nomifensine (Sup.

Fig 1 C, D) to inhibit DA uptake was unaffected by MPH self-administration. In

contrast, the potency of AMPH (F (1, 4) = 76.81, p < 0.001; Fig 2 D, E) and methamphetamine (F (1, 10) = 33.51, p < 0.001; Sup. Fig 2 A, B) was increased. Given the 187

188

Figure 1. Methylphenidate (MPH) is self-administered, increases dopamine uptake

(Vmax), and MPH potency. A, Event record from a representative animal. B, increased

rate of responding for MPH on a fixed ratio 1 schedule. Session 1 refers to the first

session following acquisition. C, progressive ratio responding for MPH in minimally trained (CTRL; black) and MPH self-administration (SA; red) animals. D, E, increased ability of MPH to inhibit the dopamine transporter (DAT) following MPH SA. F, dose- response curve using the threshold SA procedure in MPH SA and CTRL to assess motivation to administer MPH. G, H, I, increased Vmax and stimulated dopamine release

([DA]/pulse) following MPH SA. *p < 0.05 189

190

Figure 2. Methylphenidate (MPH) self-administration (SA) increases the potency

and motivation to administer releasers, but not blockers. A, B, the ability of cocaine

(COC) to inhibit the dopamine transporter (DAT) following MPH SA is unchanged. C,

motivation to administer cocaine is unchanged following MPH. D, E, increased AMPH potency, and motivation to administer AMPH (F) following MPH SA. ***p < 0.001,

**p < 0.01, *p < 0.05

191

enhanced potency of DA releasers, it is possible that these compounds will have

increased abuse liability following MPH abuse in the human population.

Therefore, motivation to take drugs was measured using a “threshold” procedure to

determine the maximal price (Pmax) an animal is willing to pay to receive drug. After a

history of MPH self-administration, there was increased responding (F (1, 13) = 35.16, p <

0.001; Fig 1F) and Pmax for MPH (t14 = 2.196, p < 0.05; Sup. Fig 2 A) and AMPH

(responding, F (1, 11) = 51.60, p < 0.001; Fig 2 F; Pmax, t10 = 3.136, p < 0.01; Sup. Fig 2 B),

but not cocaine (Fig 2 C; Sup. Fig 2 C). This shows that the increased potency of MPH

and AMPH correlates with increased drug-seeking behavior.

We hypothesized that the drug class-specific increase in releaser potency was due

to increased DAT levels. To test this hypothesis we used DAT over-expressing mice

(DAT-tg), which have increased levels of native, non-drug altered DAT7, and increased

Vmax (t31 = 3.787, p < 0.001; Fig 3 A, B). In DAT-Tg mice, there was an increased ability

of MPH (F (1, 9) = 21.44, p < 0.001; Fig 3 D), and AMPH (F (1, 9) = 16.05, p < 0.001; Fig 3

E), but not cocaine (Fig 3 F), to inhibit DA uptake. Further, DAT-tg animals showed increased MPH- (F (1, 10) = 4.093, p < 0.05; Fig 3 G) and AMPH- (F (1, 12) = 9.934, p <

0.01; Fig 3 H), but not cocaine- (Fig 3 I) induced locomotion.

Increased potency of releasers and MPH in the presence of high Vmax/DAT levels

may be important in clinical treatment settings, as individuals with ADHD have well-

documented increases in DAT levels ranging from 17-70%4. These findings may explain

in part the high frequency of drug abuse in untreated ADHD sufferers9, and these

individuals may be more susceptible to the neurochemical, behavioral, and neurotoxic

effects of MPH, AMPH and other releasers like methamphetamine and “bath salts”. 192

193

Figure 3. Overexpression of the dopamine transporter (DAT) increases the behavioral and neurochemical potency of methylphenidate (MPH) and releasers. A,

B, C increased rate of dopamine uptake (Vmax) and increased stimulated dopamine release

([DA]/pulse) in DAT overexpressing mice (DAT-tg; blue) relative to wild-type (WT; green). D, E, F, concentration-response curves for MPH, cocaine, and amphetamine

(AMPH) for inhibiting DA uptake. Enhanced locomotor activating effects of MPH (G) and AMPH (H), but not cocaine (I), in DAT-tg mice. ***p < 0.001, *p < 0.05

194

Acknowledgements: This work was funded by NIH grants R01 DA021325, R01

DA030161 (SRJ), R01 DA014030 (DCSR), P50 DA06634 (SRJ & DCSR), K99

DA031791 (MJF), T32 DA007246 and F31 DA031533 (ESC).

195

References:

1. Teter CJ, McCabe SE, LaGrange K, Cranford JA, Boyd CJ. Illicit use of specific prescription stimulants among college students: prevalence, motives, and routes of administration. Pharmacotherapy 2,1501-10 (2006)

2. Frauger E, Moracchini C, Le Boisselier R, Braunstein D, Thirion X, Micallef J. OPPIDUM surveillance program: 20 years of information on drug abuse in France. Fundam Clin Pharmacol. In press (2013)

3. Ferris MJ, Calipari ES, Mateo Y, Melchior JR, Roberts DC, Jones SR. Cocaine self- administration produces pharmacodynamic tolerance: differential effects on the potency of dopamine transporter blockers, releasers, and methylphenidate. Neuropsychopharmacology 37,1708-16 (2012)

4. Madras BK, Miller GM, Fischman AJ. The dopamine transporter and attention- deficit/hyperactivity disorder. Biol Psychiatry. 57, 1397-409 (2005)

5. Di Chiara G, Imperato A. Drugs abused by humans preferentially increase synaptic dopamine concentrations in the mesolimbic system of freely moving rats. Proc Natl Acad Sci USA 85, 5274-8 (1988)

6. Di Chiara G. Nucleus accumbens shell and core dopamine: differential role in behavior and addiction. Behav Brain Res 137, 75-114 (2002)

7. Salahpour A. et al. Increased amphetamine-induced hyperactivity and reward in mice overexpressing the dopamine transporter. Proc Natl Acad Sci USA 105, 4405- 10 (2008)

8. Calipari ES et al. Methylphenidate and cocaine self-administration produce distinct dopamine terminal alterations. Addict Biol. In Press (2012)

9. Biederman J, Wilens T, Mick E, Spencer T, Faraone SV. Pharmacotherapy of attention-deficit/hyperactivity disorder reduces risk for substance use disorder. Pediatrics 104, e20 (1999) 196

Supplementary Methodology:

Animals: Male Sprague-Dawley rats (375–400 g; Harlan Laboratories, Frederick,

Maryland) were used for all self-administration experiments. DAT over-expressing mice

were used for locomotor analysis and voltammetry. Animals were maintained according

to the National Institutes of Health guidelines in Association for Assessment and

Accreditation of Laboratory Animal Care accredited facilities on a 12:12 hour light-dark

cycle with food and water ad libitum. The experimental protocol was approved by the

Institutional Animal Care and Use Committee at Wake Forest School of Medicine. All

animals were randomly assigned to experimental groups. There was no blinding done in

the current study.

Self-Administration: Rats were anesthetized and implanted with chronic

indwelling jugular catheters. Following surgery, animals were singly housed, and all

sessions took place in the home cage during the active/dark cycle (9:00 am–3:00 pm).

All animals underwent a training paradigm where they were given access to a

methylphenidate (MPH)-paired lever on a fixed ratio one (FR1) schedule. Training

sessions were terminated after a maximum of 20 infusions or 6h, whichever occurred

first. Acquisition occurred when an animal responded for 20 injections for two

consecutive days. Typically, animals acquired a stable pattern of MPH SA within 1 to 5 days. A small percentage of animals did not acquire self-administration behavior, but this is typical of self-administration studies. We did not consider non-acquiring animals

as being part of this study. Control animals for progressive ratio (PR) and threshold (TH)

self-administration experiments underwent the training paradigm, and then were 197

immediately switched to PR or TH tests of reinforcing efficacy. We have confirmed that the control group (2x20 MPH) is not neurochemically different from naïve controls.

Treatment animals underwent five consecutive days of MPH self-administration.

Sessions were six hours long and were terminated after the animal responded for 40 injections of drug or at the end of the session. The dose of 0.56 mg/kg/injection MPH was chosen because it was the dose that produced maximal responding on a dose response curve measuring reinforcing efficacy. It is important to note that this method is different from previously described extended-access paradigms as animals do not escalate in total intake as the injection limit (40 inj per day) was set in order to eliminate variability in total consumption of cocaine.

Progressive Ratio Procedure: Response requirements were increased through the following ratio progression: 1, 2, 4, 6, 9, 12, 15, 20, 25, 32, 40, 50, 62, 77, 95, 118, 145, etc. Breakpoints were defined as the number of completed ratios before 1 h elapsed without completion of the next ratio. Data from the MPH SA group was compared to a control group (2 days, 20 injections). Differences between groups cannot be due to differences in task learning or experience, as there was no difference in the cocaine TH task, indicating that there was not an overall increase in task performance with longer experience.

Threshold Procedure: In order to determine the reinforcing efficacy of psychostimulants, subjects underwent a within-session threshold procedure. We switched from a progressive ratio procedure because the threshold procedure can assess both drug taking

(seen in the early bins in the session where the dose is high) and drug seeking (seen near 198

the latter bins where the dose is low and the final bin where animals are responding for

saline).

Rats were given access to a descending series of 12 unit doses of cocaine, MPH,

or AMPH (421, 237, 133, 75, 41, 24, 13, 7.5, 4.1, 2.4, 1.3, and 0μg/injection) on an FR1

schedule during consecutive 10 or 15-min bins within a daily session. Because MPH and

AMPH are not metabolized as rapidly as cocaine, each bin was 15 minutes for those

compounds, while it was 10 min for cocaine. The lever was not retracted at any time

during the session. Doses were manipulated by holding the concentration constant and

adjusting the pump duration.

Oral Methylphenidate Administration: MPH was administered using an oral dosing

procedure in which subjects are readily trained, in less than 3 days, to voluntarily

consume MPH in a 5 ml volume of 10% sucrose. This procedure results in a

pharmacokinetic profile of MPH distribution close to that observed in humans. MPH was

administered twice daily (7:00 am and 2:00 pm) at a dose of 5 mg/kg for two weeks (14

days). This dosing regimen takes into account the fact that MPH metabolism is more

rapid in rats than in humans and yields blood serum levels near the upper end of the

therapeutic range observed in children (5-40 ng/ml).

In Vitro Voltammetry: Fast scan cyclic voltammetry was used to characterize DA system kinetics, as well as the ability of psychostimulants to inhibit DA uptake in the

NAc. In vitro voltammetry was chosen because it allows for the accurate assessment of psychostimulant potency by running within-subject concentration response curves for each drug. Voltammetry experiments were conducted during the dark phase of the light cycle, beginning 18 hours after commencement of the final SA or oral MPH session. A 199

carbon fiber electrode and a stimulating electrode were placed on the surface of the slice in close proximity to each other in the NAc. Endogenous DA release was evoked by a single electrical pulse (300 μA, 4 msec, monophasic) applied to the tissue every 5 minutes. Extracellular DA was recorded by applying a triangular waveform (−0.4 to +1.2

V). Once the extracellular DA response was stable for three consecutive stimulations, blockers (cocaine, nomifensine), MPH and releasers [AMPH and methamphetamine

(METH)] were applied to the brain slice. DA current was converted to concentration by electrode calibration with 3 μM DA at the end of each experiment.

DEMON voltammetry software was used for analysis. To evaluate the effects of drugs, evoked levels of DA were modeled using Michaelis–Menten kinetics, as a balance between release and uptake (Wightman et al, 1988). Michaelis–Menten modeling provides parameters that describe the amount of DA released following stimulation, the maximal rate of DA uptake (Vmax), and inhibition of the ability of DA to bind to the DAT, or apparent Km. For pre-drug modeling, we followed standard voltammetric modeling procedures by setting the apparent Km parameter to 160 nM based on the affinity of DA for the DAT, whereas baseline Vmax values were allowed to vary as the baseline measure of the rate of DA uptake. Following drug application, apparent Km was allowed to vary to account for changes in drug-induced DA uptake inhibition while the respective Vmax value determined for that subject at baseline was held constant. The apparent Km parameter models the amount of DA uptake inhibition following a particular dose of drug.

Locomotor Analysis: Locomotor activity was assessed in automated locomotor activity monitors (MedAscociates). Mice were placed into the activity monitor chamber (20 cm × 200

20 cm) for 60 min, then injected with saline or the drug in 0.1 ml total volume, returned

to the chamber, and monitored for 60 min after injection. Locomotor activity was

measured as horizontal distance covered as a percent of each animal’s saline baseline.

Dose response curves were run for each drug.

Microdialysis: Animals were anesthetized with ketamine/xylazine, placed in a

stereotaxic frame, and concentric microdialysis probes (2 mm (rat) or 1mm (mouse)

membrane length; cut off 6000 Daltons; CMA-11, CMA/Microdialysis, Solna, Sweden) were implanted into the NAc core in both rats and mice the day before recording.

Appropriate placement of probes was verified by histological examination after the experiments. For rats, microdialysis surgery was performed the day following the final session of MPH self-administration. Probes were perfused with artificial CSF at 1.0

µl/min. Samples were collected every 20 min and analyzed for DA by high-performance liquid chromatography (HPLC, Bionalytical Systems, Mt. Vernon, IN). Once stable baselines were established, the inlet line was switched to a syringe containing the same artificial CSF with AMPH (10µM), MPH (30µM), or cocaine (30µM).

HPLC: A 2 × 50 mm (3 µm particle) reverse-phase column (Luna, Phenomenex,

Torrance, CA) was used and the applied potential was +650 mV as referenced to an

Ag/AgCl electrode. The mobile phase (75 mM NaH2PO4, 1.7 mM 1-octanesulfonic acid

sodium salt, 100 µL/L triethylamine, 25 µM EDTA, 10% acetonitrile v/v, pH=3.0) was

pumped at a rate of 170 µL/min, with a detection limit for DA of 10 pM. DA

quantification was achieved by comparing dialysate samples with DA standards of

known concentration. 201

Statistics: Graph Pad Prism (version 5; La Jolla, CA) was used to analyze data sets and compose graphs. Baseline voltammetry, progressive-ratio, and Pmax data were compared

across groups using a two-tailed Student’s t-test. Data obtained from MPH SA/DAT-tg

animals were subjected to a two-way analysis of variance with experimental group and

concentration of drug as the factors. TH and locomotor data were subjected to a two-way

analysis of variance with experimental group and dose as the factors. When significant

interactions or main effects were obtained (p < .05), differences between groups were

tested using Bonferroni post hoc tests. Parametric statistics were used for all analysis.

Data met the assumptions of normality and the variance between groups was similar for

all experiments. Power analyses were utilized for every measure, with expected effect

sizes and standard deviations based on hundreds of previous experiments performed in

the laboratory and from published manuscripts from experts in the field. Exclusion of

data points only occurred if the points were significant outliers as determined by

statistical analysis.

202

Supplementary Material:

Supplementary Figure 1. Increased releaser, but not blocker, potency following methylphenidate (MPH) self-administration. A, B, the ability of methamphetamine

(METH), a releaser, to inhibit the dopamine transporter (DAT) is enhanced following

MPH self-administration. C, D, the potency of nomifensine, a DAT blocker, is unchanged following MPH self-administration. **p < 0.01, ***p < 0.001 203

Supplementary Figure 2. Methylphenidate (MPH) self-administration increases motivational effects of releasers and MPH, but not blockers. Panels A, B, C, demonstrate significantly higher maximal price paid (Pmax) for both MPH and amphetamine (AMPH), but not cocaine (COC) in MPH SA animals. ***p < 0.001, **p <

0.01, *p < 0.05 204

Supplementary Figure 3. Increased releaser and methylphenidate (MPH), but not

blocker-induced DA overflow following MPH self-administration and dopamine transporter (DAT) overexpression. A, B, C Group data showing enhanced MPH-,

amphetamine (AMPH)-, but not cocaine (COC)-, induced DA overflow in response to a local drug infusion into the nucleus accumbens in MPH self-administration animals. C,

D, E, Enhanced MPH-, amphetamine (AMPH)-, but not cocaine (COC)-, induced DA overflow in DAT-tg mice. 205

Supplementary Figure 4. Oral methylphenidate (MPH) administration does not affect DA kinetics or the potency of psychostimulants. A, B Group data from animals treated with oral MPH (5mg/kg, 2x daily; blue) as compared to controls (white), demonstrating no difference in dopamine system kinetics. Panels C, D, and E show the potency of cocaine, MPH, and amphetamine (AMPH) in controls (black) and animals that underwent oral MPH self-administration (blue).

206

Supplementary Discussion:

1. Methylphenidate (MPH) self-administration as a model of MPH abuse:

MPH abuse occurs at rates comparable to cocaine abuse in the United States;

however, there is a paucity of data outlining neurochemical consequences of MPH abuse.

A survey of recent drug use indicates that 4.8 million people reported abusing MPH,

which is similar to the 5.2 million for cocaine1. When taken via the same route of

administration, the subjective effects of MPH are indistinguishable from cocaine or

AMPH, two commonly abused and highly addictive drugs2-5. In order to determine the

neurochemical consequences of MPH abuse, we used MPH self-administration to

approximate human abuse. Traditional long-access paradigms of psychostimulant self- administration, including MPH, result in escalation of intake over sessions, which have

been suggested to model the switch from recreational use to abuse6. Because of the fixed

injection maximum, which we imposed to reduce variability in intake, animals do not

escalate in total intake. This makes this paradigm different more traditional long-access

models6, however, first hour intake is increased, which is a hallmark of traditional

escalation. Further, recent studies have demonstrated that the changes that occur in the

DA system following traditional long-access paradigms and the current model (5 days, 40

inj/day) do not differ7.

2. Changes in drug potency at the DAT are consistent with changes in drug-induced DA overflow in vivo.

The reported increase in drug potency for DA uptake inhibition for MPH and

releasers following MPH self-administration is accompanied by increases in drug-

induced DA overflow as measured using in vivo microdialysis. MPH (F (1, 5) = 20.80, p < 207

0.001; Supp Fig 3 A), and AMPH (F (1, 5) = 11.51, p < 0.0001; Supp Fig 3 B), but not

cocaine (Supp Fig 3 C), resulted increased drug-induced DA overflow in the NAc. This

confirms that the DAT inhibition changes correspond to similar changes in both DA

levels and reward/reinforcement-related behaviors.

We hypothesized that alterations in DAT levels/function could underlie the

psychostimulant potency changes that we observed following MPH self-administration.

Indeed, the changes seen in DAT-tg animals are similar to what was observed following

MPH self-administration, where DAT-tg mice had increased MPH- (F (1, 5) = 18.53 p <

0.001; Supp Fig 3 D) and AMPH- (F (1, 5) = 68.84, p < 0.001; Supp Fig 3 E), but not

cocaine- (Supp Fig 3 F), induced DA overflow in the NAc. Here we demonstrate that

increased MPH potency in the NAc core, increased MPH-induced DA overflow, and increased MPH-induced locomotion are associated with increased DAT levels. These changes are similar to AMPH potency changes and significantly different from cocaine potency changes, indicating that MPH shares some characteristics with releasers.

3. Oral Intake studies indicate that high (abused) and low (therapeutic) doses of MPH have different neurochemical consequences.

Varying the dose and route of administration of a drug can produce variable

effects, and here we demonstrate that oral administration of low, therapeutic doses and

i.v. administration of high, abuse-relevant doses have completely different neurochemical consequences. Data from our lab is consistent with published work 8, 9, and here MPH (5

mg/kg; 2xday) delivered orally for a period of 14 days resulted in no changes in DA

kinetics or psychostimulant potencies (Supp Fig 4). These data suggest that although

MPH could enhance the reinforcing efficacy of MPH and releasers when taken via non- 208

oral routes, and in larger doses than prescribed, the therapeutic use of MPH, taken as prescribed, does not result in any changes in psychostimulant potencies.

MPH has differential effects at high and low doses, which is likely due to the fact that low-dose MPH preferentially increases DA in the PFC, while higher doses increase

DA in both the PFC and nucleus accumbens10, 11. The selective increase in the PFC could be involved in the cognitive enhancing effects of MPH, but is likely independent of its reinforcing effects12. The lack of effects of MPH in striatal regions at therapeutic doses could explain the lack of effects of oral MPH administration on DA terminals and psychostimulant potencies measured here. Together these data further highlight the dissociation between the effects of therapeutic and abused doses of MPH.

Currently, there aren’t consistent findings in regards to prior MPH exposure on the propensity to abuse cocaine13-19. These data do provide important information indicating that prior MPH exposure does not increase the reinforcing efficacy of cocaine at either abuse relevant, or therapeutic dosing levels. Although high dose MPH exposure does increase the potency of releaser compounds, this study suggests that therapeutic

MPH use will not increase the likelihood of developing a cocaine abuse disorder. This is particularly relevant due to the large number of children that are prescribed MPH for therapeutic use. This is consistent with previous rodent work demonstrating that MPH administration during the peri-adolescent period does not influence cocaine reinforcement. Although this points to MPH being safe as it relates to cocaine abuse disorders, the propensity of individuals to have a substance use disorder may be significantly higher for other compounds.

209

4. MPH potency as it relates to blockers and releasers:

In this study MPH effects seem to resemble those of DA releasers, even though it

is traditionally categorized as a DAT blocker. A number of other studies have found

similar effects following cocaine self-administration as well as in regards to MPH

binding to the DAT20-23. It has been suggested that MPH can function as a releaser at

high doses24, 25. However, more recent studies using oocytes consistently classify MPH

as a blocker26. The distinction between blocker and releaser is important because the two

classes of psychostimulants have very different mechanisms of action. Blockers bind to

the DAT and inhibit DA uptake. Releasers have at least two main mechanisms: 1) they compete as a substrate for the DA binding site 2) are transported into the cell and into vesicles where they cause DA to be translocated into the cytoplasm and promote release via DAT-mediated reverse transport. MPH, an AMPH analog that is categorized as a

DAT blocker, is unique since it is not transported into cells26 but has been shown to

promote reverse transport of DA at high doses24, 25. These release capabilities,

independent of being transported into the cell, could be due to a number of factors. 1)

MPH binds to the DAT in a manner that is distinct from either prototypical blockers or

releasers20, 21, with significant overlap between the binding sites for both cocaine and

AMPH. It is possible that although MPH is not transported into the cell that the

interaction with the AMPH site results in conformational changes in the DAT which

promote reverse transport in the same way as AMPH. 2) MPH has been demonstrated to

result in the mobilization of vesicles into the releasable pool. It is possible that this effect

of MPH is dependent on the DAT, thus when there are increased DAT levels, MPH is

better able to induce exocytotic release from vesicles. 210

Although not a traditional releaser, MPH effects have been demonstrated

previously to be similar to releasers. Ferris et al., (2012) demonstrated that cocaine self-

administration resulted in tolerance to the ability of all blockers to inhibit the DAT22.

However, MPH and all releasers tested were unaffected by cocaine self-administration.

Although MPH is categorized with releasers in this study and following cocaine self-

administration, the effects of MPH self-administration are different from self-

administration of AMPH. AMPH self-administration resulted in no changes in drug

potency22. Here MPH self-administration causes neuroadaptations that are different from both cocaine and AMPH self-administration, further demonstrating that it is unique. The similarities of MPH to AMPH could be due to the unique functional properties of MPH.

As mentioned previously, MPH has been shown to promote reverse transport of DA at high concentrations24, 25, thus it is possible, although it is not transported into the cell, that

MPH is releasing DA in a DAT-dependent fashion and its ability to increase DA is elevated when there are elevated transporter levels.

5. DAT cell surface expression as it relates to psychostimulant potency:

To confirm that the changes in drug potency were due directly to changes in DAT levels,

we correlated our measure of uptake inhibition (app. Km) with a functional measure of

DAT levels (Vmax). Correlation analysis of data from both MPH SA and DAT-tg show

that DAT levels are positively correlated with potency measurements for AMPH (MPH

SA: r = 0.73, p < 0.05; DAT-tg: r = 0.93, p < 0.001), MPH (MPH SA: r = 0.88, p < 0.001;

DAT-tg: r = 0.92, p < 0.001), and cocaine (MPH SA: r = 0.54, ns; DAT-tg: r = 0.84, p <

0.01). Although there was a positive correlation between uptake rates and cocaine 211

potency, the shift in cocaine potency across increasing Vmax was substantially less robust

than MPH and AMPH. Indeed, the slope of the regression line (cocaine, MPH SA: β =

1.54 ± 0.37; DAT-tg: β = 0.8289 ± 1.1) was significantly attenuated relative to both MPH

(MPH SA: β = 11.14 ± 1.59; DAT-tg: β = 7.756 ± 1.467, vs. cocaine: p < 0.0001) and

AMPH (β = 8.90 ± 1.38; DAT-tg: β = 7.714 ± 3.716, vs. cocaine p < 0.0001), and not

significantly different than a slope of zero for both MPH SA and DAT-tg animals.

Additionally, the effect size for cocaine was so small that no difference in app. Km is

observed between fast and slow Vmax based on a median split of Vmax values. A two-fold

increase in uptake rates only resulted in≈ 10 percent change in cocaine potency. MPH

and AMPH potencies were increased with increasing DAT levels over a larger range, and the slopes of the regression lines did not significantly differ from one another.

Additionally, a two-fold change in uptake rates resulted in a greater than 200 percent

increase in measures of uptake inhibition. This further supports the idea that releaser

compounds are affected in a different way from blockers, whereby increasing DAT levels

results in increased neurochemical and behavioral potency. This is important to

understand when trying to identify factors in the human population that may make certain

individuals susceptible to psychostimulant abuse.

This work uses a comprehensive approach to look at the effects of DAT levels on

psychostimulant potency in neurochemistry and behavior, and highlights that current

theories on DAT levels influencing blocker potency may need revision. The current

consensus is that increases in DAT levels lead to a reduction in cocaine potency, and that

lower DAT levels results in increased cocaine potency. This theory originates from two

main sources. 1) cell culture work shows that DAT overexpression in cells results in a 212

decrease in cocaine potency with no change in AMPH potency27. 2) Historically, the ability of cocaine to elevate DA in the NAc shell, where DAT levels are low, is much greater than that of the dorsal striatum, where DAT levels are high. Our results contradict this generally accepted view on psychostimulant potency. Here we demonstrate both behaviorally and neurochemically that increasing DAT levels in vivo does not change cocaine potency but does alter AMPH potency. Thus, we are proposing a novel idea by which cell surface expression dictates the potency of releasers, but not blockers.

With respect to discrepancies with cell culture work, it is possible that our use of endogenous DA may produce different results than cell culture studies that use [3H]-DA in order to measure uptake and uptake inhibition27. It is possible that [3H]-DA is sequestered into intracellular compartments differently than endogenous DA and that releaser compounds don’t have access to this [3H]-DA, thus any differences that may actually be present in release may not be observed. An important advantage of voltammetry is that it measures endogenous DA to look at uptake and release kinetics.

Therefore, voltammetry provides a behaviorally relevant representation of the potency changes that occur after drug treatment.

The increased potency of cocaine in the shell relative to the caudate has only been demonstrated in vivo with microdialysis, where a number of factors could be influencing the results in addition to the DAT, including different inhibitory autoreceptor function and afferent inputs to the regions. In fact, previous work using voltammetry in freely- moving animals has confirmed that brain regional variations in the potency of cocaine are due to D2 differences and not DAT levels29. 213

Regardless of possible differences in cocaine potency due to other factors, we demonstrate that the changes observed using voltammetry are predictive of behavioral outcomes in regards to both locomotor activity and reinforcing efficacy. Previously,

Salahpour et al. (2008) demonstrated that there was no difference in cocaine responses at

20mg/kg in DAT-tg mice. We also found no change in cocaine-induced locomotor activity over a full dose-response curve for cocaine in these mice30. In addition, we show that DAT-tg animals have significantly greater locomotor responses to AMPH and MPH, which is supported by voltammetry data. Further, measures of drug-seeking and reinforcement in animals with elevated DAT levels corresponded to the neurochemical effects of these compounds where MPH and AMPH were enhances, and cocaine was unchanged.

6. D2 autoreceptors and DA uptake:

One caveat to consider when determining the effects of uptake-inhibition by stimulants at the DAT is the role of D2 autoreceptors. D2 autoreceptors have been shown in numerous studies to modulate the function of the DAT, with D2 agonists increasing surface DAT expression and uptake rates, and D2 inhibition increases the potency of stimulants31. It is possible that this is one mechanism driving the increased DAT levels following MPH self-administration. Sustained D2 activation over the six-hour self- administration session due to MPH-induced DA elevations could lead to an increase in

DAT surface expression that remains following the cessation of MPH self-administration.

In addition to modulating baseline DA system kinetics, D2 autoreceptors have also been demonstrated to affect psychostimulant potencies31. DA tone is absent in a slice preparation. Therefore, these changes may not have implications for blocker compounds 214

such as cocaine and MPH as their ability to increase synaptic DA levels is action- potential dependent and only occurs following electrical stimulation of terminals.

However it is possible, that the application of AMPH results in DA tone due to its ability to actively release DA from terminals independent of DA terminal stimulation. This release could activate D2 receptors and alter electrically-stimulated DA release.

However, here we show a 267% increase in the ability of AMPH to inhibit DA uptake following MPH SA. Previous work has shown that complete removal of D2 receptors maximally increases uptake inhibition up to 48%31. Thus, subsensitive D2 receptors following MPH SA cannot account for the large effect size demonstrated in the current study.

215

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218

CHAPTER VII

UNIQUE PROFILE OF METHYLPHENIDATE-INDUCED DOPAMINE SYSTEM KINETICS: RELEASE PROFILE OF A BLOCKER AND UPTAKE PROFILE OF A RELEASER

Erin S. Calipari, Mark J. Ferris and Sara. R. Jones

The following manuscript is prepared for submission to PLoS ONE. Stylistic variations are due to the requirements of the journal. Erin S. Calipari performed the experiments and prepared the manuscript. Dr. Mark J. Ferris helped with statistical analyses and acted in an advisory capacity and Sara R. Jones acted in an advisory and editorial capacity. 219

Abstract:

Although the dopamine transporter (DAT) is the main site of action of psychostimulant

drugs, little work has focused on the effects of fluctuations in DAT levels on

psychostimulant potency. Using fast scan cyclic voltammetry, we measured the effects

of elevated DAT levels on pre-drug dopamine (DA) kinetics as well as the potency of the

blockers (cocaine, MPH) and releasers [amphetamine (AMPH)] to inhibit DA uptake in

the nucleus accumbens core (NAc). Here we find that increases in DAT levels, resulting

from both transgenic over-expression (DAT-tg) and MPH self-administration, result in an increased maximal rate of uptake (Vmax). Vmax a functional measure of DAT levels, is positively correlated with uptake inhibition for all drugs tested; however, AMPH and

MPH were more affected by these changes, with a one-fold change in Vmax resulting in a

200% increase in potency as compared to a 20% increase in potency for cocaine. We

demonstrate that Vmax and stimulated DA release are correlated in all groups; however,

release did not correlate with uptake inhibition for any of the drugs, indicating that Vmax

changes, and not DA release, are likely what are driving the changes in potency. The

regression line for the effects of Vmax on MPH potency in both DAT-tg and MPH self-

administration groups was not significantly different from AMPH, but was significantly

different from cocaine, indicating that MPH more closely resembled a releaser.

Conversely, MPH-induced DA release more closely resembled that of cocaine, with

increases in release over a dose-response curve for MPH, and was very different from the release profile of AMPH, which depleted terminals at high doses, indicating that MPH is not a releaser. This data indicates that although MPH is a DAT blocker it is affected by

DAT changes in a similar manner to releasers. 220

Introduction:

There has been some debate in the literature as to how the potency of psychostimulant compounds is altered by changes in dopamine transporter (DAT) levels

(Chen and Reith, 2007; Salahpour et al., 2008; Yamamoto et al., 2013; Rao et al., 2013;

Nelson et al., 2009). The dopamine transporter (DAT) is the main protein responsible for clearing DA from the synaptic cleft and terminating dopamine (DA) signaling (Hitri et al., 1994). In addition, it is the primary site of action for the euphorigenic, rewarding, and reinforcing properties of psychostimulant compounds such as cocaine, methylphenidate (MPH), and amphetamine (AMPH) (Chen et al., 2005, 2006; Tilley &

Gu, 2008; Ritz et al., 1989). These drugs exert their rewarding and reinforcing effects via elevating DA in the nucleus accumbens (NAc), and they are categorized as either blockers or releasers (Di Chiara 1995; DiChiara and Imperato, 1988; Carboni et al, 1989;

Woods and Meyer, 1991; Gerasimov et al, 2000). Blockers, like cocaine and MPH, act via inhibiting the ability of DAT to take up DA, thus augmenting post-synaptic DA signaling. Alternatively, releasers, like AMPH, act via two main mechanisms: first, they competitively inhibit DA uptake by competing for the DA binding site with DA, where they are transported into the cell. Second, they interact with vesicles to release DA into the cytoplasm where it can be actively released into the synapse via DAT-mediated reverse transport (Rothman and Bauman, 2003; Rudnick and Clark, 1993). There are conflicting theories as to how DAT levels affect psychostimulant potency, where cell culture studies demonstrate that increasing DAT levels reduces cocaine potency (Chen &

Reith, 2008) and in vivo studies show that it has no affect on cocaine potency (Salahpour et al., 2008). Interestingly, both cell culture and in vivo reports demonstrate that DAT levels differentially affect the potency of blockers and releasers, although it is unclear as 221

to which class is more affected by the alterations. Here we determine the relationship between maximal rate of uptake (Vmax), a functional measure of DAT levels, and the potency of AMPH, MPH, and cocaine to determine which class of drug is more affected by DAT levels and how specifically they are affected.

Although MPH is characterized as a DAT blocker, a number of studies have demonstrated that it is unique in its interaction with the DAT, where it is distinct from both blockers and releasers (Wayment et al., 1999; Dar et al., 2005). Because of this, one aim of this study was to determine if DAT levels alter MPH potency in a similar fashion to blockers or releasers. MPH is categorized as a DAT blocker as studies have demonstrated that it is not actively transported into the cell, and thus, cannot directly interact with vesicles (Sonders et al., 1997). However, at higher concentrations, MPH has been shown to have release capabilities (Russel et al., 1998; Dyck et al., 1980). In addition, in binding experiments, MPH has been shown to interact with the DAT in a manner that is dissimilar from both blockers and releasers (Dar et al., 2005, Wayment et al., 1999). Current experiments using slice voltammetry have demonstrated that MPH is unique in the way in which it is affected by a prior cocaine self-administration history, where it classes with releasers, but not blockers (Ferris et al., 2012), and that the compensatory alterations that occur following MPH self-administration are distinct from both cocaine and AMPH (Calipari et al., 2013a, b; Ferris et al., 2011, 2012, 2013). Due to the unique properties of MPH as compared to other compounds of the same class, we aimed to determine if MPH was affected more similarly to releasers or blockers by altered DAT levels. 222

It has been demonstrated previously that MPH self-administration results in

increased maximal rate of uptake (Vmax), which is due to increases in DAT levels

(Calipari et al., 2012). MPH self-administration also leads to an increase in AMPH and

MPH, but not cocaine potency demonstrating that MPH self-administration affects the subsequent potency of drugs of abuse differently (Calipari et al., 2013a, b). Here we use correlations to determine the extent to which the increase in baseline Vmax could be

responsible for the drug potency following MPH self-administration. In addition, we

utilized DAT-tg mice, which have 4 additional copies of the DAT gene and exhibit

increased DAT surface expression. The increased DAT levels lead to changes, similar to

MPH self-administration, are characterized by increased MPH and AMPH, but not

cocaine potency as measured by voltammetry, microdialysis, and locomotor behavior

(Salahpour et al., 2008; Calipari et al., 2013a). The aim of the current study was to

determine if blocker or releaser potency was positively correlated with functional

measures of DAT levels following MPH self-administration or transgenic over-

expression (DAT-tg). Additionally, we aimed to determine if MPH-induced uptake

inhibition and MPH-induced DA release effects are affected in a way that is more similar

to AMPH or cocaine.

Method

Animals: Male Sprague-Dawley rats (375–400 g; Harlan Laboratories, Frederick,

Maryland) were used for all self-administration experiments. Rats were maintained on a

12:12 hour reverse light-dark cycle (3:00 am lights off; 3:00 pm lights on) with food and

water ad libitum. Transgenic DAT over-expressing mice were maintained on a 12:12 223

hour light cycle with food and water ad libitum. All animals were maintained according

to the National Institutes of Health guidelines in Association for Assessment and

Accreditation of Laboratory Animal Care accredited facilities. The experimental protocol

was approved by the Institutional Animal Care and Use Committee at Wake Forest

University School of Medicine.

Self-Administration: Rats were anesthetized and implanted with chronic indwelling

jugular catheters and trained for i.v. self-administration as previously described (Calipari

et al., 2013b, c). Following surgery, animals were singly housed. Self-administration

sessions took place in the home cage during the active/dark cycle (9:00 am–3:00 pm).

Sessions were six hours in length and were terminated after the animal responded for 40

injections of drug or at the end of the six-hour session. Animals self-administered MPH

(0.56 mg/kg/injection over 4 sec) on a fixed-ratio 1 schedule of administration (described

previously, Calipari et al., 2013d). The dose of 0.56 mg/kg/injection MPH was chosen

because it was the dose that produced maximal responding on a dose response curve

measuring reinforcing efficacy (Marusich et al., 2010). For self-administering animals,

acquisition (Day 1) was counted when the animal reaches 35 or more responses, and

animals normally reached acquisition criteria in 0-3 days. Following establishment of stable responding, the animals were allowed to self-administer 40 injections per day for a period of 5 consecutive days.

In Vitro Voltammetry: Fast scan cyclic voltammetry was used to characterize baseline

DA system kinetics, and the ability of psychostimulants to inhibit DA uptake in the NAc.

We selected the NAc core given dense innervations of DA nerve terminals and because it is a critical locus for the reinforcing and rewarding actions of cocaine. Further, our 224

previous research has concentrated on plasticity of DATs in both the core and shell and

demonstrated similar results (Mateo et al., 2005; Ferris et al., 2011, 2012, 2013; Calipari

et al., 2013b, c, d, e). Voltammetry experiments were conducted during the dark phase of

the light cycle 18 hours after commencement of the final self-administration session in rats. Voltammetry in mice were conducted at the same time point, however, no previous procedures had been run. A vibrating tissue slicer was used to prepare 400 µm thick coronal brain sections containing the NAc core. The tissue was immersed in oxygenated artificial cerebrospinal fluid (aCSF) containing (in mM): NaCl (126), KCl (2.5),

NaH2PO4 (1.2), CaCl2 (2.4), MgCl2 (1.2), NaHCO3 (25), glucose (11), L-ascorbic acid

(0.4) and pH adjusted to 7.4. Once sliced, the tissue was transferred to the testing

chambers containing bath aCSF (32°C), which flowed at 1 ml/min. After a 30-min

equilibration period, a cylindrical carbon fiber microelectrode (100–200 μM length, 7 μM

radius) and a bipolar stimulating electrode were placed into the core of the NAc.

Endogenous dopamine (DA) release was evoked by a single electrical pulse (300 μA, 4

msec, monophasic) applied to the tissue every 5 minutes. Extracellular DA was recorded

by applying a triangular waveform−0.4 ( to +1.2 to −0.4V vs Ag/AgCl, 400 V/s)

(Kennedy et al., 1992). Once the extracellular DA response was stable for three

consecutive stimulations (within 10% variability), cocaine (.03–30 μmol/L), MPH (0.03–

30 μmol/L) and (AMPH) (0.1–10 μmol/L) were applied cumulatively to the brain slice to

determine the effects of MPH self-administration and transgenic over-expression on

drug-induced uptake inhibition.

Data Analysis: Demon Voltammetry and Analysis Software was used for data

acquisition and analysis (Yorgason et al., 2011). To evaluate the effects of drugs, evoked 225

levels of DA were modeled using Michaelis–Menten kinetics, as a balance between

release and uptake (Wightman et al, 1988). Michaelis–Menten modeling provides

parameters that describe the amount of DA released following stimulation, the maximal

rate of DA uptake (Vmax), and alterations in the ability of DA to bind to the DAT, or

apparent Km. For pre-drug modeling, we followed standard voltammetric modeling procedures by setting the baseline Km parameter to 160 nM based on the affinity of DA

for the DAT (Wu et al., 2001), whereas Vmax values were allowed to vary as the pre-drug

measure of the rate of DA uptake. Following drug application, apparent Km was allowed

to vary to account for changes in drug-induced DA uptake inhibition while the respective

Vmax value determined for that subject at baseline was held constant. The apparent Km

parameter models the amount of DA uptake inhibition following a particular dose of

drug.

For cocaine, MPH, and AMPH dose-response curves, Km, a measure of apparent

affinity for the DAT, was used to determine changes in ability of the psychostimulants to

inhibit DA uptake in the NAc relative to baseline.

Statistics: Graph Pad Prism (version 5, La Jolla, CA, USA) was used to statistically

analyze data sets and create graphs. Data are presented as mean ± standard deviation and

percentage unless otherwise stated. Correlational analyses were used to assess the

association uptake rates (Vmax) and release with cocaine, AMPH and MPH-induced DA uptake inhibition. Pearson’s correlation coefficients were used to measure the strength of correlation between Vmax and release, Vmax and drug potency, and release and drug

potency. Regression analysis was used to compare the extent to which Vmax altered drug 226

potency between MPH, cocaine and AMPH. All p values of < 0.05 were considered to

be statistically significant.

Results

AMPH and MPH potency is similarly predicted by uptake rate in DAT-tg mice.

Using voltammetry in slices from DAT-tg and wild type (WT) mice we

determined DA kinetics by modeling stimulated DA release and uptake with Michaelis-

Menten modeling. DAT-tg mice have been shown previously to have increased DAT expression and Vmax (Salahpour et al., 2008; Calipari et al., 2013a). To confirm that the

changes in drug potency were due directly to changes in DAT levels, we correlated our

measure of uptake inhibition (app. Km) with a functional measure of DAT levels

(maximal rate of uptake; Vmax). Correlations were run with baseline Vmax and drug-

induced uptake inhibition for equivalent doses (based on DAT affinity) for MPH (30µM),

cocaine (30µM), and AMPH (10µM). Because AMPH is more potent at inhibiting DA

uptake, the lower dose was chosen to equate the extent of uptake inhibition between the

three compounds tested. These doses were based on previous data from our lab in which

full dose-response curves were run from each compound and compared to each other

(John & Jones, 2007). Correlation analysis of data from DAT-tg show that DAT levels

are positively correlated with potency measurements for AMPH (r = 0.93, p < 0.001),

MPH (r = 0.92, p < 0.001), and cocaine (r = 0.84, p < 0.01). Although there was a

positive correlation between uptake rates and cocaine potency, the shift in cocaine

potency across increasing Vmax was substantially less robust than MPH and AMPH (Fig.

1 A). 227

228

Figure 1. Maximal rates of dopamine (DA) uptake (Vmax) are positively correlated with psychostimulant potency. Dopamine transporter transgenic over-expressing mice

(DAT-tg) were used in order to increase DAT levels. The functional measure of DAT levels, Vmax, was used to determine the effects of increased DAT on psychostimulant

potency within subject. (A) Correlational analysis was run to compare the pre-drug

measure of Vmax with the apparent Km (app. Km) of DA uptake inhibition for

methylphenidate (MPH; red; 30μM), amphetamine (AMPH; green; 10μM) and cocaine

(COC; blue; 30μM). Differential doses were used to equate the potency of the drug at the

DAT. Vmax and DAT levels were correlated for all drugs. (B) The regression lines of

AMPH and MPH were compared to show that the range over which increases in Vmax

increased drug potency was similar. Although MPH is a DAT blocker it resembles the

profile of a releaser. (C) The extent to which Vmax was correlated with uptake inhibition

was significantly different between MPH and COC.

229

In order to determine how MPH compared to a prototypical blocker (cocaine) and a

prototypical releaser (AMPH), MPH was compared to the other compounds tested by

comparing the slopes of the regression lines. The regression lines for MPH and AMPH

were not significantly different (Fig. 1 B), indicating that the extent to which increased

Vmax results in increased uptake inhibition for both MPH and AMPH does not differ.

Alternatively, The slope of the regression line for cocaine (β = 0.8289 ± 1.1) was significantly attenuated relative to both MPH (β = 7.756 ± 1.467, vs. cocaine: p < 0.0001) and AMPH (β = 7.714 ± 3.716, vs. cocaine p < 0.0001), and not significantly different than a slope of zero for both MPH self-administration and DAT-tg animals (Fig. 1 C), as demonstrated by significantly different regression lines. This indicates that MPH- induced uptake inhibition is affected by baseline changes in Vmax in a fashion that is not

significantly different from releasers (AMPH), but is significantly different from blocker

compounds (cocaine) of the same class in DAT-tg mice.

MPH self-administration-induced increases in DAT levels alter AMPH and MPH, but

not cocaine potency.

In order to determine if any increase in DAT levels/Vmax at baseline was capable of altering the potency of psychostimulant compounds we used MPH self-administration to elicit a drug-induced increase in Vmax/DAT levels. MPH self-administration has been

demonstrated previously to result in increases in DAT levels and Vmax at baseline

(Calipari et al, 2013d). Here we show that increasing DAT levels either by transgenic

overexpression or by MPH self-administration results in similar effects (Fig. 2). 230

231

Figure 2. Increases in dopamine transporter (DAT) levels by methylphenidate

(MPH) self-administration result in enhanced potency of releasers and MPH, but not blockers. MPH self-administration was used in order pharmacologically increase

DAT levels. The functional measure of DAT levels, Vmax, was used to determine the effects of increased DAT on psychostimulant potency within subject. (A) Correlational analysis was run to compare the pre-drug measure of Vmax with the apparent Km (app.

Km) of DA uptake inhibition for methylphenidate (MPH; red; 30μM), amphetamine

(AMPH; green; 10μM) and cocaine (COC; blue; 30μM). Differential doses were used to equate the potency of the drug at the DAT. Vmax and DAT levels were correlated for

MPH and AMPH, but not COC. (B) The range over which increases in Vmax increased drug potency was similar for AMPH and MPH. Although MPH is a DAT blocker it resembles the profile of a releaser. (C) The extent to which Vmax was correlated with uptake inhibition was significantly different between MPH and COC.

232

Correlation analysis of data from MPH self-administration animals show that DAT levels are positively correlated with potency measurements for AMPH (r = 0.73, p < 0.05) and

MPH (r = 0.88, p < 0.001), but not cocaine (r = 0.54, ns) potency (Fig. 2 A).

In order to determine if MPH was more similar to AMPH or cocaine the slope of the regression line for MPH was compared to the regression lines for both cocaine and

AMPH (Fig. 2 B, C). Similar to the data from DAT-tg mice, the regression lies for

AMPH and MPH were not significantly different (Fig. 2 B), indicating that MPH and

AMPH potencies are affected by baseline changes in DAT levels/Vmax to a similar extent.

Conversely, the slope of the regression line for cocaine (β = 1.54 ± 0.37) was

significantly attenuated relative to both MPH (β = 11.14 ± 1.59, vs. cocaine: p < 0.0001)

and AMPH (β = 8.90 ± 1.38, vs. cocaine p < 0.0001), and not significantly different than

a slope of zero for MPH self-administration animals (Fig. 2C). This demonstrates that

baseline DAT levels/Vmax are capable of altering the potency of psychostimulants,

however, the extent to which uptake inhibition is affected by Vmax differs across drugs.

Vmax and DA release are correlated at baseline, but DA release does not predict drug potency.

In DAT-tg mice there is an increase in stimulated DA release in addition to

increases in uptake rate; therefore, we aimed to determine if the drug effects were also

correlated with pre-drug stimulated DA release. Determining if these two measures are

dissociable allows for the determination that one of them alone is responsible for the

overall Km effects. Stimulated DA release and Vmax were positively correlated in DAT-tg 233

Figure 3. Although maximal rate of dopamine uptake (Vmax) and release are

positively correlated in DAT-tg mice, dopamine (DA) release is not correlated with

drug potency. (A) Vmax and pre-drug evoked DA release were positively correlated in all animals (B) Correlational analysis of the relationship between Vmax and evoked DA

release in the methylphenidate (MPH; red), amphetamine (AMPH, green), and cocaine

(COC, blue) groups. (C) There is no significant relationship for any of the drugs tested

between pre-drug evoked DA release and uptake inhibition. (D) There is no significant

relationship for any of the drugs tested between Vmax and evoked DA release in the

presence of MPH (red; 30μM), AMPH (green, 10μM), or COC (blue; 30μM).

Differential doses were used to equate the potency of the drug at the DAT. Vmax and

DAT levels were correlated for MPH and AMPH, but not COC. 234

mice (r = 0.71, p < 0.0001) (Fig. 3 A). To demonstrate that pre-drug baseline differences across groups were not responsible for the differences in correlations across drugs, we split up the groups to demonstrate that stimulated DA release and uptake was correlated to the same extent and over approximately the same range before drug was added (Fig. 3

B). Following the determination of equivalent baseline measurements, we ran correlations to determine if baseline DA release, like Vmax, was correlated with the drug- induced uptake inhibition with MPH, AMPH, and cocaine. We found that although Vmax and stimulated release are correlated at baseline, and that Vmax is correlated with drug- induced uptake inhibition, there was not a significant correlation between baseline stimulated release and drug-induced uptake inhibition for any of the drugs (Fig. 3 C). In addition, Vmax is not correlated with post-drug stimulated release (Fig 3 D) indicating that the correlation between Vmax and stimulated release is only present at baseline and that drug-induced release is not affected by Vmax.

In order to determine if these correlations held true following drug-induced DAT upregulation these correlations were run in control animals and animals that had a history of MPH self-administration. Not surprisingly, stimulated DA release and Vmax were positively correlated in both groups (r = 0.77, p < 0.001) (Fig. 4 A) with the MPH self- administration group having significantly higher Vmax values overall. Congruent with the

DAT-tg group, stimulated DA release and uptake were correlated to the same extent and over approximately the same range before drug was added in the MPH, AMPH, and cocaine groups (Fig. 4 B). To determine if baseline DA release, like Vmax, was correlated with the drug-induced uptake inhibition we correlated baseline DA release with MPH, 235

Figure 4. Dopamine release is not correlated with psychostimulant potency in

methylphenidate (MPH) self-administration animals. (A) Vmax and pre-drug evoked

DA release were positively correlated in all animals (B) Correlational analysis of the

relationship between Vmax and evoked DA release in the methylphenidate (MPH; red),

amphetamine (AMPH, green), and cocaine (COC, blue) groups. (C) There is no significant relationship for any of the drugs tested between pre-drug evoked DA release and uptake inhibition. (D) There is no significant relationship for any of the drugs tested between Vmax and evoked DA release in the presence of MPH (red; 30μM), AMPH

(green, 10μM), or COC (blue; 30μM). Differential doses were used to equate the potency of the drug at the DAT. Vmax and DAT levels were correlated for MPH and AMPH, but

not COC. 236

AMPH, and cocaine-induced uptake inhibition. We show that although Vmax and

stimulated release are correlated at baseline, and Vmax and uptake inhibition are

correlated, baseline stimulated release is not significantly correlated with uptake

inhibition of any of the drugs tested (Fig 4 C). Vmax is not correlated with post-drug

stimulated release (Fig 4 D) indicating that the correlation between Vmax and stimulated

release is only present at baseline.

Stimulated DA release and uptake inhibition are not correlated for any drugs.

In addition, to further confirm that stimulated release, and the peak height of the

signal, does not affect the uptake-inhibition induced by drugs, we correlated stimulated

DA release in the presence of drug with drug-induced uptake inhibition in both the MPH self-administration (Fig. 5 A) and DAT-tg (Fig. 5 B) groups. We found that stimulated release after drug did not correlate with uptake inhibition for any of the drugs tested, indicating that release, and the peak height of the signal, is not a significant factor that influences uptake inhibition (Fig. 5).

Increasing Vmax results in reduced AMPH-induced stimulated release; however, the

release profile of MPH resembles cocaine.

Because MPH had the uptake inhibition profile of a releaser where its potency

was changed to a similar extend in regards to Vmax changes, but MPH is traditionally

categorized as blocker, we analyzed the release profile of MPH as compared to cocaine

and AMPH in our two animal models. Not surprisingly, in groups that have significantly

higher Vmax, which is likely mediated by increased DAT levels, AMPH peak height is

237

Figure 5. Drug-induced dopamine release does not affect dopamine uptake

inhibition following methylphenidate (MPH) self-administration or DAT over-

expression. Correlational analysis was run in order to confirm that evoked DA release

was not influencing drug induced uptake inhibition. Evoked DA release in the presence of drug was not correlated with uptake inhibition for any of the drugs tested (A) following MPH self-administration or (B) in transgenic DAT over-expressing mice

(DAT-tg).

238

239

Figure 6. Methylphenidate (MPH) has the release profile of a blocker. To determine

if MPH, a blocker, had the release profile of a blocker or releaser, full concentration-

response curves for MPH, amphetamine (AMPH) and cocaine were run in DAT overexpressing mice (DAT-tg; left) and following MPH self-administration (right). (A)

AMPH, a prototypical DA releaser results in reductions in DA release over a concentration-response curve for the compound. The AMPH-induced reductions in release were greater in DAT-tg mice. (B) Cocaine, a prototypical DAT blocker, results in an inverted “U” shape release curve. Release was not different between wild type and

DAT-tg mice. (C) MPH has the release profile of a blocker. Evoked release in the

presence of MPH was unchanged between groups. (D) Following MPH self-

administration AMPH-induced reductions in release were exacerbated. (E) Evoked DA

release in the presence of cocaine was unchanged between MPH self-administration and

control groups. (F) The release profile of MPH resembles cocaine and is unchanged

following MPH self-administration.

240

significantly reduced (Fig. 6 A, D). ANOVA revealed a main effect of group on

stimulated DA release over a dose-response curve for both DAT-tg (F1,40 = 14.79, p <

0.001) (Fig. 6 A) and MPH self-administration (F1,39 = 16.32, p < 0.001) (Fig. 6 D)

groups, indicating that AMPH was more potent at reducing DA release in animals that

had elevated DAT levels.

Because cocaine is a blocker, and as such does not actively release DA from

terminals, we expected no depletion of stimulated DA signals as with AMPH. The pattern of stimulated DA release across a dose-response curve for cocaine was not

significantly different between DAT-tg and tintype mice (Fig. 6 B). The same was true

for MPH SA with no significant difference being present between stimulated DA release

across a cocaine dose-response curve (Fig. 6 E). In addition the pattern of stimulated

release with cocaine present was an inverted “U” shaped curve, with the downward

portion of the curve likely being due to prolonged autoreceptor activation, which leads to

reduced release. This pattern was very different from the releaser AMPH, highlighting

the distinction between the two compounds mechanisms of action.

In order to compare MPH to the other compounds tested we assessed stimulated

DA release in the presence of a MPH dose-response curve in both DAT-tg and MPH self- administration animals (Fig. 6 C, F). We found that there was no significant difference between DAT-tg and wild type animals in stimulated release effects of MPH (Fig. 6 C).

In addition, there was also no difference between MPH self-administration and control animals in stimulated DA release in the presence of MPH (Fig. 6 F). This indicates in two different models that changes in Vmax as seen with both DAT-tg and MPH self-

administration that increases in DAT levels do not affect stimulated release. In addition, 241

the release profile of MPH more closely resembles the release profile of cocaine, another

transporter blocker, which exhibit an inverted “U” shaped release curve. Although MPH

potency as measured by apparent Km is affected by transporter level in a manner more

similar to releasers, its release profile resembles that of blockers.

Discussion

Here we show that although MPH is traditionally characterized as a DAT blocker,

its mechanism is more complicated, having characteristics of both blockers and releasers.

MPH is affected by changes in Vmax in a similar manner to releasers, whereby increases in Vmax result in large increases in MPH potency. Conversely, although MPH potency is

affected by Vmax, more similarly to releasers, the release profile, as measured by

stimulated release across a dose-response curve of the compound, more closely mimics that of the blocker cocaine, indicating that MPH is not actually a releaser. In addition, although Vmax and stimulated DA release are correlated at baseline, they are not correlated with the MPH effects, indicating that the factor that is actually driving the differences in drug potency is the uptake at baseline, which is controlled by DAT levels.

These data indicate that MPH, a drug commonly used in the clinic, is a unique compound that has characteristics of both blockers and releasers and its potency can be affected purely by DAT level changes at baseline.

MPH is characterized as a DAT blocker because it is not actively transported into

cells, thus it cannot interact with vesicles and actively release DA (Sonders et al., 1997).

Because of this, much of the MPH literature has focused on MPH as a blocker and has

considered it to be similar to cocaine in both acute and chronic pharmacological effects. 242

Here we show that MPH resembles a releaser in its acute uptake inhibition profile where

its potency is affected by Vmax changes and a blocker in its release profile. Presently, it is

unclear as to how MPH can be affected by DAT levels in a manner similar to releasers,

but not release from vesicles. One possible explanation is that the effects are related to

the binding site on the DAT, where MPH and AMPH have been shown to share some

similarities (Dar et al., 2005; Wayment et al., 1999). Another possible explanation is that

MPH has the ability to release DA at high concentrations, which has been seen in cell

culture studies, thus making it a blocker at lower concentrations and a releaser at higher

concentrations (Russel et al., 1998; Dyck et al., 1980). Additionally, it is possible that

MPH-DAT interactions signal second messenger cascades that promote shifts in vesicles

from membrane-bound to releasable pools, thus increasing MPH’s effects (Chadchankar

et al., 2012; Volz et al., 2007, 2009). MPH has been previously been shown to mobilize

vesicles, the mechanism of which is not clear, but could be through its interaction with

the DAT, thus leading to increased MPH effects in situations where there are increased

DAT levels (Chadchankar et al., 2012; Volz et al., 2007, 2009). Although it is unclear as

to how transporter levels affect MPH potency, the fact that this phenomenon occurs

suggests that care should be taken when administering this compound to individuals that

may have differences in DAT levels, such as ADHD sufferers (Madras et al., 2005), as

the potency/efficacy of this drug may be increased in these individuals.

Although MPH potency is affected by DAT levels in a similar manner to

releasers, its release profile demonstrated that it is not a pure releaser. In the groups that

had increased Vmax the releaser AMPH was more efficacious at reducing peak height, due to its ability to deplete vesicles, an effect not seen with MPH. The reduction in peak 243

height in the MPH self-administration and DAT-tg groups is likely due to an increase in

AMPH-induced DA efflux and depletion of the terminals leading to reduced stimulated release (Jones et al., 1998). This is not surprising as a number of studies have demonstrated that releasers, like AMPH, are more neurotoxic in scenarios where DAT function/levels are elevated, indicating that these compounds are likely more potent (Xie et al., 2000; Fumagalli et al., 1998). Here we show that stimulated DA release in the presence of AMPH is significantly reduced in two animal models that have increases in

DAT levels at baseline. It has been demonstrated that the depleting actions of AMPH are dependent on the presence of the DAT (Jones et al., 1998), and it is likely that AMPH is better able to release DA into the synapse when there are more transporters present, leading to the enhanced depletion of terminals observed in the present study. Because

MPH is not transported into cells, it cannot release actively from terminals, an effect that

is highlighted by the increase, not decrease, in DA release when MPH is applied to the

brain slice. This indicated that although MPH potency at the DAT is increased in a

similar way to releasers, it is not functioning as a releaser and cannot deplete DA from

terminals. This would also indicate that even if MPH is capable of releasing from

terminals, it is far less potent than AMPH as highlighted by the ability of AMPH to

reduce release with MPH having no effect.

One important factor to consider is the contribution of stimulated DA release, or

the peak height of the DA signal, on drug-induced uptake inhibition. It is difficult to

dissociate the contribution of differences in pre-drug DA release or uptake on the potency

of drug. Release and uptake are often correlated, but have been shown to be dissociated

in a number of studies (Mateo et al., 2005; Calipari et al., 2013e), demonstrating that the 244

correlation between the two measures is physiological. Here we extensively analyzed the

extent to which Vmax and release are correlated and demonstrated that although release

and Vmax are related, that Vmax is the primary factor dictating changes in psychostimulant

potencies. Further, differences in evoked DA release in the presence of drug could

potentially influence potency measurements. This is particularly important in the case of

AMPH, which affects the peak-height of the DA signal differently across groups. In the

AMPH groups there were significant differences between MPH self-administration and control animals as well as between DAT-tg and wild type animals. To demonstrate that the peak height of the signal has no effect on the measured uptake inhibition correlations were run with post-drug stimulated release and uptake inhibition, which revealed that the two measures were not correlated. Additionally, we determined that the reduction in peak height in the MPH and DAT-tg groups did not significantly contribute to the measures of uptake inhibition, indicating that the reduction in release was a separate phenomenon from the potency of AMPH at the DAT. This also was true for the other groups tested, although it was not as pertinent, as there was no significant different in release between groups following MPH or cocaine.

These results are particularly important as they contradict the cell-culture theories on psychostimulant potency; however, differences between the current literature and this study can be accounted for by differences between cell culture and vivo models. We are proposing a theory by which cell surface expression dictates the potency of releasers in an opposite direction from which would be supported by in vitro cell studies. Cell culture studies have demonstrated that cocaine, but not AMPH potency, is altered by increasing

DAT levels. The differences between cell studies and this particular study are numerous. 245

Cell studies often use [3H]-DA in order to look at uptake and uptake inhibition (Chen &

Reith, 2008). It is possible that [3H]-DA is sequestered into intracellular compartments

differently than endogenous DA and that releaser compounds do not have access to this

[3H]-DA, thus any differences that may actually be present in release may not be

observed. An important advantage of FSCV is that it uses endogenous DA to look at

kinetics and functioning of the system, which may better elucidate potency changes that

occur after drug treatment or in transgenic animal models. In addition, the behavioral

data supports enhanced releaser potency following DAT over-expression, which gives

greater support to this neurochemical model (Calipari et al., 2013a, Salahpour et al.,

2008).

Because the DA system is responsible for mediating the reward and reinforcement of drugs, it is important to know how the behavioral and neurochemical effects of psychostimulants are altered by differences in DA system functioning. In addition, because MPH is uniquely affected by DA changes that affect releasers, but still has the release profile of a blocker, it makes it difficult to make predictions about MPH use and abuse without conducting studies on the compound itself. This data demonstrates 1.) the positive relationship between DAT levels and psychostimulant releaser, but not blocker potency, and 2.) that predictions on the effects of MPH based on previous work using similar compounds may not give an accurate representation of what is actually happening in vivo.

Acknowledgements: This work was funded by NIH grants R01DA024095,

RO1DA003016. T32DA007246 and F31 DA031533 (ESC). 246

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250

CHAPTER VIII

INTERMITTENT ACCESS METHYLPHENIDATE SELF-ADMINISTRATION RESULTS IN A SENSITIZED DOPAMINE SYSTEM

Erin S. Calipari and Sara. R. Jones

The following manuscript is prepared for submission at Neuropharmacology. Stylistic variations are due to the requirements of the journal. Erin S. Calipari performed the experiments and prepared the manuscript and Dr. Sara R. Jones acted in an advisory and editorial capacity. 251

Abstract:

Although methylphenidate (MPH), the active compound in Ritalin, is categorized as a

dopamine transporter (DAT) blocker, similar to cocaine, the effects of MPH, both acute

and following repeated administration, are unique. Previous work has demonstrated that

MPH classes with releasers following MPH self-administration, where extended-access

self-administration results in enhanced MPH and releaser, but not blocker potency at the

DAT. Extended-access self-administration results in escalation of MPH intake, an effect

that has been suggested to mediate the neurochemical changes that occur following

extended-access self-administration. Here we used intermittent access of MPH (0.56 mg/kg; 14 days), which results in consistent MPH intake over sessions, in order to

determine if escalation is necessary to cause the increased MPH and releaser potencies at

the DAT. Further, recently, it was determined that the temporal pattern of cocaine self-

administration dictates the DA system changes that occur, with extended-access resulting in tolerance to cocaine’s effects and intermittent access resulting in sensitization. Thus, we aimed to determine if the compensatory changes that occur following MPH self-

administration are dependent on the temporal pattern of intake. Intermittent access MPH self-administration resulted in enhanced releaser and MPH potency, but no change in cocaine potency, demonstrating that the effects are not due to escalation, and, unlike cocaine, MPH effects are not affected by pattern of intake. Further, although MPH’s effects are enhanced similar to releasers following MPH self-administration, its release profile more similarly resembles a blocker, whereby MPH increases release and does not deplete DA terminals. Taken together, this data demonstrates that MPH exhibits properties of both blockers and releasers, and that the compensatory effects of MPH may increase the abuse liability of amphetamines independent of pattern on administration. 252

Introduction:

Methylphenidate (MPH), the active compound in Ritalin®, is commonly diverted

for non-medical use, with up to 17% of college students reporting abusing MPH for its

cognitive enhancing effects or euphoric effects to “get high” (Teter et al., 2006). MPH is

taken orally, intranasally or intravenously (IV), and is one of the prescribed drugs most

diverted onto the illicit market worldwide (Frauger et al., 2013); however, little work has

focused on understanding the acute actions of MPH or determining the neurochemical

consequences of MPH abuse. A survey of drug use indicates that 4.8 million people reported abusing MPH, which is similar to the 5.2 million for cocaine (SAMHSA, 2008).

Even more alarming, when taken via the same route of administration, the subjective

effects of MPH are indistinguishable from cocaine or AMPH, two commonly abused and

highly addictive drugs (Rosen et al., 1985; Silverman & Ho, 1980). Further, a number of

case studies demonstrate numerous instances of IV MPH administration in the human

population, which is alarming given the paucity of empirical data on the behavioral and

neurochemical consequences of IV administration of the compound (Sherman, Hudson,

and Pierson, 1987; Parran &Jasinski, 1991).

MPH, like other stimulants, exerts its rewarding and reinforcing effects by

inhibiting the dopamine transporter (DAT), which leads to elevation in dopamine (DA) in

the nucleus accumbens (NAc) (Tilley & Gu, 2008). As a result, much work has focused

on the compensatory effects that occur within the DA system following MPH self- administration, as they are predictive of changes in the rewarding and reinforcing potential of psychostimulants (Calipari et al., 2013a). Previous work has used extended access MPH self-administration demonstrating that abuse-relevant MPH exposure results 253

in enhanced MPH and releaser, but not blocker potency and reinforcing efficacy (Calipari

et al., 2013a, b). Work using fixed-intake extended access paradigms has also showed

escalation in first-hour intake and rate of intake over sessions (Calipari et al., 2013 a, b),

an effect that has been suggested to model the switch from recreational use to abuse

(Koob & Le Moal, 1997). Currently, all of the neurochemical studies on MPH self-

administration use paradigms that result in escalation of intake, making it unclear as to

whether the effects are due to escalation or MPH administration. Here we use

intermittent access (Calipari et al., 2013c; Zimmer et al., 2012), which does not result in

escalation, to determine if administration of the compound independent of temporal

pattern of intake is responsible for the compensatory changes that occur following MPH

self-administration. Additionally, it was recently demonstrated that the compensatory effects that occur with cocaine at the DAT are different when cocaine is administered intermittently versus continuously, with sensitization and tolerance occurring, respectively (Calipari et al., 2013 c). Thus, we also aimed to determine how intermittent

MPH administration influenced the compensatory changes that occur within the DA system as it compares to previous work with extended-access conditions.

The compensatory effects of MPH self-administration as they relate to the DA

system are different from both cocaine and amphetamine (AMPH) self-administration

(Mateo et al., 2005; Ferris et al., 2011, 2012, 2013; Calipari et al., 2013 a, b, c, d, e)

suggesting that MPH is unique in its actions at the DAT. Indeed, MPH has been shown

to interact with the DAT in a way that is unique, where it binds to the DAT in a way that

is different from both AMPH and cocaine (Wayment et al., 1999; Dar et al., 2005).

Further, while the effects of blockers at the DAT are reduced following cocaine self- 254

administration, MPH is unchanged like releasers, suggesting that it may have properties

of both classes of psychostimulants (Ferris et al., 2012). MPH is traditionally categorized

as a DAT blocker because it is not transported into the cell; however, it has been

demonstrated to have release capabilities at high concentrations (Russel et al., 1998;

Dyck et al., 1980; Sonders et al., 1997). Using voltammetry, blockers and releasers have distinct profiles with releasers resulting in a depletion of stimulated DA release from

terminals with increasing concentrations and blockers increasing DA release (Ferris et al.,

2012). Here we used the release profiles of cocaine, AMPH, and MPH to determine if

MPH changes release in a fashion that is similar to blockers or releasers.

Here we find that MPH intermittent access MPH self-administration resulted in

enhanced releaser and MPH potency, but no change in cocaine potency. These effects

have been demonstrated previously using extend-access MPH self-administration, demonstrating that the effects are not due to escalation (Calipari et al., 2013a, b). Further unlike cocaine, MPH effects are not affected by pattern of intake, demonstrating that

MPH self-administration results in a sensitized response to releasers and MPH regardless of how it is administered, an effect that could be predictive of significant abuse/addiction potential for the compound. Additionally, although MPH’s effects are enhanced similar to releasers following MPH self-administration, its release profile more similarly resembles a blocker, whereby MPH increases release and does not deplete DA terminals, suggesting that MPH may represent a new class of psychostimulants.

255

Method:

Animals: Male Sprague-Dawley rats (375–400 g; Harlan Laboratories, Frederick,

Maryland) were used for all self-administration experiments. Rats were maintained on a

12:12 hour reverse light/dark cycle (3:00 am lights off; 3:00 pm lights on) with food and

water ad libitum. All animals were maintained according to the National Institutes of

Health guidelines in Association for Assessment and Accreditation of Laboratory Animal

Care accredited facilities. The experimental protocol was approved by the Institutional

Animal Care and Use Committee at Wake Forest University School of Medicine.

Self-Administration: Rats were anesthetized and implanted with chronic indwelling

jugular catheters and trained for i.v. self-administration as previously described (Liu et al., 2007). Following surgery, animals were singly housed, and all self-administration sessions took place in the home cage during the active/dark cycle (9:00 am–3:00 pm).

After a 2-day recovery period, animals underwent a training paradigm within which animals were given access on a fixed ratio one (FR1) schedule to a MPH-paired lever, which, upon responding, initiated an intravenous injection of MPH (0.56 mg/kg, infused over 4 s). After each response/infusion, the lever was retracted and a stimulus light was illuminated for a 20 second timeout period, during which the animal had no access to the lever, and thus could not respond for drug. During training, sessions were terminated after a maximum of 20 infusions or 6 hours, whichever occurred first. An animal was considered to have acquired upon responding for 20 injections for two consecutive days and a stable pattern infusion intervals was present. Following training, animals were assigned intermittent access after which the dopaminergic alterations that resulted were assessed. 256

Intermittent Access Group: Animals were given access to MPH on an intermittent

schedule of administration described previously (Calipari et al., 2013c). During each 6h

session animals had access to MPH for 12 five minute trails separated by 25-minute

timeout periods. Within each five-minute session, there were no timeouts other than

during each infusion, and the animal could press the lever on an FR1 schedule to receive

a 1-sec infusion of MPH (0.140 mg/kg/inf). Upon responding a stimulus light illuminated

concurrently with the 1-sec infusion of drug.

In Vitro Voltammetry: Fast scan cyclic voltammetry was used to characterize baseline

DA system kinetics, D2 autoreceptor activity, and the ability of psychostimulants to

inhibit DA uptake in the nucleus accumbens (NAc) core. Voltammetry experiments were

conducted during the dark phase of the light cycle 18 hours after commencement of the

final self-administration session. A vibrating tissue slicer was used to prepare 400 µm

thick coronal brain sections containing the NAc. The tissue was immersed in oxygenated

artificial cerebrospinal fluid (aCSF) containing (in mM): NaCl (126), KCl (2.5),

NaH2PO4 (1.2), CaCl2 (2.4), MgCl2 (1.2), NaHCO3 (25), glucose (11), L-ascorbic acid

(0.4) and pH was adjusted to 7.4. Once sliced, the tissue was transferred to the testing chambers containing bath aCSF (32°C), which flowed at 1 ml/min. After a 30-min

equilibration period, a cylindrical carbon fiber microelectrode (100 –200 μM length, 7 μM

radius) and a bipolar stimulating electrode were placed into the core of the NAc. The

NAc was selected because of the important role in the reinforcing and rewarding actions

of cocaine. Further, our previous research has concentrated on plasticity of DATs in the

core and demonstrated that these alterations occur due to self-administration history of a number of drugs (Calipari et al., 2013a, b, c, d; Ferris et al., 2011, 2012, 2013). 257

Endogenous DA release was evoked by a single electrical pulse (300 μA, 4 msec,

monophasic) applied to the tissue every 5 minutes. Extracellular DA was recorded by

applying a triangular waveform (−0.4 to +1.2 to −0.4V vs Ag/AgCl, 400 V/s). Once the

extracellular DA response was stable for three consecutive stimulations, cocaine (0.3–30

μmol/L), MPH (0.3–30 μmol/L) and (AMPH 0.1–10 μmol/L) were applied cumulatively

to the brain slice to determine the effects of cocaine self-administration on drug-induced

uptake inhibition. In order to determine D2 autoreceptor sensitivity following these self-

administration paradigms, we also ran dose-response curves for quinpirole (0.01-1

μmol/L), a D2 receptor agonist, and reversed the effects with sulpiride (2 μmol/L), a D2

antagonist.

Data Analysis: For all analysis of FSCV data DEMON voltammetry software was used

(Yorgason et al., 2011). To evaluate the effects of MPH self-administration on DA

system kinetics, evoked levels of DA were modeled using Michaelis-Menten kinetics as

described previously (Calipari et al., 2013a). Immediately following the completion of

each concentration–response curve, recording electrodes were calibrated by recording

their response (in electrical current; nA) to a known concentration of DA in aCSF (3 μM)

using a flow-injection system. This value was then used to convert electrical current to

DA concentration. For cocaine, MPH, and AMPH dose-response curves, Km, a measure

of apparent affinity for the DAT, was used to determine changes in ability of the

psychostimulants to inhibit DA uptake in the NAc relative to baseline. Because

quinpirole is a D2 agonist it concentration-dependently reduces the peak height of the DA signal. As a result we can assess the functional sensitivity of D2 autoreceptors by 258

determining if there is a shift in the concentration-response curve for quinpirole. All curves for D2 function are expressed as percent baseline DA release.

Calculating Ki values: As described by Jones et al. (1995), inhibition constants (Ki) were determined by plotting the linear concentration-effect profiles and determining the slope of the linear regression. The Ki was calculated by the equation Km/slope. Ki values are reported in µM and are a measure of the drug concentration that is necessary to produce 50% uptake inhibition.

Statistics: Graph Pad Prism (version 5, La Jolla, CA, USA) was used to statistically analyze data sets and create graphs. Baseline voltammetry data and Ki values were

compared using a one-way analysis of variance (ANOVA). When main effects were

obtained (P < 0.05), differences between groups were tested using a Tukey post hoc tests.

Release data and data obtained after perfusion of COC, MPH, AMPH, or quinpirole were

subjected to a two-way ANOVA with experimental group and concentration of drug as

the factors. Differences between groups were tested using a Bonferroni post hoc test.

Results:

IntA MPH self-administration does not result in escalation. Long-access self-

administration of MPH has been previously been shown to result in escalation of intake

over sessions (Marusich et al., 2010). Here we find that intermittent self-administration

of MPH results in stable intake over sessions (Fig 1 A). Regression analysis indicates

that the slope of intake over sessions is not significantly different from zero indicating

that escalation does not occur in these animals with this model (Fig 1 B). 259

Figure 1: Animals self-administer methylphenidate (MPH) at high rates when given intermittent access. Rats were given five minute unlimited access followed by a 25 minute time-out period to induce an intermittent pattern of self-administration within each six hour sessions. (A) Representative data showing the pattern of self- administration over the 14 sessions. Tick marks represent earned infusions. (B) Group data plotting total infusions (0.140 mg/kg/inf) in each session over the 14 total sessions.

The slope of the regression line (red) is not significant indicating that animals do not escalate their intake.

260

Intermittent MPH self-administration results in increased stimulated DA release

and Vmax at baseline. Pre-synaptic baseline DA system kinetics were assessed using

FSCV in MPH self-administration and control groups. MPH self-administration resulted in an increase in maximal rate of uptake (Fig 2A) and stimulated DA release (Fig 2B). A two-tailed student’s t-test revealed a significant increase in stimulated DA release following intermittent MPH self-administration (t36 = 2.191, p < 0.05). In addition, a

two-tailed student’s t-test also revealed a significant increase in Vmax following MPH

self-administration (t33 = 2.919, p < 0.01; Fig 2C).

D2 autoreceptors are subsensitive following MPH self-administration. In order to

determine if the differential DA kinetic effects could be due to differences in D2

autoreceptor activity, we assessed the sensitivity of the DA system to quinpirole, a D2

autoreceptor agonist. ANOVA revealed a significant interaction (F1, 28 = 4.079, p < 0.01)

(Fig 3A). Bonferroni post-hoc analysis revealed that quinpirole was significantly less

effective at reducing DA release at the 30 nM dose following MPH self-administration (p

< 0.05), indicating that D2 autoreceptor activity is reduced. The subsensitive D2

autoreceptors that are present following MPH self-administration could explain, at least

in part, the increase in stimulated DA release. Sulpiride reversal was run to confirm that

the reduction in peak height of DA release was due to D2 receptors and not another

mechanism (Fig 3B). Sulpiride reversed quinpirole effects, and there was no significant

difference between groups.

Intermittent MPH self-administration results in increased MPH potency. To

investigate how intermittent MPH-DAT interactions affect MPH potency, we ran 261

Figure 2: Intermittent methylphenidate (MPH) self-administration leads to

increased stimulated dopamine (DA) release and uptake. Baseline DA system

kinetics assessed by fast scan cyclic voltammetry. (A) Representative plot of DA release

and uptake at baseline in control and MPH self-administration groups. Data is

normalized to peak height to highlight differences in uptake between groups. Color plots

which show DA (green) over time as measured in current (z-axis). (B) Group data

showing that stimulated release is elevated following intermittent MPH self- administration. (C) Group data demonstrating that maximal rate of DA uptake (Vmax) is

elevated at baseline following MPH self-administration. IntA, intermittent access; *, p <

0.05; **, p < 0.01

262

Figure 3. Intermittent methylphenidate (MPH) self-administration causes D2 autoreceptor subsensitivity. D2 autoreceptors were assessed by quinpirole dose- response curves. (A) Quinpirole dose-response curve represented as percent of baseline

DA peak height. Intermittent MPH self-administration resulted in subsensitive D2 autoreceptors as compared to controls. (B) Sulpiride reversal was used to confirm that the reduction in peak height was due to D2 autoreceptors. IntA, intermittent access; *, p <

0.05 vs control

263

cumulative dose-response curves for MPH following intermittent MPH self- administration. Using FSCV in brain slices, MPH effects on DA uptake inhibition were recorded over a five-point dose-response curve for the compound. MPH was found to be more effective at inhibiting DA uptake inhibition following MPH self-administration (Fig

4A). ANOVA revealed a significant interaction of MPH self-administration on the dose- response curve for MPH (F1, 28 = 3.238, p < 0.05; Fig 4B). Bonferroni post hoc analysis

revealed that MPH-induced uptake inhibition was augmented at the 30 μM dose

following MPH self-administration (p < 0.05). A linear dose-response curve was plotted

to calculate the Ki of MPH in control and self-administration animals (Fig 4C). The slopes of the regression lines of the linear dose-response curve for MPH-induced uptake inhibition were significantly different (p < 0.01), indicating that MPH was more potent following MPH self-administration.

The Ki is the dose of drug at which 50% uptake inhibition is achieved, and is

calculated from the slope of the linear dose-response curve for the compound. A

Student’s t-test revealed that MPH potency as measured by Ki was increased (t7 = 2.30, p

< 0.05; Fig 4D), with a lower concentration of MPH resulting in 50% uptake inhibition

following MPH self-administration as compared to controls.

AMPH, potency is increased following IntA MPH self-administration. Because MPH

is structurally similar to the releaser AMPH, but functionally similar to the blocker

cocaine, we assessed the effects of MPH self-administration on AMPH and cocaine

potencies to determine if the neurochemical are conferred to compounds of a similar

structural or functional class. If the effects are structure specific AMPH potency should

be similar to the effects of MPH self-administration on MPH potency. AMPH was found 264

265

Figure 4. Sensitization of the neurochemical effects of methylphenidate (MPH). Fast

scan cyclic voltammetry was used to assess changes in the potency of MPH at the DAT

following MPH self-administration. (A) Representative data showing MPH-induced uptake inhibition at the 10 µM dose. Traces demonstrate that MPH is more effective at inhibiting uptake, as demonstrated by the increased time to return to baseline. Data was

normalized to peak height to highlight differences in uptake across groups. Color plots

which show DA (green) over time as measured in current (z-axis). (B) Group data

showing that MPH self-administration results in increased potency of MPH over a dose- response curve. (C) Ki values across groups were calculated based off of the linear dose-

response curve for MPH in each group. (D) Bar graph of Ki values for cocaine in control

and MPH self-administration groups. Ki values are a measure of the concentration of

drug at which 50% inhibition is achieved. IntA, intermittent access; *, p < 0.05 vs

control; **, p < 0.01 vs control

266

to be more effective at inhibiting DA uptake inhibition following MPH self-

administration (Fig 5A), an effect that was similar to that of MPH. ANOVA revealed a

significant interaction of MPH self-administration on the dose-response curve for AMPH

(F1, 32 = 2.744, p < 0.05; Fig 5B). Bonferroni post hoc analysis revealed that AMPH- induced uptake inhibition was augmented at the 10 μM dose following MPH self- administration (p < 0.05). In addition, the linear dose-response curve was plotted to calculate the Ki of AMPH in control and self-administration animals (Fig 5C). The

slopes of the regression lines of the linear dose-response curve for AMPH-induced uptake inhibition were significantly different (p < 0.05), indicating that AMPH was more potent following MPH self-administration. A Student’s t-test revealed that MPH potency as

measured by Ki was increased (t7 = 2.7, p < 0.05; Fig 5D) as well, with a lower

concentration of AMPH resulting in 50% uptake inhibition following MPH self-

administration as compared to controls. Because AMPH effects are similar to MPH

following MPH self-administration it is likely that these effects are specific to the

structure of these compounds rather than their function as blocker or releaser.

Cocaine potency is unchanged following IntA MPH self-administration. Because

AMPH and MPH behaved similarly after MPH self-administration, we hypothesized that

these effects were due to the structure of the compound; however, to confirm this, we

used cocaine, a compound structurally dissimilar from MPH, but functionally the same.

Cocaine was found to be equivalently effective at inhibiting DA uptake inhibition

following MPH self-administration (Fig 6A), an effect that was dissimilar to that of

MPH. There was no significant effect of MPH self-administration on the dose-response 267

268

Figure 5. Enhanced amphetamine (AMPH) potency following methylphenidate

(MPH) self-administration. Fast scan cyclic voltammetry was used to assess changes in

the potency of AMPH following MPH self-administration. (A) Representative data

showing AMPH-induced uptake inhibition at the 1 µM dose. AMPH is more effective at

inhibiting uptake, as demonstrated by the increased time to return to baseline in the

traces. Data was normalized to peak height to highlight differences in uptake across

groups. Color plots which show DA (green) over time as measured in current (z-axis).

(B) Group data showing that MPH self-administration results in increased potency of

AMPH. (C) Ki values across groups were calculated based off of the linear dose-response curve for AMPH in each group. (D) Bar graph of Ki values for AMPH in control and

MPH self-administration groups. IntA, intermittent access; *, p < 0.05 vs control

269

270

Figure 6. Cocaine potency is unaffected by a history of methylphenidate (MPH) self-

administration. Fast scan cyclic voltammetry was used to assess changes in the potency

of MPH at the DAT following MPH self-administration. (A) Representative data

showing cocaine (10 µM) -induced uptake inhibition. Data was normalized to peak

height. Color plots which show DA (green) over time as measured in current (z-axis).

(B) Group data showing no change in cocaine potency following MPH self-

administration. (C) Ki values across groups were calculated based off of the linear dose-

response curve for cocaine in each group. (D) Bar graph of Ki values for cocaine in

control and MPH self-administration groups. Ki values are a measure of the

concentration of drug at which 50% inhibition is achieved. IntA, intermittent access; *, p

< 0.05 vs control curve for cocaine (Fig 6B). In addition, the linear dose-response curve

was plotted to calculate the Ki of AMPH in control and self-administration animals (Fig

6C). The slopes of the regression lines of the linear dose-response curve for cocaine- induced uptake inhibition were not significantly different. In addition, cocaine potency as measured by Ki was unchanged (Fig 6D).

271

Stimulated DA release profiles for MPH, cocaine, and AMPH are differentially affected by MPH self-administration. To determine how MPH affected DA release we measured the release effects of MPH, AMPH, and cocaine across a dose-response curve for each of these drugs. First, we assessed the release profile of MPH to determine how it was affected by a prior MPH self-administration history. MPH exhibits an inverted “U” shaped profile that is indicative of a DAT blocker (Fig 7A). Curves are expressed as percent peak height at baseline, and peak height is a measure of both release and uptake as uptake occurs continuously in the presence of DA. Because of this, blockers result in inverted-u shaped dose-response curves, where they increase peak height at the early doses, due to their uptake-inhibition affects. At the higher doses, the peak height of the signal is reduced, due to more uptake-inhibition resulting in D2 autoreceptor activation.

In addition, ANOVA revealed a significant main effect of MPH self-administration (F1, 33

= 6.929, p < 0.05), indicating that MPH-induced DA release was increased as compared to control animals.

To determine if the release effects were common to all drugs or specific to a certain class/structure, cocaine was also run. As with MPH, cocaine exhibited an inverted “U” shaped release profile indicative of blockers (Fig 7B). Although the release profile was similar to MPH, like with drug potency, the release effects of cocaine were unaffected by MPH self-administration. This gives further support to the idea that the effects of MPH self-administration on subsequent psychostimulant effects are driven by the structure of the compounds and are not specific to function as blocker or releaser.

To further characterize the release effects of MPH self-administration, the release profile over a dose-response curve for AMPH was assessed. AMPH has a different 272

273

Figure 7. Stimulated DA release profile of cocaine, methylphenidate (MPH), and

amphetamine (AMPH) following intermittent MPH self-administration. Stimulated

release was determined by the peak height of the signal throughout the dose-response curve for each respective drug. Data was then reported as percent baseline peak height.

(A) AMPH dose-response curve demonstrating that AMPH-induced release is reduced following MPH self-administration. Profile of releasers is characterized by decreased

DA, due to depleted terminals, as doses are increased. (B) MPH dose-response curve that indicates that MPH-induced DA release is augmented following MPH self- administration. The release profile of MPH indicates that it is a DAT blocker. Profile of

DAT blockers is characterized by an inverted “U” shaped curve with increased DA at lower concentrations and reduced DA at higher concentrations. (C) Cocaine dose-

response curve that indicates that cocaine-induced DA release is unchanged following

MPH self-administration.

274

profile due to its mechanism of action as a DA releaser. Because AMPH is releasing DA

at all times, independent of stimulated release, it dose-dependently depletes DA

releasable pools terminals leading to decreased DA release over the dose-response curve

(Fig 7C). ANOVA revealed a significant main effect of MPH self-administration on

AMPH release (F1, 28 = 13.96, p < 0.01). Bonferroni post hoc analysis revealed that

AMPH release was significantly reduced at the 300nM dose (p < 0.001). The increase in

AMPH-induced DA reduction indicates an increase in the potency of AMPH to release

DA in these animals. In addition, the fact that both MPH and AMPH are more potent in their DA releasing effects, although it is through different release profiles, gives further

support to the idea that the effects of MPH self-administration on subsequent psychostimulant effects are driven by structure.

Discussion:

Here we find that intermittent MPH self-administration results in DA system changes that may increase the abuse liability of some psychostimulants. In regards to DA

kinetics, we found increased maximal rate of uptake and increased stimulated DA release

as well as subsensitive D2-like autoreceptors. Further, the potency of AMPH and MPH

for DA uptake inhibition, but not cocaine, was increased as was the Ki of AMPH and

MPH for the DAT. AMPH and MPH, but not cocaine, release effects were also

sensitized, whereby, MPH-induced DA release was enhanced and AMPH-induced

reductions in evoked DA release were augmented. Although MPH release effects were

sensitized, the release profile of MPH resembled that of cocaine, confirming that MPH is

not a releaser, even though it classes with releasers in regards to its potency effects. The 275

similarities between the MPH self-administration-induced DA system adaptations in the current study as compared to previous work with extended access administration

(Calipari et al., 2013 a, b) further highlights the unique properties of MPH, as cocaine self-administration when administered intermittently versus continuously results in divergent effects (Calipari et al., 2013 c). Taken together, this suggests that MPH is a unique compound and the effects cannot be generalized to other psychostimulants.

Further, prior MPH abuse may increase the neurochemical potency of releasers and

MPH, which could lead to increases in reinforcement and abuse of those compounds.

The NAc core region is involved in reward learning, goal oriented behaviors, and continued self-administration after acquisition has already occurred (Willuhn et al, 2010).

As a result, changes in release and uptake in this region can have implications, not only for drug effects, but also for learning and the execution of goal-oriented behaviors in the absence of drug. Here we see an increase in evoked DA release, which is likely due to subsensitive D2-like autoreceptors that are not as effective at reducing DA release. The increase in evoked release could lead to enhanced goal-reward associations, which could, in turn, lead to increased associations between drugs and their rewarding/reinforcing effects (Flagel et al., 2011; Wanant et al., 2009). It is important to note that although there are increases in evoked DA release following intermittent MPH self-administration, uptake rates are also increased, which could be a compensatory mechanism for the increased DA release. The increase in uptake rate is likely caused by an increase in DAT levels, which has been demonstrated previously following MPH self-administration

(Calipari et al., 2013a). The increase in DAT levels are particularly important, as increasing DAT levels alone, by transgenic over-expression has been shown to increase 276

the behavioral and neurochemical potency of releasers such as AMPH (Salahpour et al.,

2008; Calipari et al.. 2013a), highlighting that these baseline changes alone may increase

the susceptibility of individuals to abuse/addiction of psychostimulants.

In addition to differences in baseline evoked DA release between the groups, there

was a facilitation of MPH and AMPH-induced release effects. At increasing

concentrations, AMPH leads to depletion of DA terminals, observed as reduced

stimulated DA release (Jones et al., 1998), an effect that is enhanced by intermittent MPH

self-administration. This release profile is shared by releaser compounds and can be

used to determine the function of psychostimulants, specifically if they have releasing

properties (Ferris et al., 2011). Although MPH-induced DA release effects are enhanced,

MPH exhibits the release profile of a blocker, which is characterized by increased DA release with increasing concentrations. This demonstrates that although MPH classes with releasers in regards to its potency effects at the DAT it is not a pure DA releaser, but rather exhibits properties of both classes of psychostimulants. This is in line with previous work demonstrating that although MPH is not transported into cells, and thus, cannot release from vesicles, it binds to the DAT in a way that is similar to releasers

(Sonders et al., 1997; Dar et al., 2005; Wayment et al., 1999). Importantly, the difference between the release profile of MPH and AMPH highlights that the release effects of the compounds are not responsible for the enhanced potency of both of the compounds, as release is decreased for AMPH and increased for MPH but they both have enhanced uptake inhibition effects. Additionally, the D2 subsensitivity is also unlikely to drive the enhanced release of AMPH and MPH, as cocaine release was unaffected by MPH self- administration. 277

A potential mechanism for the increased potency of AMPH and MPH for causing

both uptake inhibition and release effects is via increased DAT levels. Previous work has

demonstrated that the enhanced potency of AMPH and MPH following extended access

MPH self-administration are due to elevated DAT levels, and here we observe the same

neurochemical effects, suggesting that these changes may occur via the same mechanism

(Calipari et al., 2013a, b). It has been shown previously that both the behavioral and

neurochemical effects of both AMPH and MPH, but not cocaine, are enhanced in mice

over-expressing the DAT (Calipari et al., 2013a; Salahpour et al., 2008). Although, this

is the first study to show enhanced MPH-induced DA release following MPH self- administration, it is possible that DAT levels dictate these effects as well. MPH self- administration results in AMPH depleting terminals faster, this could be due to the increased DAT levels, which allow more AMPH into the cell, resulting in enhanced vesicular DA depletion. Although MPH is not a releaser, it has been shown to redistribute vesicles from storage pools into the readily releasable pool (Chadchankar et al., 2012; Volz et al., 2008). This could be a potential mechanism for its release effects and it is possible that these effects could be dependent to MPH binding to the DAT.

Behaviorally, these neurochemical changes have important implications, as psychostimulant reinforcement is mediated by the ability of the compound to elevate DA and inhibit the DAT (Ritz et al., 1989; Roberts et al., 1977). Further, changes in drug potency in the NAc core, as measured by voltammetry, have been shown to be associated with concomitant changes in reinforcement behavior, with increases in potency resulting in increases in reinforcing efficacy (Calipari et al., 2013 b). This suggests that intermittent administration of MPH may lead to an increase in reward and reinforcement 278

behavior for amphetamines and other releasers, which could increase the abuse liability/addiction potential of these compounds. This is of particular importance, given the high increasing levels of MPH abuse in the adult and adolescent populations in recent years, as well as the co-abuse of MPH with other drugs such as amphetamines (Teter et al., 2006).

Both the kinetic changes and the drug potency changes are the same as have been seen previously with an extended access model of MPH administration, demonstrating that the neurochemical effects are due to MPH administration and not the escalation that occurs in extended-access situations (Calipari et al., 2013 a, b). Extended-access self- administration of MPH, and a number of other psychostimulants such as methamphetamine, nicotine, and cocaine, results in escalation of first-hour intake, and is thought to model the switch from abuse to addiction (Marusich et al., 2010; Ahmed &

Koob, 2003; Kitamura et al., 2006; Cohen et al., 2012). As such, much work has focused on the effects of escalation on reward, reinforcement, and DA neurochemistry (Ahmed &

Koob, 2003; Ben-Shahar et al., 2006). In previous work it was unclear if the effects were due to MPH administration itself, or the pattern of self-administration, which resulted in escalation. In the current intermittent access model, escalation does not occur; as a result, the neurochemical changes that occur cannot be due to escalation. Increased drug potency in the NAc core region has been shown previously to be predictive of similar changes in reinforcement and reward behaviors (Calipari et al., 201a), suggesting that

MPH administration may result in changes that could increase the abuse liability of amphetamines independent of escalation of intake. Further, this suggests that any temporal pattern of MPH intake can cause these effects, although the total intake per day 279

is a factor in determining if any changes occur (Calipari et al., 2013a). The changes

outlined in this study seem to be characteristic of abuse relevant doses, as therapeutic

doses seem to have no effect on DA system neurochemistry in the NAc core region.

Previous work using oral administration of MPH at low doses (5mg/kg, 2x per day)

resulted in no change in any DA system measures in the NAc. This is not surprising, as

at low doses MPH has been shown to preferentially increase DA in the prefrontal cortex,

an effect, which is thought to mediate is therapeutic cognitive enhancing effects. It is only

until higher doses that MPH effectively enhances DA release in the NAc (Berridge et al.,

2006; Devilbiss et al., 2008).

The lack of difference between previous work with an extended-access model and the

current intermittent access model highlights that MPH is unique in the compensatory changes that occur following self-administration as they relate to other psychostimulants

(Calipari et al., 2013a, b). In regards to cocaine self-administration, intermittent-access and long-access self-administration have different neurochemical effects, with long- access causing cocaine tolerance and intermittent access sensitization, demonstrating the pattern of intake plays an important role in determining the compensatory changes that occur following self-administration (Calipari et al., 2013c). Previous work using extended-access MPH self-administration has shown the same compensatory changes as intermittent self-administration, suggesting that for MPH self-administration, pattern of administration is not a factor in determine the neurochemical changes that occur. This is particularly relevant as MPH causes a sensitized effect when given both continuously and intermittently, while previous work with many other compounds has shown tolerance with continuous administration and sensitization with intermittent administration (Jones 280

et al., 1996; Griggs et al., 2010). The fact that sensitization, which is used as an addiction

model, occurs when MPH is taken in any pattern of administration, suggests that MPH

may be a particularly dangerous compound, especially when taken via non-oral routes of

administration.

Taken together, this work further highlights that MPH is a unique compound, both

in its acute effects as well as the compensatory effects that occur following self-

administration. Acutely, MPH exhibits the uptake-inhibition profile of a releaser but the release profile of a blocker suggesting that MPH is part of a unique class of compounds that does not fit into either the releaser or blocker category. Further, the compensatory effects that occur following MPH self-administration are not dependent on the temporal profile of MPH intake, an effect that is different from previous work with cocaine self- administration. This highlights that MPH, when taken in larger amounts than prescribed and via any pattern of self-administration, could potentially enhance the abuse and addiction potential of psychostimulant releasers such as AMPH, methamphetamine, and

“bath salts”.

Acknowledgements: This work was funded by NIH grants R01 DA024095, R01

DA03016 (SRJ), K99 DA031791 (MJF), T32 DA007246 and F31 DA031533 (ESC).

281

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CHAPTER IX

DISCUSSION

286

1. Introduction

A new, well-documented trend in the adolescent and young adult population is

diverting methylphenidate (MPH) prescriptions for recreational use. Individuals

administer MPH at levels 2-10 times the prescribed dose, however, until recently, there

has been no systematic evidence in the basic research literature on the neurochemical and

behavioral effects of this type of abuse (Teter et al., 2006). This work demonstrates that high-dose MPH self-administration, which models abuse of the compound, leads to

sensitized responses of the dopamine system to amphetamines and enhanced amphetamine (AMPH)-seeking in rats (Calipari et al., 2013a, b). These data suggest that

human MPH abusers may be more susceptible to abuse of, and addiction to, AMPH and related compounds.

To our surprise, a second major discovery was a basic mechanism that may predict vulnerability to abuse AMPH and other dopamine (DA) releasers. Namely, increases in DA transporter (DAT) levels produce increases in AMPH and DA releaser potency (Calipari et al., 2013a). This is important because it suggests that known variability in human dopamine transporter expression, particularly in disorders such as

ADHD (Madras et al., 2005), may serve as a marker for vulnerability for substance abuse disorder/addiction. Because both MPH and AMPH are readily available and are used commonly in the clinic, these results may have important implications for treating “at risk” individuals.

A third major discovery is that MPH may represent a new class of psychostimulant compounds. Although considered a DAT blocker, MPH has actions 287

similar AMPH, where increases in DAT levels increase MPH potency, a phenomenon

that does not extend to traditional blockers (Calipari et al., 2013a). In addition to its acute

actions at the DAT, MPH is unique in the compensatory changes that occur after repeated

self-administration of the compound (Calipari et al., 2013b). The sensitized releaser and

MPH potency that occur following MPH self-administration are different from the

alterations that occur after both cocaine and AMPH self-administration (Ferris et al.,

2011, 2012, 2013; Calipari et al., 2013c, d, e). Further, while cocaine self- administration-induced alterations are dependent on the temporal pattern of cocaine intake (Calipari et al., 2013c), the alterations that occur with MPH are independent of self-administration paradigm (Chapter 8). These results, taken together, necessitate a revision of the current two-category model for psychostimulants to allow for classifications beyond purely blocker or releaser.

2. The Effects of Methylphenidate Self-Administration on the Dopamine System are

Different from Other Psychostimulants

One of the first major findings of this work, outlined in Chapter 5, is that MPH, a

DAT blocker, had dopaminergic effects that were opposite from cocaine self- administration (Figure 1; Calipari et al., 2013b, c, d, e). We aimed to determine if the effects of MPH self-administration on the DA system would resemble that of blockers or releasers, as we had originally hypothesized that the compensatory effects that occurred following cocaine self-administration were due to the functional properties of cocaine as a DAT blocker (Mateo et al., 2005; Ferris et al., 2011, 2012, 2013). However, the lack of 288

289

Figure 1. Representative voltammetric dopamine traces highlighting the effects of

cocaine, amphetamine (AMPH), and methylphenidate (MPH) self-administration

(SA) on cocaine potency. For all panels (not real data), red traces represent typical baseline (pre-drug) release and uptake of dopamine in both naïve and cocaine SA animals. Black traces represent typical dopamine release and uptake following application of cocaine in naïve animals. Naïve animals represent animals with no drug history, but have cocaine applied to brain slices. Uptake is inhibited when cocaine is applied, leading to greater maximal peak-height and slower return to baseline. Blue traces represent inhibition of dopamine uptake following application of cocaine in animals with a history of cocaine (A), AMPH (B), or MPH (C) SA. Note that the blue trace in Panel A

(cocaine SA) exhibits a reduced maximal peak-height and reduced rightward-shift in the descending limb of the curve relative to the black trace (naïve). Therefore, cocaine SA produces tolerance to the neurochemical effects of cocaine (A), while AMPH (B) or

MPH (C) self-administration does not affect cocaine potency. Reprinted with permission from Ferris et al. Copyright (2013) American Chemical Society.

290

similarities between the compensatory effects following MPH and cocaine self-

administration demonstrated that the functional classification was not predictive of the

neurochemical outcomes following self-administration.

Despite almost identical behavioral profiles, baseline changes in maximal DA

uptake rate (Vmax) and stimulated DA release following MPH or cocaine self- administration were found to be opposite. Cocaine self-administration resulted in decreased stimulated DA release, decreased Vmax, and decreased DAT density, while

MPH self-administration resulted in an increase in Vmax and DAT density as well as an

increase in stimulated DA release in the nucleus accumbens core. The effects of MPH

and cocaine self-administration on drug potencies were opposite as well. Indeed, MPH

self-administration increased the potency of MPH, but not cocaine, and cocaine self- administration decreased the potency of cocaine, but not MPH, demonstrating that two drugs that result in identical self-administration behavior are capable of causing opposite neurobiological adaptations. Additionally, the changes following MPH self- administration are not in line with the changes associated with AMPH self-administration

(no changes; Ferris et al., 2011), suggesting that MPH is unique and does not fit into either the blocker or releaser class.

While MPH and cocaine are both classified as DA uptake blockers, they have different chemical structures, which may account for the disparate neurochemical changes that occur following self-administration. MPH is structurally related to AMPH, while cocaine is a tropane (Uhl et al., 2002; Volkow et al, 2002; Heal et al, 2009; Han &

Gu 2006). Additionally, MPH, exhibits binding properties that are distinct from both prototypical blockers and releasers, and these unique interactions with the DAT could, at 291

least in part, drive the differential compensatory changes associated with MPH self- administration as compared to AMPH or cocaine (Dar et al., 2005; Wayment et al.,

1999). MPH is not a DAT substrate, as it is not transported into cells (Sonders et al.,

1997); however, some studies have shown that MPH has the ability to promote reverse-

transport of DA through the DAT at very high doses (Sproson et al., 2001; Dyck et al.,

1980; Russell et al., 1998; Heal et al., 1996). It is clear that DAT inhibition-induced increases in extracellular DA levels do not explain the distinct neurochemical adaptations

MPH or cocaine self-administration, and we hypothesize that drug interactions with specific regions of the DAT may explain the differences observed.

3. Psychostimulant Self-Administration-Induced Changes at the DAT are not

Dependent on the Function of the Compound as a Blocker or Releaser

One of the questions addressed by this work was whether the structure of the compound, or its function, as a blocker or releaser, was responsible for the compensatory changes that occur at the DAT following self-administration. We conducted a number of studies using cocaine and MPH self-administration and were able to compare the results to previous work with AMPH self-administration (Ferris et al., 2011). Using MPH,

AMPH, and cocaine as comparator drugs gives the unique advantage of having a prototypical blocker (cocaine), a prototypical releaser (AMPH), and a compound that is classified as a blocker but is structurally similar to releaser (MPH). The unique structural and functional profile of MPH allows for the determination of how structure and function affect the DAT. We hypothesized that if psychostimulant self-administration-induced 292

alterations to the DAT were due to structure, MPH effects would resemble those of

AMPH. Alternatively if the changes were due to the function of the compound as a

blocker or releaser then MPH-induced alterations would closely resemble those of

cocaine.

Ferris et al. (2012) demonstrated that cocaine self-administration resulted in tolerance to the ability of cocaine and other DAT blockers, but not releasers, to inhibit

DA uptake at the DAT. It was initially hypothesized that the effects were due to the function of cocaine as a blocker, thus all compounds of the same class were affected.

However, following cocaine self-administration, MPH potency was unaffected,

suggesting that the effects were not purely due to the function of the compound. MPH is

structurally similar to releasers, and is an AMPH analog (Uhl et al., 2002; Heal et al.,

2009; Han & Gu 2006), thus we hypothesized that the changes following cocaine self-

administration were due to the structure of the compound, but not the function.

Using AMPH, a prototypical releaser, Ferris et al., (2011) determined the effects

of releaser self-administration on the DA system. Not surprisingly, self-administration of

releasers (AMPH self-administration) results in no change in potency for any of the drugs

tested (blockers or releasers). This is likely due to the fact that the structures of many DA

releaser drugs are closely related to the structure of DA itself. Because of the structural

similarities between DA and releaser compounds, any changes in the potency of these

compounds for the DAT would likely also result in changes in the affinity of DA for the

transporter. 293

In order to determine if cocaine and AMPH self-administration-induced changes at the DAT are due to structure or function of the compound we then assessed the consequences of MPH self-administration on the DA system, as discussed in Chapter 6.

Because we initially hypothesized that the compensatory changes at the DAT were associated with the function of the compound, we expected MPH-induced changes to resemble the changes associated with cocaine self-administration. However, MPH self- administration produced a neurochemical profile that did not resemble the adaptations associated with blocker or releaser self-administration. Because MPH interacts with the transporter in a way that is distinct from both blockers and releasers (Dar et al., 2005;

Wayment et al., 1999), it is likely that the compensatory changes associated with psychostimulant self-administration are actually due to the interactions of the compound with the DAT, and not their function as a blocker or releaser.

Of particular importance, these data confirm that the changes associated with psychostimulant self-administration are not due to the ability of the compounds to elevate

DA levels, as all of the drugs do this acutely, and to a similar extent at the doses tested.

If the psychostimulant-induced alterations were due to elevations in extracellular DA, the compounds tested here should result in similar changes to the DA system following self- administration. In contrast, we observed distinct neurochemical adaptations following self-administration of MPH, AMPH or cocaine, demonstrating that the differential DA system alterations following psychostimulant self-administration are likely a result of the compounds interacting with the DAT at different binding sites.

Although it is likely that the structure of the compound is the main factor dictating the compensatory changes that occur at the DAT following psychostimulant self- 294

administration, there are a number of potential caveats. First, MPH has been shown to

have release capabilities at high doses (discussed in chapter 8), thus it is possible that the

effects of MPH self-administration, which are divergent from cocaine self-administration,

are due to MPH acting as a releaser, and not a blocker. However, this is unlikely because

if MPH was acting as a releaser to cause its effects, it would be expected that the changes associated with MPH self-administration would resemble that of AMPH self- administration.

Second, it is possible that the differences between the affinities of these compounds for the DAT, serotonin transporter (SERT), and norepinephrine transporter

(NET) could play a role in the differential neurochemical consequences observed following self-administration of each compound. While AMPH and cocaine have high affinity for the DAT, SERT and NET, MPH has low affinity for the SERT as evidenced

by studies demonstrating that physiologically relevant doses of MPH do not result in

increased serotonin levels or SERT inhibition (John & Jones, 2007; Gatley et al., 1996).

It is possible that differential effects on serotonin levels underlie discrepancies in

compensatory changes that occur following MPH self-administration as compared to self-

administration of cocaine and AMPH. This could be tested by administering a serotonin

reuptake inhibitor, such as fluoxetine, in combination with MPH to determine if

modulation of serotonin levels can account for differences between MPH and cocaine-

induced alteration of dopaminergic function

295

4. The Pattern of Intake (Intermittent vs. Continuous) Dictates the Compensatory

Changes that Occur at the DAT Following Cocaine, but not MPH Self-

Administration.

In the literature, there are reports of increased, decreased and unaltered DA uptake

rates following cocaine self-administration (Ferris et al., 2011; Ramamoorthy et al., 2010;

Mateo et al., 2005; Wilson and Kish, 1996). The discrepancies in previous results may

result from differential self-administration paradigms producing different neurobiological

effects, emphasizing the need for equating doses as well as injection frequency, timing

and duration when comparing the compensatory effects of different drugs. We aimed to

determine what was driving MPH and cocaine-induced neurochemical changes to DA

system. We have observed both sensitization of effects (following MPH self-

administration; intermittent cocaine self-administration) and tolerance to the effects of

drugs (following long-access cocaine self-administration); thus, we focused on exploring

how intake and temporal profile of self-administration dictate the compensatory effects of

MPH and cocaine.

As outlined in Chapter 4, for cocaine self-administration intake is responsible for the development of neurochemical tolerance, while temporal pattern of self- administration (intermittency) dictates the development of a sensitized response to

cocaine (Calipari et al., 2013c). These findings are consistent with previous work using

intermittent experimenter-administered intraperitoneal (IP) injections of cocaine, which

has documented sensitization of the mesolimbic DA system and corresponding behavior

(Kalivas and Duffy, 1990, 1993; Parsons and Justice, 1993; Addy et al., 2010).

Conversely, experiments using continuous cocaine administration (via mini-pumps or 296

long-access self-administration), like the long-access model within this work, resulted in neurochemical tolerance (Jones et al., 1996; King et al., 1998; Inada et al., 1992; Calipari et al., 2013b, c), highlighting the importance that pattern of administration plays in determining the neurochemical effects elicited by cocaine.

Discussed in Chapter 5, in contrast to the changes observed following cocaine self-administration, temporal pattern had no effect on MPH self-administration-induced

DA system adaptations (Calipari et al., 2013a, c). Both extended-access and intermittent access MPH self-administration resulted in increased releaser and MPH, but not cocaine potency, as well as elevated maximal rates of uptake and enhanced pre-drug evoked DA release. While previous work with many other compounds has shown tolerance with continuous administration and sensitization with intermittent administration, MPH is unique as MPH self-administration causes sensitized effects of both MPH and releaser compounds when given both continuously and intermittently (Jones et al., 1996; Griggs et al., 2010). The fact that sensitization of MPH and amphetamines occurs independent of the pattern of MPH intake, suggests that MPH may be particularly dangerous, even following limited, sporadic administration.

5. Methylphenidate Abuse May Result in an Increased Abuse Liability for Releaser

Psychostimulants

Our results demonstrating increased potencies of MPH and releasers following

MPH self-administration suggest that there may be an increased abuse liability for these compounds following MPH abuse in the human population. These effects occur 297

following both intermittent and extended access self-administration further supporting the idea that MPH is dangerous when abused, and, unlike cocaine, any pattern of self- administration results in increased potency of psychostimulant releasers. The increase in neurochemical potency is accompanied by an increase in reinforcement behavior

(Calipari et al., 2013a), where animals will expend more effort in order to obtain MPH at both high and low doses. Increased reinforcement behavior is thought to model abuse liability and increases in effort on higher order schedules such as progressive ratio or the threshold procedure used here, are thought to signify an increased abuse liability in humans.

Although this work has implications for augmented abuse potential of MPH following prior MPH use, the increase in motivation to obtain releaser compounds demonstrates that the effects of MPH extend beyond MPH abuse in isolation. It has been proposed in the literature that MPH does not have significant abuse/addiction potential, and that, accordingly, changes in the motivation to administer MPH do not have clinical relevance (Schubiner, 2005). Although there is some epidemiological data to support these ideas, the reduced addiction rates of MPH as compared to cocaine are likely due to differences in the route of administration, and not due to an intrinsic property of the compound (Parasrampuria et al., 2007; Kollins et al., 1998). The idea that

MPH is safe and has limited addiction potential has prevented much of the MPH abuse literature from being deemed clinically relevant. Here we demonstrate with a number of studies that the perceived lack of clinical relevance is particularly misguided based on the effects of MPH self-administration on other psychostimulants. Independent of the effects

of MPH self-administration on MPH reinforcement, MPH also increases the 298

neurochemical potency of releasers, such as AMPH and methamphetamine (METH).

Because AMPHs have relatively high addiction potential, it is possible that MPH abuse could lead to an increased propensity for AMPH and METH abuse/addiction. This is particularly relevant given the co-abuse of MPH with a number of other compounds including nicotine, alcohol, and other stimulants such as AMPH and METH (Sepúlveda et al., 2011)

6. Therapeutic Administration of MPH Does Not Result in the Same Dopamine

System Changes as Abuse Relevant Doses

Although we have shown that pattern of self-administration does not dictate the dopamine system changes that occur following MPH self-administration, intake plays an obvious role in the effects of MPH administration on the DA system. Here we demonstrate that oral administration of low, therapeutic doses and i.v. administration of high, abuse-relevant doses have completely different neurochemical consequences. The lack of effect of oral MPH administration on the DA system is consistent with published work showing no significant neurochemical changes following long-term therapeutic

MPH administration (Gill et al., 2012; Humphreys et al., 2013). These data suggest that although MPH could enhance the reinforcing efficacy of MPH and releasers when taken via non-oral routes, and in larger doses than prescribed, the therapeutic use of MPH, taken as prescribed, may be safe.

MPH has differential effects at high and low doses, which is likely due to the fact that low-dose MPH preferentially increases DA in the PFC, while higher doses increase 299

DA in both the PFC and nucleus accumbens (Berridge et al., 2006; Devilbiss et al.,

2006). The selective increase in the PFC could be involved in the cognitive enhancing

effects of MPH, but is likely independent of its reinforcing effects (Devilbiss et al., 2008).

The inability of MPH to elevate DA in striatal regions at therapeutic doses could explain the lack of effects of oral MPH administration on DA terminals and psychostimulant potencies measured here. Together these data further highlight the dissociation between the effects of therapeutic and abused doses of MPH.

7. DAT Levels Dictate Releaser, but Not Blocker, Potency

This work uses a comprehensive approach to look at the effects of DAT levels on

psychostimulant potency in neurochemistry and behavior, and highlights that current

theories on DAT levels influencing blocker potency may need revision. The current

consensus is that increases in DAT levels lead to a reduction in cocaine potency, and that

lower DAT levels results in increased cocaine potency. This theory originates from two

main sources: 1) Cell culture work showing that DAT overexpression in cells results in

decreased cocaine potency with no change in AMPH potency (Chen & Reith, 2007), and

2) Historically, the ability of cocaine to elevate DA in the NAc shell, where DAT levels

are low, is much greater than that of the dorsal striatum, where DAT levels are high.

Here we demonstrate both behaviorally and neurochemically, that increasing DAT levels

in vivo does not change cocaine potency but does alter AMPH potency. Thus, we are

proposing a novel theory by which posits that cell surface expression dictates the potency

of releasers, but not blockers. 300

First, with respect to discrepancies between the findings demonstrated here and previous cell culture work, one possibility is that the use of endogenous DA in voltammetry may produce different results than [3H]-DA used in cell culture studies

(Chen & Reith, 2007). It is possible that [3H]-DA is sequestered into intracellular compartments differently than endogenous DA and that releaser compounds do not have access to this [3H]-DA. Additionally, it should be noted that many cell culture studies have determined the absolute effect of psychostimulants on DA levels, neglecting the influence of baseline rates of uptake in the overall effects of these drugs. This is particularly relevant as much work has suggested that behavioral outputs are dependent on a change relative to baseline, not the overall DA levels in isolation (Cragg 2006;

Threlfell & Cragg. 2011; Calipari & Ferris, 2013). For example, when DAT levels are increased, as seen in mice with genetic overexpression of functional DATs, baseline uptake is faster. Thus, even with comparable absolute effects between animals, the change from baseline is greater in an animal with increased baseline uptake.

Voltammetry determines the effects of the drug while accounting for baseline uptake rates, and therefore, our voltammetry data is consistent with the behavioral outcome of the current study as well as a number of other studies (Salahpour et al, 2008).

Second, the increased potency of cocaine in the shell relative to the caudate has been demonstrated in vivo with microdialysis; however, there are a number of factors that could be influencing the differential cocaine potency across regions. In fact, previous work using voltammetry in freely-moving animals has confirmed that brain regional variation in the potency of cocaine are attributed to differences in D2 autoreceptor 301

sensitivity in regulating DA release, and not differences in DAT levels (Aragona et al.,

2008).

Regardless of possible differences in cocaine potency due to other factors such as D2

receptor function or methodological differences, we demonstrate that the changes

observed using voltammetry are predictive of behavioral outcomes in regards to both

locomotor activity and reinforcing efficacy. Increases in DAT levels as observed

following DAT overexpression or following MPH self-administration result in increased

MPH and AMPH, but not cocaine potency. This was consistent with both locomotor

activity and reinforcement behavior showing an augmentation of AMPH and MPH-

induced behaviors, with no change in the effects of cocaine. It is important to note that,

previously, Salahpour et al. (2008) demonstrated that there was no difference in MPH-

induced locomotor responses at 20 mg/kg in DAT-tg mice. We also found no change in

MPH-induced locomotor activity at the 20 mg/kg dose, however, the dose was on the descending limb of the inverted “U” shaped dose-response curve dose-response curve, and at lower doses, MPH-induced locomotion was enhanced in DAT-tg mice.

8. Methylphenidate is Unique in the Way that it Interacts with the DAT

As discussed previously, MPH is traditional classified as a blocker, as cell culture

studies have demonstrated that it is not transported into the cell via the DAT, and thus

cannot interact with vesicles and cause active release of DA, as has been observed with

releasers (Sonders et al., 1997). Even though MPH is categorized as a blocker, it has

been shown to have releasing capabilities at 0.1mM, suggesting that MPH may have 302

properties of blocker and releaser compounds (Sproson et al., 2001; Russell et al., 1998;

Heal et al., 1996).

Although MPH has been suggested to have release capabilities, within this work

(discussed in chapters 7 & 8) we show that MPH exhibits the release profile of a blocker, which is characterized by increased DA release with increasing concentrations. This demonstrates that although MPH classes with releasers in regards to its potency effects following MPH and cocaine self-administration, it is not a pure DA releaser, but rather exhibits properties of both classes of psychostimulants. Since MPH is not a substrate, like the prototypical blocker cocaine, yet classes with releasers in its acute effects at the DAT following cocaine and MPH self-administration, MPH may function as an atypical DAT inhibitor, exhibiting pharmacological characteristics similar to AMPH as well as COC via a number of mechanisms.

In regards to effects at the DAT, MPH actions seem to resemble those of DA releasers, even though it is traditionally categorized as a DAT blocker. A number of other studies have found similar results in regards to DAT binding as well as following cocaine self-administration where MPH seems to group with releasers (Dar et al., 2005;

Ferris et al., 2011, 2012; Wayment et al., 1999). Because MPH has been shown to promote reverse transport of DA at high doses (Russel et al., 1998; Dyck et al., 1980) it is possible that these effects are responsible for its classification as a releaser in these studies. However, as mentioned previously MPH is not transported into the cell (Sonders et al., 1997), therefore its releasing properties must act through different mechanisms than traditional releasers such as AMPH. These release capabilities, independent of being transported into the cell, could be due to a number of factors. 1) MPH binds to the 303

DAT in a manner that is distinct from prototypical blockers or releasers (Dar et al., 2005;

Wayment et al., 1999), with significant overlap between the binding sites for both cocaine and AMPH. It is possible that, although MPH is not transported into the cell, the interaction with the AMPH binding site on the DAT results in conformational changes in the DAT which promote reverse transport in the same way as AMPH. 2) MPH has been demonstrated to result in the mobilization of vesicles into the releasable pool. It is possible that this effect of MPH is dependent on the DAT, thus when there are increased

DAT levels, MPH is better able to induce exocytotic release from vesicles (Volz et al.,

2007, 2009; Sandoval et al., 2002; Chadchankar et al., 2012).

9. Clinical Relevance

This work has revealed an important, novel concept, whereby increased DAT levels, such as those documented in individuals suffering from ADHD (Spencer et al.,

2012), lead to an increase in potency of DA releasers such as AMPH. Many of these individuals, as is the case with ADHD, are treated with stimulant drugs, making it critically important to understand the effects that these drugs have in the case of elevated

DAT levels in order to minimize abuse liability, neurotoxicity, and negative side effects.

Additionally, models of PTSD (Hoexter et al., 2012), early life stress (Yorgason et al.,

2012), and repeated stress (Kohut et al., 2012) all result in similar increases in DAT levels; therefore, many individuals fall into this “at risk” category, making these findings relevant to a large population that extends far beyond the drug abuse field. 304

In regards to drug abuse, in the last SAMHSA survey, 4.8 million people reported abusing MPH, compared to 5.2 million for cocaine. While these reports are already alarming, they rely on the self-reporting of abuse of these compounds and as a result the numbers could be an underestimation for what is actually occurring in the human population. Given the high prevalence of MPH abuse, it is important to determine the neurochemical and behavioral consequences in pre-clinical models. There are numerous reports in humans of co-abuse of MPH with a number of other compounds including

AMPH and cocaine (Barrett et al., 2005; Teter et al., 2006; Wilens et al., 2008), and here we show that prior MPH abuse may sensitize releaser reinforcement. This sensitized reinforcement may lead to an increased propensity for abuse of releaser compounds, such as AMPH and methamphetamine.

10. Future Directions

Future work should focus on finding the mechanism for differential alterations in

DAT levels/uptake rates and stimulant potency caused by MPH and cocaine self- administration. Functional regulation of the DAT protein occurs by a number of processes including phosphorylation, glycosylation, palmitoylation, and oligomerization of the DAT protein itself, as well as interactions with other presynaptic receptor subtypes such as D2 autoreceptors (Ferris et al., 2013). Discussed below are some potential mechanisms for drug-induced DAT trafficking changes following MPH self- administration and the DAT-trafficking-independent tolerance caused by cocaine self- administration. 305

10.1. Cocaine Self-Administration Mechanisms

10.1.1. N-Terminal Interactions

Both the N and C terminals of the DAT are cytoplasmic, and various regions of

both of these domains are involved in protein interactions that are capable of modifying

the function of the transporter (Giros and Caron, 1993). Of particular importance are the

N-terminal and the first transmembrane domain, which is extremely important for the

binding of transporter substrates such as DA. A large body of research exists concerning

the modulation of the DAT at the N-terminus by phosphorylation and interaction with

intracellular signaling molecules (Chen et al., 2010; Giros and Caron, 1993; Guptaroy et

al., 2008, 2010).

The N-terminus of the DAT contains phosphorylation sites for a number of

kinases including protein kinase C (PKC), protein kinase A (PKA), and

Ca2+/Calmodulin protein kinase II, and is also important for substrate binding (Giros and

Caron, 1993). A number of studies have used human embryonic kidney (HEK) cells

stably transfected with various mutated forms of the human DAT (hDAT) to study the

role that the N terminal threonine residue (Thr62) has on the functionality of the

transporter (Guptaroy et al., 2008, 2010). One of the mutants, T62D-hDAT (threonine to aspartic acid), was particularly interesting, in regards to cocaine self-administration

effects. In line with the compensatory effects that occur following cocaine self-

administration the T62D mutant had reduced surface expression as well as reduced

uptake rates (Guptaroy et al. 2008). Further, the T62D-hDAT also had a reduced potency 306

of cocaine to inhibit [3H]-DA uptake compared to hDAT; however, their efficacy was unaffected as they were able to completely block DA uptake. This suggests a large role for Thr62 in transporter function and psychostimulant action. It is possible that following cocaine self-administration, modifications to this region of the DAT are responsible for the reduced cocaine effects as well as the other dopaminergic changes that have been observed.

10.1.2. Dopamine Transporter Complexes: Oligomers and D2 Interactions

It has been demonstrated that the DAT forms oligomer complexes with itself and other proteins such as D2 autoreceptors (Chen & Reith 2008; Hadlock et al., 2010).

Further, it has been suggested that the oligomerization of DAT proteins could lead to changes in uptake rates, where by the complexes have reduced uptake function than the same number of monomer DAT. It is possible that DAT complex formation reduces the potency of cocaine to inhibit DA uptake. In line with this, it is possible that cocaine self- administration is resulting in DAT complex formation, an effect that leads to reduced uptake and reduced cocaine potency.

This can be easily tested and would be a powerful mechanism to explain the reductions in cocaine potency that occur following cocaine self-administration. Western blot hybridization can be utilized to determine the formation of higher-order complexes; however, it is difficult using western blot to determine what each complex is comprised of. Pull-down assays can be used to assess the changes in the interaction of D2 receptors with the DAT to determine if the complexes contain D2 autoreceptors. Determining if 307

these complexes are responsible for the changes associated with cocaine self- administration and what proteins are within the complex will allow new insights into the neural mechanisms driving the addiction process.

10.2. Methylphenidate Self-Administration Mechanisms

10.2.1. Substrate-Induced Rapid Trafficking of DAT

Because of the structural similarities of MPH and AMPH, it is possible that MPH is increasing DAT levels via some of the same mechanisms as AMPH. AMPH has been shown to rapidly increase surface expression of DAT (Johnson et al., 2005; Furman et al.,

2009). AMPH-induced changes in DAT surface expression happened almost instantaneously with significant increases occurring after only ten seconds. Using reversible biotinylation it was determined that AMPH increases surface expression by promoting insertion of transporters into the membrane, and not by delaying the endocytosis of transporters already present in the membrane (Johnson et al., 2005;

Furman et al., 2009). The effect on DAT trafficking in these studies was brief with the increased surface expression lasting only 2.5 minutes. However, these studies were done in cell culture and it is possible that the effects would be more sustained in an in vivo model. Although the mechanism for this effect is unclear, it is possible that MPH is upregulating DAT levels via a similar mechanism, an effect that is a promising avenue for exploration.

308

10.2.2. D2-DAT Interactions

Another possible mechanism for the upregulation of DAT function/number

following MPH is through D2 autoreceptors. D2 receptors are located presynaptically

on DA nerve terminals and function to inhibit DA release and synthesis in order to reduce

synaptic DA levels. Additionally, it has been demonstrated that activation of D2/D3 type

autoreceptors can cause rapid DAT toward the cell surface an increases in uptake rates

(Cass & Gerhard, 1994; Thompson et al., 2001 a, b). The DAT and D2 interact through

direct physical interactions at N-terminus and the third intracellular loop of the D2 autoreceptor (Thompson et al., 2001b), which has been hypothesized to facilitate intracellular DAT trafficking to the surface. The disruption of this interaction in vivo results in decreased striatal synaptosomal DA uptake and increased locomotor activity, mimicking DAT-knockout mice (Thompson et al., 2001b), indicating that this interaction is essential for DAT function. Further, voltammetry studies have shown that D2 agonists increase the rate of uptake (Vmax) (Meiergerd et al., 1993; Batchelor and Schenk, 1998;

Dickinson et al., 1999). Vmax is often regulated by DAT levels, thus it is likely that the

increased Vmax is due to increases in DAT surface expression.

Because D2 activation leads to increases in DAT surface expression and Vmax, it

is possible that MPH-induced activation of D2 autoreceptors is leading to the increasing

DAT levels following MPH self-administration. Because MPH is structurally similar to

both AMPH and DA it is possible that MPH has binding properties at the D2 receptor.

However, it has been demonstrated that at physiologically relevant concentrations that

MPH only exhibits limited affinity for D2 receptors (Gatley et al., 1996). Therefore, if D2

receptor activation is the mechanism of the upregulated DAT levels it is likely that it is 309

due to MPH-induced elevations in DA levels. However, because cocaine, which

increases DA to a similar extent, causes opposite changes this suggests that either

elevations in DA does not mediate this effect, or for cocaine there is another competing

mechanism causing the decreases in DAT expression observed following cocaine self- administration.

It is possible that MPH is activating some of the signaling cascades originating from the D2 receptor, which leads to these effects. D2 receptors signal via G proteins to a number of downstream effectors, including adenylyl cyclase, ERK1/2, and the PI3k cascade via phosphorylation of Akt (Neve et al., 2004; Brami-Cherrier et al., 2002; Beom et al., 2004; Burgering and Coffer, 1995; Brami-Cherrier et al., 2002; Beaulieu et al.,

2005). Recent work has shown that the PI3K pathway (Carvelli et al., 2002) and the mitogen-activated protein kinase pathway (MAPK; Moron et al., 2003) modulate DAT function by altering cell surface expression, suggesting that if MPH was modulating this pathway that these effects could occur.

Indeed, Pascoli et al., (2005) showed that MPH increased ERK phosphorylation.

Increasing ERK1 and ERK2 phosphorylation affects DAT function by increasing surface

DAT expression, which is consistent with MPH increasing DAT levels via this pathway

(Parnas & Vaughn, 2008; Morón et al., 2003; Schmitt & Reith, 2010). Therefore it is possible that MPH self-administration results in increased activity of the MAPK pathway containing ERK 1 and ERK 2, which leads to increased DAT expression at the surface.

However, conversely, Mines and Jope (2012) show that after eight days of methylphenidate treatment, striatal Akt was dephosphorylated. Although this is consistent with D2 activation, which has been shown to reduce Akt levels (Beaulieu et 310

al., 2005, 2008), reductions in Akt levels/phosphorylation would likely lead to reduced

surface expression. It is also possible that immediately following or during the MPH self-

administration session that Akt levels/phosphorylation are reduced, and following acute

withdrawal the levels increase, increasing DAT levels, in order to compensate for the

sustained reduction. Within this work, changes following MPH self-administration were only assessed at one time point≈ 18hrs( following the commencement of the final session), thus it is unclear as to what changes occur at other points of withdrawal. A time

course of DAT changes following MPH self-administration would elucidate this and could determine if this is a potential mechanism.

10.3. Determine Regional Specificity of Effects

Although the nucleus accumbens (NAc) core plays an integral role in

reinforcement behavior (Roberts et al., 1977), it is possible that other striatal brain

regions may mediate different aspects of MPH self-administration, such as reinstatement

responding, especially after long periods of exposure. The dorsal striatum has been

shown to mediate cocaine seeking following abstinence, whereby, inactivation of the

dorsal striatum reduces cocaine seeking, and inactivation of the ventral striatum has no

effect (See et al., 2007). In humans, presentation of drug-paired cues to cocaine addicts increases DA activity in the dorsal striatum, which is correlated with the intensity of cue- induced craving, suggesting that the dorsal striatum may play a role in relapse in humans as well as cue-induced reinstatement in rodents (Volkow et al., 2006; Wong et al., 2006).

Because of this, it is possible that the ventral striatum is mediating the 311

rewarding/reinforcing properties of drugs during and immediately following self- administration paradigms, such as what was seen in this work with MPH self- administration. However, following abstinence, it is possible that the effects are driven by changes in the dorsal striatum. This is particularly important for drugs like MPH, which are taken intermittently, as there are repeated abstinence periods that occur between exposures. It will be important to determine the changes that occur during different periods of abstinence and how these neurochemical changes in the ventral versus dorsal stratum differentially mediate reinstatement and reinforcement behaviors.

The dorsolateral striatum is thought to control well-established cue-controlled cocaine seeking, and it mediates habit learning, specifically the association of motor outputs with reinforcement, such as an animal responding on a lever for drug (Everitt and

Robbins, 2005; Pierce and Vanderschuren, 2010; Ito et al., 2000, 2002; Vanderschuren et al., 2005; Belin and Everitt, 2008; Packard and Knowlton, 2002; Yin and Knowlton,

2006). This region plays a role in drug seeking following repeated self-administration sessions, especially when drug administration becomes habitual and stimulus driven

(Everitt and Robbins, 2005; Pierce and Vanderschuren, 2010). Because of the importance of the dorsolateral striatum in drug-seeking and habitual responding, two behaviors that are integral to the addiction process, it will be important to determine the effects of MPH self-administration both neurochemically and behaviorally in this region.

This can be done pairing voltammetry with reinstatement studies as well as inactivation studies and studies determining the functional activity of specific brain regions following self-administration, abstinence, and reinstatement in rodents. 312

Additionally, it has been shown with cocaine self-administration in monkeys in regards to the DA system, that in the early stages of cocaine self-administration the ventral striatum is most active, while over time the activity shifts to include the dorsal striatum (Porrino et al., 2007; Moore et al., 1998; Letchworth et al., 2001; Nader et al.,

2002; Porrino et al., 2004). It is possible that the same changes in drug potency occur in all of the striatal regions following MPH self-administration; however, that the changes in the more dorsal regions of the striatum are what is really driving the reinforcement behavior. Inactivation studies could be done in order to determine the contribution of these regions to threshold responding following MPH self-administration.

10.4. MPH Allows for the Determination of the Relationship Between Tolerance and the Development of Addictive-Like Behaviors.

Because MPH and cocaine are virtually identical in their behavioral self- administration profile in regards to FR1 self-administration (Calipari et al., 2013a, b, c, d, e), but cause sensitization and tolerance, respectively, studies that compare these drugs provide unique insight as to the contribution of tolerance to the drug addiction process.

Although tolerance to the euphorigenic and neurochemical effects of cocaine is often seen in cocaine addicts and abusers, it is unclear if this tolerance is a cause or consequence of the addiction process. It is possible that tolerance to the effects of cocaine are a byproduct of repeated cocaine self-administration, however, it is also possible that tolerance is driving many of the behavioral effects that occur during the addiction process, such as increased motivation to administer drug. In animals the 313

addiction process has been modeled using a variety of techniques, including measures of

reinforcing efficacy such as progressive ratio (PR) paradigms.

Although the PR paradigm of self-administration is thought to assess reinforcing

efficacy it is possible that it is not assessing solely that. It is currently accepted that neurochemical tolerance to a compound would result in reduced responding on a PR schedule, and decrease breakpoints. Because of this much literature has used increases in

PR to suggest that animals are not tolerant to the effects of cocaine following long-access

cocaine self-administration (Paterson and Markou, 2003; Wee et al., 2008). However,

contrary to this theory, Lack et al., (2008) demonstrate that tolerance to the locomotor

activating effects of cocaine occur following escalation on a PR schedule. Therefore,

increased breakpoints are associated with tolerance to cocaine’s effects behaviorally.

Additionally, because locomotor activity is mediated by the DA system, it is likely that

these animals are tolerant to the effects of cocaine neurochemically, a phenomenon that

has been shown repeatedly following a number of cocaine self-administration paradigms

(Hurd et al., 1989; Calipari et al., 2013b, c, d, e; Ferris et al., 2011; Mateo et al., 2005).

The threshold procedure of reinforcement (Oleson et al., 2009, 2011, 2012)

provides a perfect avenue to study the effects of neurochemical tolerance and

sensitization on reinforcement behavior. Although the threshold procedure can still show

information about reinforcing efficacy, where the Pmax is positively correlated with PR, it

also allows for the assessment of other factors. For example, while Zimmer et al., (2012)

demonstrate that the Pmax for cocaine is increased following long-access cocaine self-

administration, Oleson et al., (2009) show that intake is only increased at high doses

where price is low and is actually decreased at doses where animals have to expend more 314

effort to obtain drug, indicating tolerance. Taking advantage of the threshold procedure

following MPH and cocaine self-administration may allow for the determination of how tolerance and sensitization change different aspects of drug reinforcement.

11. Conclusions

Taken together, this work provides important information, not only about the

consequences of MPH and cocaine self-administration on the DA system, but also about how compensatory effects of psychostimulant self-administration occur at the DAT following repeated drug administration. These data have implications for not only the

DAT, but also all other transporters in the solute carrier 6 (SLC6; also known as: neurotransmitter-sodium-symporter family or Na(+)/Cl(-)-dependent transporters) family of transporters (Kristensen et al., 2011). These transporters include transporters for serotonin, norepinephrine, GABA and glycine, and it is likely that the compensatory changes that occur at these transporters do so in a similar fashion.

Further, these data highlight the importance in continuing work on the neurochemical consequences of high-dose MPH self-administration. The neurochemical changes that occur following MPH self-administration suggest that individuals that abuse

MPH may be more susceptible to the abuse and addiction of a number of highly addictive psychostimulants. Given the high prescription rates of MPH, it is readily available, and highly abused, making studies highlighting the consequences of its misuse imperative. 315

And finally, this work elucidates some of the factors that influence the compensatory changes that occur at the DAT following cocaine self-administration.

Because intake and pattern play a prominent role in determining the neurochemical adaptations that occur, it is important to choose a model that accurately mimics human administration of the compound. 316

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APPENDIX I

CONSERVED DORSAL-VENTRAL GRADIENT OF DOPAMINE RELEASE AND UPTAKE RATE IN MICE, RATS, AND RHESUS MACAQUES

Erin S. Calipari, Kimberly N. Huggins, Tiffany A. Mathews, and Sara. R. Jones

The following manuscript was published in Neurochemistry International, volme 61(7), pages 986-91, 2012, and is reprinted with permission. Stylistic variations are due to the requirements of the journal. Erin S. Calipari performed all rat and mouse experiments, all data analysis, and prepared the manuscript. Dr. Tiffany Mathews performed all monkey voltammetry experiments. Drs. Kimberly N. Huggins and Sara R. Jones acted in an advisory and editorial capacity. 326

Abstract

Although the vast majority of research on the dopamine system has been

performed in rodents, and it is assumed that this work will inform us about the human

condition, there have been very few direct comparisons of presynaptic dopamine terminal

function across multiple species. Because it is difficult to query rapid sub-second dopamine signaling in humans using voltammetric methods, we chose to compare dopamine signals across multiple striatal subregions in slices from C57BL/6J mice,

Sprague-Dawley rats and rhesus macaques. We found a dorsal to ventral gradient of dopamine uptake rates with highest levels in the dorsal striatum and lowest levels in the nucleus accumbens shell, which is conserved across species. In addition to uptake rates, there was also a dorsal to ventral, high to low, gradient in the magnitude of stimulated

DA release observed in monkeys, mice, and rats. These data demonstrate that there is considerable functional homology across striatal regions in non-human primates and rodents, lending support to the use of rodents as model systems to study dopamine-related circuitry and disorders that are clinically relevant to the human population.

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1. Introduction

Because of the ethical limitations of conducting research in humans, model

systems must be used to gather information about human disorders. Monkeys and

rodents are both commonly used as model systems to study neurobiology, and there is a

great deal of homology across various neural networks as well as the actions of drugs

across species (Bradberry, 2008; Levey et al., 1993). Currently, monkeys are the closest

models of human conditions, but rodents are commonly used to model processes such as

neurodegenerative diseases, stress, anxiety and addiction, due to the ability to use more

invasive and comprehensive techniques (Chesselet and Richter, 2011;Roberts et al.,

2007; Silberman et al., 2010). Although it is obvious that humans and rats differ

significantly, it is important to determine the translational capability of neurobiological studies in rodents by determining how well functional parameters in the rat and mouse brain are similar to non-human primates and humans.

The dopamine (DA) system is dysregulated in many human disorders, including addiction, schizophrenia, Parkinson’s disease, anxiety, attention deficit/hyperactivity disorder (ADHD) and many others (Carlsson, 1988; Jentsch et al., 2000; Goto et al.,

2010). Thus, comparing the functionality of dopaminergic regions across species is vital for determining the translational validity of animal models of a multitude of human neurological conditions. There are some cross species comparisons using PET imaging and dopamine transporter (DAT) occupancy in humans, baboons and rats (Ding et al.,

1997; Fowler et al., 1998), however, there is limited information on region specific DA kinetic parameters, such as release and uptake (Cragg et al., 2000, 2002). Anatomical distinctions within the striatum are generally similar in rodents and nonhuman primates; 328

however, there are some important differences. Striatal organization differs in rodents

and primates, most notably with a lack of anatomical separation of caudate and putamen

structures in rodents, marked by the internal capsule in primates. In the rodent brain

these structures are not anatomically distinct and are referred to as the caudate-putamen

(CPu); however the striatum of both primates and rodents contains the nucleus

accumbens (Mitchell et al., 1999). The lack of completely homologous structures across

species complicates the translation of results of rodent studies to humans; however,

additional knowledge of functional homology could lead to better and more accurate

translational studies.

Although anatomically divergent, inputs into the striatum are largely conserved

across species with the two major dopaminergic inputs being the mesolimbic and

nigrostrial pathways from the A10 neurons of the ventral tegmental area (VTA) and the

A9 neurons of the substantia nigra pars compacta, respectively (Zahm et al., 2011).

These projections separate along a ventromedial-dorsolateral axis with ventromedial striatum predominately receiving A10 and dorsolateral striatum receiving A9 projections.

Even more important is the functional homology across species with more dorsal regions of the striatum being associated with motor planning and execution, central regions with associative learning and directed attention, and ventral regions with emotional and reward-related processing (Lynd-Balta and Haber, 1994a,b; Reep et al., 2003; Kunzle

1975; Selemon and Goldman-Rakic 1985; Haber and McFarland 1999). Although neuroanatomical homology is convenient for comparisons across species, it is also important to determine functional homology, as changes in structure that do not result in changes in function are not as directly relevant to human behavior/disease processes. 329

This study was aimed at assessing functional homology of the DA system by

measuring regional DA system parameters in the caudate and nucleus accumbens in three

different species, monkeys (Rhesus Macaques), rats (Sprague-Dawley) and mice

(C57BL/6J). Using fast-scan cyclic voltammetry, we measured release and uptake

parameters for five specific regions in each species: dorsal CPu, medial CPu, ventral

CPu, nucleus accumbens core, and nucleus accumbens shell. We found that there is a

conserved gradient of both uptake and release with highest levels of both measures

occurring in the dorsal caudate of all species, and lowest levels in the nucleus accumbens shell. This conservation of functionality across these species further validates the use of rodent models for translational studies of the DA system.

2. Materials and methods

2.1 Tissue preparation

Rats and mice were sacrificed by decapitation and brains were rapidly removed and transferred into ice-cold, pre-oxygenated (95% O2/5% CO2) artificial cerebral spinal

fluid (aCSF) consisting of (in mM): NaCl (126), KCl (2.5), NaH2PO4 (1.2), CaCl2 (2.4),

MgCl2 (1.2), NaHCO3 (25), glucose (11), L-ascorbic acid (0.4) and pH was adjusted to

7.4. Rhesus macaques were anesthetized with ketamine (10 mg/kg, i.m.) and maintained

at a deep surgical plane of anesthesia with pentobarbital. Transcardial perfusion (90 s)

with cold modified Kreb’s buffer (pH =7.4) was performed and brains were rapidly

removed and cooled in pre-oxygenated aCSF (Daunais et al., 2010). For all samples, the

tissue was sectioned into 400 μm-thick coronal slices containing the striatum with a

vibrating tissue slicer (Leica VT1000S, Vashaw Scientific, Norcross, GA). Brain slices 330

were transferred to a submersion recording chamber, perfused at 1 ml/min at 32 °C with

oxygenated aCSF.

2.2 Fast Scan Cyclic Voltammetry

After a 30-min equilibration period, a carbon fiber microelectrode ≈( 150 μM length, 7 μM radius) and a bipolar stimulating electrode were placed in close proximity to each other (≈ 100 μM) into the dorsal, medial, or ventral striatum, or the nucleus accumbens core or shell. DA was evoked by a single, rectangular, electrical pulse

(300 μA, 2 ms) applied every 5 min. Extracellular DA was recorded every 100 ms using fast-scan cyclic voltammetry (Kennedy et al., 1992) by applying a triangular waveform

(−0.4 to +1.2 to −0.4V vs Ag/AgCl, 400 V/s). One recording was obtained per subregion in each animal (rhesus n = 5, mouse n = 3, rat n = 4).Once the extracellular DA response was stable the electrode was moved to the next subregion for recording, where the process was repeated. Immediately following the completion of each experiment, recording electrodes were calibrated by recording their response (in current; nA) to 3 μM

DA in aCSF using a flow-injection system.

To determine kinetic parameters, evoked levels of DA were modeled using

Michaelis–Menten kinetics, as a balance between release and uptake (Wightman et al.,

1988). Michaelis–Menten modeling of baseline DA signals provides parameters that describe the amount of DA released following stimulation (ie, the peak height of the signal) and the maximal rate of DA uptake (Vmax). For baseline modeling, we followed

standard voltammetric modeling procedures by setting the apparent Km value to 160 nM for each animal based on well-established research on the affinity of DA for the DAT 331

(Wu et al., 2001), whereas baseline Vmax values were allowed to vary as the maximal rate

of DA uptake. All voltammetry data were collected and modeled using Demon

Voltammetry and Analysis Software (Yorgason et al., 2011).

2.3 Statistics

Baseline voltammetry data were compared across groups using one-way analysis of variance (ANOVA) using Graphpad statistical software (La Jolla, CA, USA). Data obtained from the five striatal areas was subjected to a two-way ANOVA, with species and brain region as the factors. When significant main effects were obtained (p < 0.05), differences between groups at each dose were tested using Bonferroni post hoc tests.

Comparisons of release to Vmax ratios, as well as comparisons between species at specific

brain regions were subjected to one-way ANOVA.

3. Results

3.1 Electrically stimulated DA release in the striatum follows a dorsal to ventral gradient.

Fast scan cyclic voltammetry was used to assess DA system kinetics in five striatal subregions from C57BL/6J mice, Sprague-Dawley rats, and rhesus macaques

(Fig. 1). Electrically stimulated DA release followed a similar pattern across the five measured regions in the three species. A two-way ANOVA revealed a significant difference by region (F2,45 = 6.906, p < 0.01) in all species (Fig. 2 A, B). Bonferroni post

hoc analysis determined that the dorsal caudate had the highest level of DA release and

release was reduced in each region along a dorsal to ventral axis, with the nucleus

accumbens shell displaying the lowest level of DA release (Fig 2B). In addition, there

were significant differences by species (F4,45 = 5.937, p<0.01), with mouse release 332

Figure 1. Location of voltammetric recordings in striatal slices from rat, mouse, and rhesus macaque. Five regions spanning the caudate putamen (CPu) and nucleus accumbens (NAc) were assessed across three species: Dorsolateral CPu (DC), medial

CPu (MC), ventromedial CPu (VC), NAc core (core), and NAc shell (shell). (A)

Diagram of a rat coronal section from Paxinos and Watson (2007) denoting the location where the recordings were made in each of the five regions, AP 1.32 (B) Diagram of a mouse coronal section adapted from Paxinos and Franklin (2007), AP 1.10 (C) Diagram of coronal section in rhesus macaque, AP 10.5. AP – anterior-posterior coordinates, Put

– putamen, IC-internal capsule.

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Figure 2. Dopamine (DA) release from five striatal regions in monkey, rat, and mouse. (A) Representative traces of the five striatal regions in monkey rat and

mouse expressed as µM DA over time. (B) Mean peak release ± SEM evoked at five

loci in each species showing an overall gradient of release from dorsal (highest) to ventral

(lowest) that is conserved across species. *** p < 0.001 across region; ### p < 0.001

versus monkey; &&& p < 0.001 versus rat.

334

measurements being significantly higher overall than both monkey and rat (Figure 2

A,B).

3.2 Maximal rate of DA uptake follows a dorsal to ventral gradient

This study also assessed the rate of DA uptake following electrical stimulation and revealed a gradient of uptake across the striatal regions. There were significant differences by region (F2,45 = 32.47, p < 0.001) which were present in all species (Fig 3A,

B). Bonferroni post hoc analysis revealed the highest levels of uptake in the dorsal

striatum and lower levels in a gradient from more dorsal to more ventral regions with the

lowest level of uptake being present in the nucleus accumbens shell (Fig. 3B).

In addition to a conserved gradient of uptake across species, there were

differences in overall uptake rates between rat, mouse, and monkey (F4,45 = 42.24, p <

0.001). Post hoc analysis revealed that rat and mouse rates of uptake were significantly

higher than the uptake rates recorded for the monkeys (Fig. 3B).

3.3 Ratio of DA release to Vmax across species

The ratio of DA release to Vmax was used to determine if there were differences in

the regulation of presynaptic DA kinetics, across regions or species. There was a

significantly lower ratio of release to uptake in rats in the dorsal caudate (F2,6 = 10.60, p

< 0.05) (Fig. 4C) as compared to both monkey and mice. This difference between

species was maintained across all regions. In addition, there were no regional differences

in the ratio of DA release to Vmax in any of the species tested, suggesting that this

measure is inherent to the type of animal and not regionally variable. 335

Figure 3. Maximal dopamine (DA) uptake rate (Vmax) as measured by fast scan

cyclic voltammetry from dorsal striatum through ventral striatum in each species.

(A) Representative traces of DA over time normalized for peak height. (B) Vmax across

five regions (dorsal caudate-putamen (CPu), medial CPu, ventral CPu, nucleus

accumbens core, nucleus accumbens shell) showing a gradient of uptake rate in three

species. Vmax was determined using Michaelis-Menten modeling to determine kinetic

parameters. Mean peak Vmax (µM/s) ± SEM evoked at the five listed loci. *** p <

0.001 across region; ### p < 0.001 versus monkey.

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Figure 4. Ratio of dopamine (DA) release to uptake differs across species. (A)

Maximal rate of DA uptake (Vmax) in the dorsal striatum across monkey, rat, and mouse.

(B) Stimulated DA release in the dorsal striatum across species, represented as DA per pulse. (C) Ratio of DA release to Vmax in the dorsal striatum across species. * p <0.05 vs monkey; # < 0.05 vs rat; & p <0.05 vs mouse.

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4. Discussion

We found that DA system organization in the striatum is conserved across three

common model systems: rats, mice, and monkeys. The dorsal to ventral gradient in

stimulated DA release across regions has been shown previously in marmosets by Cragg

et al., (2002), however, the present study is the first to show that this gradient is present

in rhesus macaques. This gradient of release suggests that the distinctions between

striatal subregions are not absolute, but rather, they lie along a functional continuum.

Because this striatal organization is conserved across species it suggests that the

organization of DA inputs into these regions are also conserved and that studies in these

regions are translatable across species. In addition, maximal uptake rates, Vmax, also exhibited a gradient, with greater uptake in dorsal regions of the striatum and the lowest uptake in the nucleus accumbens shell. It is likely that differences in uptake rates are associated with differences in transporter levels along a similar gradient. The fact that the gradient in uptake is similar to the gradient in release suggests that the two aspects of DA signaling are linked, and this may be related to the innervation density of DA terminals.

It is not surprising that DA system functionality is conserved across these species.

Although there are considerable differences in cortical organization between rodents and primates, there have been many studies outlining the anatomical homology between species within sub-cortical structures. DA plays similar major roles in a number of essential functions such as movement, goal-directed behaviors, associative learning, and reward and reinforcement, across species (Bradberry, 2008; Levey et al., 1993l; Lynd-

Balta and Haber, 1994a,b; Reep et al., 2003; Künzle 1975; Selemon and Goldman-Rakic

1985; Haber and McFarland 1999). In addition, It has been determined previously that 339

the DAT is highly conserved, with 92% homology between rat and human DAT

transporters (Giros and Caron 1993), supporting the idea of DA system conservation

across species. Conservation in not only function, but also the proteins involved in the

regulation of DA in these regions, suggests that interventions in rodents are likely to

result in changes similar to those in higher primates under similar conditions, although studies in rodents allow more mechanistic and invasive studies on the DA system.

Although the proteins are conserved across species, the levels of presynaptic DA regulatory proteins including D2 autoreceptors and DAT differ across brain regions

(Shimada et al., 1992; Hurd et al., 1994; Haber et al., 1995), suggesting regional

differences in DA function/regulation.

Independent of determining functional homology between model systems, it is

also important to determine the functional differences across brain regions, specifically in

the striatum, where the DA pathways that innervate this region have divergent actions. In

both rodents and non-human primates the striatum is divided into functional domains that

control different behavioral outputs, and receive inputs from different dopaminergic

nuclei. The A9 pathway, which is degenerated in Parkinson’s disease, projects to the

dorsolateral striatum and is involved in motor function, while the A10 projections, which

synapse in the ventromedial striatum, are implicated in reward and reinforcement, and are

essential for the reinforcing effects of drugs of abuse (Kish et al., 1988; Gibb and Lees,

1991). Consistent with functional differences in behavioral outputs, here we show that

there are differences in regional DA release, characterized by a dorsal to ventral pattern

of DA release across five regions spanning the striatum in rodents as well as non-human

primates. This gradient in release could be due to a similar gradient that is seen with the 340

rate-limiting enzyme for the production of DA synthesis, tyrosine hydroxylase (Salvatore

and Pruett, 2012). In addition, there are regional differences between the dorsal striatum

and NAc in the levels of vesicular monoamine transporter 2 expression, which may also

contribute to the differences in repackaging of DA and release in these areas (Salvatore et

al., 2005). This functional organization has been shown in marmosets where Cragg et al.

(2002) demonstrated that there is a dorsal to ventral gradient in DA release with more

dorsal regions of the striatum exhibiting higher levels of stimulated DA release. Because

we did not have access to putamen tissue, we were unable to assess if the same trend was

present in that region; however, Cragg et al. (2002) previously showed that in marmosets

the same trend is present in both the caudate and putamen. Even though marmosets and

rhesus macaques are very different, the conservation of a gradient between macaques and

rodents, which are different species of a different genus, makes it likely that there is

similar functional homology between two animals of the same genus. It is likely that this

regional conservation in uptake and release across regions in all species is due to the

conservation of inputs from dopaminergic cell bodies in the VTA and substantia nigra, suggesting that rodents are good model systems to study the disease processes that affect these regions. In addition, Montague and Phillips have done voltammetric recordings in humans that are also similar to the kinetic parameters we find here, giving further support to the idea that rodents are acceptable translational models of dopaminergic organization

(Kishida et al., 2011).

Extracellular levels of DA are controlled by a delicate balance between vesicular release and reuptake of DA by the dopamine transporter (DAT) (Jones, 1998; Kuhar

1973, Horn 1990, Amara and Kuhar 1993). Thus, determining the contribution of each 341

measure to evoked efflux profiles can give us some insight as to what is driving

extracellular DA signaling in the behaving animal. The data here show that there is a

smaller ratio of DA release to DA uptake in the rat compared to mouse and monkey,

suggesting that Vmax plays more of a role in controlling DA kinetics in the rat than the

other species, thus the rat has uptake dominated DA signals. The ratio of release to

uptake does not differ across regions, suggesting that even if there are overall differences

in each measure, the relationship between these two measures remains constant. In other

words, the gradient in Vmax and release are proportional to each other across regions, even if there is a difference in overall Vmax or release as compared to other species. It is

important to note that absolute values of DA parameters differ across species; however,

because of the conserved relationship between the regions, it is logical to postulate that

one can obtain translatable results in a range of neurological models. This is important

because it suggests that not only is there a functional gradient, but the species differences

in Vmax and release values do not alter the functional relationship across regions.

5. Conclusions

Overall, this study demonstrates that extracellular DA is dynamically controlled

in a similar fashion across the three species studied here (Rhesus macaque monkey,

Sprague-Dawley rat and C57BL/6J mouse) and that DA dynamics are different in limbic

and motor associated functional regions. These findings allow studies of DA dynamics in

rodents to be more broadly generalized to the functioning of primate striatal regions.

Although it is too simplistic to say the DA systems are identical, results here reveal an

impressive conservation of function across the striatum. This suggests that vulnerabilities

found in the DA system in rodents, either to drug or chemical insult, are likely to have 342

similar responses and results in the primate brain. In an era of constraints on science with

both budgetary and ethical concerns, this finding confirms a long-held assumption that

DA function is similar across species.

Acknowledgements

This work was funded by NIH grants R01DA021325, RO1DA030161, U01AA014091,

P50DA06634, P01AA017056 (SRJ), T32DA007246 and F31DA031533 (ESC).

343

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347

APPENDIX II

AMPHETAMINE MECHANISMS AND ACTIONS AT THE DOPAMINE TERMINAL REVISITED

Erin S. Calipari and Mark J. Ferris

The following manuscript was published in The Journal of Neuroscience volume 33(21), pages, 8923-5, 2013, and is reprinted with permission. Stylistic variations are due to the 348

requirements of the journal. Erin S. Calipari and Mark J. Ferris worked together to write the manuscript. Amphetamine (AMPH) exerts its rewarding and reinforcing effects by elevating

extracellular dopamine (DA) and prolonging DA receptor signaling in the striatum.

Traditionally, AMPH has been characterized as a DA releaser that elevates DA by three

major mechanisms. First, it is a substrate for the DA transporter (DAT) that competitively

inhibits DA uptake; second, it facilitates the movement of DA out of vesicles and into the

cytoplasm; and third, it promotes DAT-mediated reverse-transport of DA into the synaptic cleft independently of action-potential-induced vesicular release (Fleckenstein et

al., 2007). In vitro studies on the mechanisms of AMPH action have demonstrated that

AMPH causes DA release, which can result in saturation of DA receptors (Richfield et

al., 1989), and eventually lead to depletion of intracellular DA stores (Jones et al., 1998;

Schmitz et al., 2001). In their recent publication in The Journal of Neuroscience,

Daberkow et al. (2013) propose a new model of AMPH action that not only extends

accepted mechanisms, but also calls some traditional hypotheses of AMPH action into

question. Their main conclusion is that low-dose (1 mg/kg) AMPH administration facilitates both electrical- and cue-evoked vesicular DA release and does not change DA-

dependent behaviors in vivo, contrary to what one would expect if AMPH were depleting

terminals as shown in vitro.

Daberkow et al. (2013) used fast-scan cyclic voltammetry in freely moving rats to

determine the effects of AMPH on DA system kinetics and signaling. First, they

electrically stimulated ascending dopamine fibers to elicit DA release in the nucleus

accumbens (NAc). Instead of reducing stimulated DA release as would be expected if

DA in nerve terminals was depleted, intraperitoneal (i.p.) injection of AMPH (1 and 349

10mg/kg) enhanced DA release as compared to a pre-drug baseline (Daberkow et al.,

2013, Fig. 1). They completed their recordings after DA release returned to the pre-drug baseline level, at two-hours post-injection (Daberkow et al., 2013, Fig. 2A). In vitro studies suggest that this time frame is sufficient to result in at least partial depletion of terminals, particularly at higher concentrations (Jones et al., 1998); however, instead of observing reduced release, Daberkow et al. (2013) observed increased release. It is important to note that because DA release had not stabilized at this time, it is possible that a longer recording time would have revealed depletion of DA from terminals, and a concomitant decrease in stimulated DA release. In addition to increasing electrically evoked release, AMPH increase both the frequency and amplitude of spontaneous DA release events, even at the highest dose of AMPH, further supporting the idea that AMPH increases DA release. Additionally, their analysis of stimulated DA release following

AMPH administration suggested that increased amplitude did not result from DAT reversal (Daberkow et al., 2013, Fig. 3). If AMPH was depleting terminals via reverse transport, one would predict a decrease in the amplitude of vesicular DA release independent of frequency (Daberkow et al., 2013, Fig. 4). Together, these data suggest that AMPH does not deplete DA terminals as suggested by in vitro studies.

Daberkow et al., (2013) extend this work in behaving animals to test whether

AMPH can facilitate DA release in response to cues that predict rewarding stimuli in the environment. To test this, the authors used a discriminative stimulus task whereby a distinct audiovisual cue indicated the availability of a lever, that when pressed, resulted in the delivery of a sugar pellet reward. Once animals were trained to associate the appropriate audiovisual cue with the reward-paired lever, DA was monitored in a drug- 350

naïve state for all animals. Subsequently, DA responses were monitored following saline, low dose AMPH (1 mg/kg), or high dose AMPH (5 mg/kg) injections. In the drug naïve trials, phasic DA release was time-locked to the cue that indicated the presentation of the reward-paired lever. This cue-induced DA release is the signal that encodes the motivational value of rewards and thus is essential for goal-directed behaviors, such as correctly responding to obtain a reward following the presentation of a reward-paired lever. If AMPH depletes terminals and causes saturation of postsynaptic DA receptors, cue-evoked DA release and corresponding goal-directed behavior should be disrupted.

There was no significant effect on the magnitude of cue-induced DA release or goal- directed behavior in the group receiving saline injections. The low dose of AMPH (1 mg/kg) enhanced the absolute magnitude of cue-induced DA signals without affecting behavior. Conversely, the high dose (5 mg/kg) disrupted DA signals by causing DA release events that were not time-locked to the cue and thus effectively abolished goal- directed behavior (Daberkow et al., 2013, Fig. 6).

Based on these results, Daberkow et al. (2013) argue that differences between in vivo and in vitro findings are attributable to differences in the preparation such as stimulation parameters, and AMPH acting on different vesicular storage pools. However, another possibility is that the concentration of AMPH at the terminal is different between cited in vitro studies and the present study. The authors argue that in in vitro studies

AMPH ubiquitously depletes terminals, but they cite work using concentrations of

AMPH that exceed what could be reached with a single i.p. injection. For example, a 5.0 mg/kg i.p. injection of AMPH in vivo was reported to only reach brain concentrations of

7.7 nM (Honecker and Cooper, 1975). This is substantially lower than the 10 µM 351

referenced from in vitro studies. The brain concentration of AMPH in the present study can be estimated by determining the amount of uptake inhibition caused by AMPH in vivo and comparing it to in vitro studies. The authors report a 200 and 400% increase in the DA uptake parameter apparent Km, reflecting a decreased affinity of DA caused by competitive inhibition following a single injection of 1 mg/kg and 10mg/kg AMPH, respectively. Increases of this magnitude in vitro correspond to approximately100-300 nM AMPH. This is particularly important because at such doses there is no depletion of

DA terminals in vitro. Ferris et al. (2012) showed that AMPH does not reduce DA release in brain slices until concentrations reach 1-3 µM, which are much higher than is likely reached in the present study even at the higher injected dose, confirming some of the

Daberkow et al. (2013) results. Therefore, the differences in AMPH effects probably do not result from the preparation per se, but rather from differences in the concentration of

AMPH interacting with the DA terminal.

While Daberkow et al. (2013) make a good case for considering a new mechanism of AMPH based on vesicular release, it is important not to disregard the mechanism that occurs via DAT-mediated reverse transport. Repeated AMPH administration, which is often used as a model of AMPH abuse, was not discussed. Self- administration studies in which animals administer AMPH over an extended period result in much higher levels of drug intake (Ciano, Blaha, and Phillips, 2002). Indeed, animals with a history of AMPH self-administration show reduced DA following a period of abstinence, suggesting that at these high, abuse-relevant doses, AMPH is depleting terminals of DA in vivo (Ciano, et al., 2002). This emphasizes the point that AMPH leads to depletion of DA at synaptic terminals both in vitro and in vivo, but only at high doses. 352

It is possible that the AMPH-induced augmentation of stimulated DA release, as seen in the Daberkow et al. (2013) study, occurs at low doses because the reverse- transport effects of AMPH are not engaged. AMPH-induced reverse-transport of DA via the DAT relies on sufficient cytoplasmic concentrations of DA. AMPH-induced depletion of vesicles has been suggested to result from its properties as a weak base that increases the pH in vesicles, thus leading to the release of DA from vesicles into the cytoplasm (Sulzer et al., 1992). Once in the cytoplasm, DA can be released into terminals via AMPH-induced reversal of the DAT. It is possible that at low doses, AMPH cannot reach sufficient concentration within vesicles to alter pH to the extent necessary for efflux. The inability of AMPH to produce efflux from vesicles at low does would cause pharmacological effects resembling those of traditional DAT blockers. Indeed, Daberkow et al. (2013) states that the AMPH-induced elevation of DA seen in their study is similar to what has been demonstrated previously for cocaine, a prototypical DAT blocker, which facilitates vesicular release.

The paper by Daberkow et al. (2013) also speaks to the importance of the ratio of cue-induced phasic DA release relative to the pre-cue DA baseline in the facilitation of goal-directed behaviors. The authors report that AMPH (1 mg/kg) increased the absolute peak height of the DA signal (mean ± S.E.M.), which included both the cue-induced phasic signal and the pre-cue DA baseline (Daberkow et al., 2013, Figure 7). Close inspection of the figure suggests that the increased peak magnitude of DA in the AMPH group relative to saline or pre-drug controls largely results from a greater pre-cue DA baseline (Daberkow et al., 2013, Figure 7C, baseline epoch), rather than greater cue- induced phasic release per se (Daberkow et al., 2013, Figure 7C, cue epoch). Indeed, 353

when examining the ratio of phasic release to the pre-cue baseline, the increase in the signal between groups appears to be virtually identical. If, as suggested in the manuscript, the total magnitude of DA increase was relevant for behavior, one would expect improved behavioral performance in the discriminative stimulus behavioral task, as DA elevations are responsible for the execution of goal-directed behaviors. However, in the behavioral task, animals that received AMPH (1 mg/kg) did not perform differently than control animals. This suggests that phasic/baseline ratios, rather than absolute DA magnitude, drive shifts in goal-directed behavior. This is supported by the high dose (5 mg/kg) condition, in which the phasic/baseline ratio and goal-directed behavior were disrupted concurrently (Daberkow et al., 2013, Figure 7D). It is likely that the ability to process phasic events depends on the contrast between the phasic signal and the baseline

DA level that was present prior to presentation of the cue.

In conclusion, we believe the study by Daberkow et al. (2013) has two important implications that were not discussed by the authors. First, the facilitation or disruption of goal directed behaviors is dependent on the magnitude of phasic DA release relative to baseline DA levels (i.e. phasic/baseline), rather than general increases in overall DA levels (i.e. phasic + baseline). Second, they show that AMPH dose is critical in determining its acute effects in vivo and in vitro, because AMPH acts as a blocker at low concentrations and a releaser at high concentrations. This latter point is particularly relevant when considering the low-dose therapeutic use of AMPH in comparison to higher doses used in AMPH abuse. Given the possible shift in mechanism with increasing

AMPH concentrations, it is important to amend, but not to disregard, the traditional models of AMPH action. 354

References

Daberkow DP, Brown HD, Bunner KD, Kraniotis SA, Doellman MA, Ragozzino ME, Garris PA, Di Ciano P, Blaha CD, Phillips AG (2002) Inhibition of dopamine efflux in the rat nucleus accumbens during abstinence after free access to d-amphetamine. Behav Brain Res. 128(1):1-12.

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Sulzer D, Pothos E, Sung HM, Maidment NT, Hoebel BG, Rayport S (1992) Weak base model of amphetamine action. Ann N Y Acad Sci. 654:525-8

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APPENDIX VI

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This is a License Agreement between Erin S Calipari ("You") and Elsevier ("Elsevier") provided by Copyright Clearance Center ("CCC"). The license consists of your order details, the terms and conditions provided by Elsevier, and the payment terms and conditions.

All payments must be made in full to CCC. For payment instructions, please see information listed at the bottom of this form. Elsevier Limited Supplier The Boulevard,Langford Lane Kidlington,Oxford,OX5 1GB,UK Registered Company Number 1982084 Customer name Erin S Calipari Customer address Medical Center Blvd WINSTON SALEM, NC 27101 License number 3221460521774 License date Sep 03, 2013 Licensed content publisher Elsevier Licensed content publication Neurochemistry International Conserved dorsal–ventral gradient of dopamine release Licensed content title and uptake rate in mice, rats and rhesus macaques Erin S. Calipari,Kimberly N. Huggins,Tiffany A. Licensed content author Mathews,Sara R. Jones Licensed content date December 2012 Licensed content volume 61 number Licensed content issue number 7 Number of pages 6 Start Page 986 End Page 991 Type of Use reuse in a thesis/dissertation

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CHAPTER X

CURRICULUM VITA

375

CURRICULUM VITAE

ERIN SUE CALIPARI

Department of Physiology and Pharmacology Program in Neuroscience Wake Forest University School of Medicine

PERSONAL INFORMATION

Business Address Department of Physiology and Pharmacology Wake Forest School of Medicine Medical Center Blvd. Winston-Salem, NC 27157 Phone (336) 716-5504 Fax (336) 716-8501 E-mail [email protected]

EDUCATION 2009-2013 Wake Forest School of Medicine Winston-Salem, NC Advisor, Sara R. Jones, Ph.D. Ph.D. in Neuroscience

2009 (May) BS in Psychology (Neuroscience) with Honors, University of Massachusetts Amherst

2009 (May) BS in Biology with Honors, University of Massachusetts Amherst

EMPLOYMENT HISTORY

Graduate

2009-2013 Research Assistant / Doctoral Candidate Department of Physiology and Pharmacology Program in Neuroscience Wake Forest School of Medicine Laboratory of Sara R. Jones, Ph.D.

Undergraduate

2007-2009 Research Assistant 376

Department of Psychology University of Massachusetts Amherst Laboratory of Jerrold S. Meyer, Ph.D.

PROFESSIONAL MEMBERSHIPS

2012– Present American Society for Pharmacology & Experimental Therapeutics 2011 – Present Society for Neuroscience 2011 – Present Western North Carolina Society for Neuroscience 2007 – 2009 Psi Chi Psychology Honor Society

HONORS AND AWARDS

2013 NIDA Director’s Travel Award to attend the The College on Problems of Drug Dependence; San Diego, CA

2013 Wake Forest University Alumni Travel Award to attend the Dopamine conference; Alghero, Italy

2013 Graduate Student Travel Award, American Society for Pharmacology and Experimental Therapeutics; Boston, MA

2012 Mary A. Bell Award for Best Poster, Western North Carolina Society for Neuroscience Poster Competition; Winston-Salem, NC

2012 Best Poster Award, XICS Catecholamine Symposium; Pacific Grove, CA

2012 Irwin J. Kopin Fellowship for Excellence in Catecholamine Research (travel award), XICS Catecholamine Symposium; Pacific Grove, CA

2012 Individual Ruth L. Kirschstein National Research Service Award (Predoctoral NRSA; F31 DA031533-01A1)

2011 Institutional Ruth L. Kirschstein National Research Service Award (Graduate NRSA; T32 DA007246-20), Wake Forest School of Medicine

2010 Wake Forest University Alumni Travel Award to attend the International Conference on In Vivo Methods; Brussels, Belgium

2009 Commonwealth College Honors in Biology; University of Massachusetts Amherst

2009 Commonwealth College Honors in Psychology; University of Massachusetts Amherst 377

2008 Commonwealth College Honors Research Grant

2007 Psi Chi Member – Psychology National Honor Society

SERVICE

Institutional

2010-Present Lecturer for Kernersville Cares for Kids Scientific Outreach Events, Wake Forest School of Medicine 2010-Present Brain Awareness Outreach Presenter, 3-5 visits to local K-12 schools yearly

Student Mentorship / Training

2013-present Cody Siciliano, Wake Forest School of Medicine, Graduate 2011-present Jamie Rose, Wake Forest School of Medicine, Graduate 2010-2011 Jamil Hopkins, Wake Forest University, Undergraduate

Ad Hoc Reviewer

Journal of Neuroscience ACS Neuroscience Neurochemistry International Journal of Neurochemistry Journal of Clinical Investigation

PUBLICATIONS

Peer-Reviewed Journals

Calipari ES, Ferris MJ, Caron MG, Jones SR. Methylphenidate self-administration increases the potency and reinforcing effects of releasers through a dopamine transporter mechanism. Nature Communications. In press. Calipari ES, Ferris MJ, Roberts DCS, Jones SR. Extended Access Cocaine Self- Administration Results in Tolerance to the Dopamine-Elevating and Locomotor- Stimulating Effects of Cocaine. The Journal of Neurochemistry. In press. Calipari ES, Beveridge TJ, Jones SR, Porrino LJ. Persistent decreases in functional activity of limbic brain regions following extended access cocaine self-administration. European Journal of Neuroscience. In press. Calipari ES, Ferris MJ, Zimmer BA, Roberts DCS, Jones SR. (2013) Temporal pattern 378

of cocaine intake determines tolerance versus sensitization of cocaine effects at the dopamine transporter. Neuropsychopharmacology. In press. Calipari ES, Ferris MJ. (2013) Amphetamine mechanisms and actions at the dopamine terminal revisited. Journal of Neuroscience. In press. Ferris MJ, Calipari ES, Melchior JR, España RE, Jones SR. (2013) Paradoxical tolerance to cocaine after initial supersensitivity in drug use prone animals. European Journal of Neuroscience. In press.

Ferris MJ, Calipari ES, Yorgason JT, Jones SR. (2013) Evaluating the voltammetric measures of dopamine release and uptake in striatal slices. ACS Neuroscience. In press.

Calipari ES, España RE. (2013) The hypocretin/orexin system regulates dopamine signaling and behavioral responses to drugs of abuse. Frontiers in Behavioral Neuroscience. In press.

Calipari ES, Ferris MJ, Melchior JR, Bermejo K, Salahpour A, Roberts DC, Jones SR. (2013). Methylphenidate and cocaine self-administration produce distinct dopamine terminal alterations. Addiction Biology. In press.

Calipari ES, Huggins KN, Matthews T, Jones SR. Conserved dorsal-ventral gradient of dopamine release and uptake rate in mice, rats and rhesus macaques. (2012) Neurochemistry International. 61(7):986-91.

Ferris MJ, Calipari ES, Melchior JR, Roberts DC, Jones SR. (2012). Cocaine self- administration produces pharmacological tolerance: Differential effects on the potency of dopamine transporter blockers, releasers, and methylphenidate. Neuropsychopharmacology, 37(7): 1708-1716. *Figure 1 selected for journal front cover illustration.

Under Review or Revision for Peer-Reviewed Journals

Rose JH, Calipari ES, Mathews TA, Jones SR. Divergent presynaptic striatal dopamine dynamics are not a predictor of ethanol-induced hyperlocomotion in DBA/2J compared to C57BL/6J mice. Under Resubmission. Siciliano CA, Calipari ES, Ferris MJ, Jones SR. Amphetamine increases dopamine release via uptake inhibition at the dopamine transporter. Under Resubmission.

Conference Proceedings

Calipari ES, Ferris MJ, Roberts DCS, Jones SR. (2012). Cocaine vs methylphenidate self-administration: Opposite effects on dopamine and reinforcement. Monitoring 379

Molecules in Neuroscience 2012. Proceedings of the 14th International Conference on In Vivo Methods; London, England.

Calipari ES, Caron MG, Jones SR. (2012). Overexpression of the dopamine transporter enhances responses to methylphenidate and amphetamine, but not cocaine. In Progress on Catecholamine Research. Proceeding of the 10th International Catecholamine Symposium (XICS). *Won Best Poster Award.

Calipari ES, Ferris MJ, Melchior J, Jones SR. (2010). Methylphenidate (MPH) self- administration potentiates MPH and amphetamine, but not cocaine, inhibition of dopamine transport in the nucleus accumbens. In Westerink B, Clinckers R, Smolders I, Sarre S, Michotte Y (Eds.) Monitoring Molecules in Neuroscience 2010. Proceedings of the 13th International Conference on In Vivo Methods, 347-349.

ABSTRACTS

Chen R, Calipari ES, Sun H, Jones SR (2013, August) Amphetamine-induced adaptations in dopamine D2 autoreceptor function. Poster presented at the Gordon Conference on Catecholamines, West Dover, VT.

Roberts DCS, Calipari ES, Zimmer BA, Ferris MJ, Jones SR (2013, November). Intermittent access cocaine self-administration results in behavioral and neurochemical sensitization. Society for Neurosicence.San Diego, CA.

Yorgason JT, Calipari ES, McCool BA, Weiner JL, Jones SR (2013, November) Increases in rapid nucleus accumbens dopamine signaling and methylphenidate, but not cocaine, potency in socially isolated rats. Poster Presentation. Society for Neuroscience. San Diego, CA.

Rose JH, Calipari ES, Mathews TA, Jones SR. (2013, June) Ethanol-induced hyperlocomotion of DBA/2J mice is not mediated by striatal dopamine. Poster Presented at Research Society on Alcoholism. Orlando, FL. Ferris MJ, Calipari ES, Rose JH, Siciliano CA, Chen R, Roberts DCS, Porrino LJ, Jones SR (2013, June). A single amphetamine bolus restores dopamine nerve terminal function and sensitivity to cocaine following a history of cocaine self-administration. Oral presentation. The College on Problems of Drug Dependence. San Diego, CA.

Calipari ES, Ferris MJ, Salahpour A, Caron MG, Roberts DCS, Jones SR (2013, June). Methylphenidate self-administration increases the potency and reinforcing effects of releasers through a dopamine transporter mechanism. Poster presentation. The College on Problems of Drug Dependence. San Diego, CA.

Calipari ES, Ferris MJ, Rose JH, Roberts DCS, Jones SR (2013, May). Cocaine self- administration results in neurochemical tolerance and dopamine transporter complex formation which is reversed by a single amphetamine bolus. Poster presentation. 380

Dopamine Conference. Alghero, Italy.

Calipari ES, Yorgason JT, McCool BA, Weiner JL, Jones SR (2013, April) Increases in rapid nucleus accumbens dopamine signaling and methylphenidate, but not cocaine, potency in socially isolated rats. Poster Presentation. Kappa Conference. Boston, MA.

Calipari ES, Sun H, Jones SR, Chen R (2013, April). Neuroadaptations in D2-like autoreceptor function following AMPH self-administration. Poster presentation. Experimental Biology (American Society for Pharmacology & Experimental Therapeutics). Boston, MA.

Calipari ES, Caron MG, Roberts DCS, Jones SR. (2013, March). Overexpression of the dopamine transporter enhances responses to methylphenidate and amphetamine, but not cocaine. Poster Presented. Graduate School Research Day. Winston-Salem, NC. Rose JH, Calipari ES, Mathews TA, Jones SR. (2012, December) Differential dopamine system dynamics in mouse models of alcohol vulnerability. Poster Presented at Western North Carolina Society for Neuroscience Research Day. Winston-Salem, NC. Calipari ES, Caron MG, Roberts DCS, Jones SR. (2012, December). Overexpression of the dopamine transporter enhances responses to methylphenidate and amphetamine, but not cocaine. Poster Presented at Western North Carolina Society for Neuroscience Research Day. Winston-Salem, NC. *Won best poster. Zimmer BA, Calipari ES, Jones SR, Roberts DCS (2012, October) The effects of intermittent cocaine access on reinstatement of drug-seeking behavior. Poster presented at the Society for Neuroscience Meeting, New Orleans, LA. Calipari ES, Ferris MJ, Melchior JR, Roberts DCS, Jones SR (2011, November). Opposite effects of long-access methylphenidate and cocaine self-administration on dopamine transporter function and trafficking. Poster presented at the Society for Neuroscience Meeting, Washington DC.

Melchior JR, Calipari ES, Ferris MJ, Jones SR (2011, November). Escalation of cocaine self-administration alters the effects of cocaine on dopamine signaling in the nucleus accumbens. Poster presented at the Society for Neuroscience Meeting, Washington DC.

Calipari ES, Ferris MJ, Melchior JR, Roberts DCS, Jones SR (2011, August). Enhanced potency of amphetamines following I.V. methylphenidate self-administration. Poster presented at the Gordon Conference on Catecholamines, Lewiston, ME.

Calipari ES, Tallant,EA, Lesser G, Debinski W, & Gallagher, PE. (2010) Angiotensin- (1-7) and temozolomide provide combinatorial inhibition of glioblastoma cell growth. 381

Poster presented at the American Association for Cancer Research conference, Washington D.C.

Calipari ES & Meyer JS. (2009). Adolescent intermittent dosing effects on MDMA binge-induced oxidative stress damage. Poster presented at the Commonwealth College Honors Research Symposium, Amherst, MA.

Calipari ES & Meyer JS. (2009). Possible attenuation of binge-induced oxidative stress damage by an adolescent Intermittent dosing regimen. Poster presented at the Howard Hughes Medical Institute Massachusetts State Undergraduate Research Conference, Amherst, MA.

TALKS

Conferences / Invited

Calipari ES (2013, September) Temporal pattern of cocaine intake determines tolerance versus sensitization of cocaine’s effects at the dopamine transporter. Invited Talk. Emory- Wake Forest University Lab Exchange. Atlanta, GA.

Calipari ES (2012, September) Pattern of self-administration determines dopamine transporter sensitivity to cocaine: intermittent versus long access. Invited Talk. Emory- Wake Forest University Lab Exchange. Winston-Salem, NC.

Calipari ES (2012, September) Overexpression of the dopamine transporter enhances responses to methylphenidate and amphetamine, but not cocaine. Invited Talk. XICS Catecholamine Symposium. Pacific Grove, CA.*Won Best Poster

Calipari ES (2011, August) Enhanced potency of amphetamines following I.V. methylphenidate self-administration. Oral Presentation. Gordon Research Conference on Catecholamines. Lewiston, ME.

Institutional / Departmental

Calipari ES (2012, October). Dopamine transporter-induced changes in psychostimulant potency: trafficking dependent and independent mechanisms. Neuroscience Graduate Student Seminar, Wake Forest School of Medicine, Winston-Salem, NC.

Calipari ES (2012, October). The dopamine transporter can alter psychostimulant potency through trafficking dependent and independent mechanisms. Physiology and Pharmacology Graduate Student Seminar, Wake Forest School of Medicine, Winston- Salem, NC. 382

Calipari ES. (2012, April). Methylphenidate (MPH) self-administration selectively increases the potency of releasers and MPH via dopamine transporter up-regulation. Neuroscience Graduate Student Seminar, Wake Forest School of Medicine, Winston- Salem, NC.

Calipari ES. (2011, July). Differential effects of self-administration of two dopamine transporter blockers, methylphenidate, and cocaine on the dopamine system. Summer Tutorial Series, Wake Forest School of Medicine, Winston-Salem, NC.

Calipari ES (2010, October). Plasticity in dopamine system function following methylphenidate self-administration. Physiology and Pharmacology Graduate Student Seminar, Wake Forest School of Medicine, Winston-Salem, NC.

Calipari ES. (2010, May). Methylphenidate (MPH) self-administration alters the pharmacology of dopamine transport in the nucleus accumbens. Physiology and Pharmacology Graduate Student Seminar, Wake Forest School of Medicine, Winston- Salem, NC.

CURRENT RESEARCH SUPPORT

F31 DA031533-01A1 Calipari (PI) 08/01/2012 – 08/01/2015 Mentor: Sara R. Jones, Ph.D. Ruth L. Kirschstein National Research Service Award (NIDA) The Effect of Methylphenidate Use and Abuse on Dopamine System Kinetics The goal of this award is to receive training in self-administration, in vitro voltammetry and western blot hybridization. Concurrently, this project is aimed at understanding the effects of methylphenidate self-administration on dopamine transporter levels and psychostimulant potency. Transgenic dopamine transporter overexpressing mice are used to explore a potential mechanism for the methylphenidate self- administration-induced neurochemical effects. Role: PI

COMPLETED REASEARCH SUPPORT

T32 DA007246-20 Calipari 06/01/2011 – 07/31/2012 Mentor: Sara R. Jones, Ph.D. NIDA Neuroscience of Drug Abuse Training Grant – predoctoral fellowship The goal of this award is to receive graduate training in self-administration, basic biochemical techniques and in vitro fast scan cyclic voltammetry in brain slices. Concurrently, this project is aimed at documenting the time course and mechanisms of an increase in the sensitivity of the dopamine transporter to methylphenidate following binge methylphenidate self-administration. Role: Graduate student 383

TECHNICAL PROFICIENCIES

Since beginning research in neuroscience in 2007, I have acquired proficiency in a number of techniques used in mice, rats, and cell culture. Training was received in the laboratories of Jerrold Meyer (Univ. of MA), Sara Jones (WFSM), Dave Roberts (WFSM), and Rong Chen (WFSM). These techniques include biochemical assays for lipid peroxidation and protein carbonylation, cell culture, western blot hybridization, synaptosomal preparations, in vitro and in vivo voltammetry, microdialysis, work with transgenic mouse lines, various behavioral assays (e.g., locomotor assessment, CPP), and rodent self-administration of psychostimulants.

PROFESSIONAL REFERENCES

Sara R. Jones, Ph.D. Tenured Professor, Department of Physiology and Pharmacology Wake Forest School of Medicine Medical Center Boulevard Winston-Salem, NC 27101 Phone: 336.716.8533 Fax: 336.716.8501 Email: [email protected]

David C.S. Roberts, Ph.D. Tenured Professor, Department of Physiology and Pharmacology Wake Forest School of Medicine Medical Center Boulevard Winston-Salem, NC 27101 Phone: 336.716.8597 Email: [email protected]

Jerrold S. Meyer, Ph.D. Tenured Professor, Department of Psychology Director, Neuroscience and Behavior Program Tobin Hall University of Massachusetts Amherst, MA 01003 Phone: 413.658.7174 Email: [email protected]

Rong Chen, Ph.D. Assistant Professor, Department of Physiology and Pharmacology Wake Forest School of Medicine Medical Center Boulevard Winston-Salem, NC 27101 Phone: 336.716.8506 Email: [email protected]