Excessive alcohol consumption and dependence on amphetamine are associated with parallel increases in subjective ratings of both 'wanting' and 'liking'

AIM: One of the tenets of the incentive sensitization theory of drug addiction is that 'as drugs come to be wanted more and more, they often come to be liked less and less'. The aim of this study was to test whether this assumption holds true. Specifically, the study aimed to test the hypothesis that in non-clinical samples, dependence on amphetamines and excessive alcohol use are associated with increased 'wanting' but decreased 'liking' for the drug. DESIGN, SETTING AND PARTICIPANTS: In two studies, the Desires for Alcohol Questionnaire (DAQ) was administered to 380 recreational drinkers, and the Desires for Speed Questionnaire (DSQ) and the Leeds Dependence Questionnaire (LDQ) were administered to 174 amphetamine users. Scales were derived from the DAQ and DSQ representing craving, on one hand, and positive and negative reinforcement on the other hand. Craving and positive reinforcement were taken as measures of alcohol or amphetamine 'wanting' and 'liking', respectively. FINDINGS: Scores on all three DAQ scales increased monotonically as a function of the extent of alcohol consumption. Scores on all three DSQ scales increased monotonically as a function of dependence, as measured by the LDQ. 'Liking' for amphetamine was unrelated to time since the drug was last taken. (These data were not available for alcohol.) CONCLUSIONS: The finding that 'wanting' increased as a function of dependence on amphetamine or level of consumption in the case of alcohol is as predicted by the incentive sensitization theory, but the finding that 'liking' also increased as a function of dependence or excess is the opposite of the predicted effects While not refuting the incentive sensitization theory directly, the study questions the validity of one of the tenets of the theory.     

The effects of methadone on operant behavior maintained with and without conditioned reinforcement in the pigeon

Effects of methadone on key pecking supplemented with brief stimuli either correlated with or independent of unconditioned reinforcement was investigated. On average, key pecks by pigeons produced brief stimuli (BS) once per minute and food once per 4 min during both components of a multiple schedule (i.e., VI1:BS, VI4:Food). Brief stimuli were paired with food presentation during one component and not related to food during the second component. Acute methadone administration (0.56, 1.0, 1.7, and 3.0 mg/kg) decreased response rates during both components; however, the decrease was smaller by a constant amount during the paired brief stimulus component, regardless of drug dose. These results suggest conditioned reinforcement is not a primary mechanism through which methadone exerts behavioral effects and that reinforcer-correlated stimuli have potential for diminishing the reduced behavioral output observed following methadone administration.     

Dopamine-dependent and dopamine-independent actions of cocaine as revealed by brain thermorecording in freely moving rats

Brain temperature fluctuates biphasically in response to repeated, intravenous (i.v.) cocaine injections, perhaps reflecting cocaine's inhibiting effect on both dopamine (DA) transporters and Na+ channels. By using a DA receptor blockade, one could separate these actions and determine the role of DA-dependent and DA-independent mechanisms in mediating this temperature fluctuation. Rats were chronically implanted with thermocouple probes in the brain, a non-locomotor head muscle and subcutaneously. Temperature fluctuations associated with ten repeated i.v. cocaine injections (1 mg/kg with 8-min inter-injection intervals) were examined after a combined, systemic administration of selective D1-like and D2-like receptor blockers (SCH-23390 and eticlopride) at doses that effectively inhibit DA transmission. In contrast to the initial temperature increases and subsequent biphasic fluctuations (decreases followed by increases) seen with repeated cocaine injections in saline-treated control, brain and muscle temperatures during DA receptor blockade decreased with each repeated cocaine injection. DA receptor blockade had no effects on skin temperature, which tonically decreased and biphasically fluctuated (decreases followed by increases) during repeated cocaine injections in both conditions. DA receptor blockade by itself slightly increased brain and muscle temperatures, with no evident effect on skin temperature. DA antagonists also strongly decreased spontaneous movement activity and completely blocked the locomotor activation normally induced by repeated cocaine injections. Although our data confirm that cocaine's inhibitory action on presynaptic DA uptake is essential for its ability to induce metabolic and behavioral activation, they also suggest that the physiological effects of this drug cannot be explained through this system alone. The continued hypothermic effect of cocaine points to its action on other central systems (particularly blockade of Na+ channels) that may be important for the development of cocaine abuse and adverse effects of this drug.     

Ratio and time requirements on operant schedules: effort-related effects of nucleus accumbens dopamine depletions

Accumbens dopamine (DA) depletions produce deficits that are related to the ratio requirement of the operant schedule; however, it is also possible that time without reinforcement is a factor. The present study examined the effects of accumbens DA depletions in rats using variable interval (VI) schedules with additional fixed ratio (FR) requirements. Four VI schedules were used (VI 60/FR 1, VI 120/FR 1, VI 60/FR 10, VI 120/FR 10). Attachment of the additional work requirement increased response rates under control conditions. After surgery, there was no interaction between interval level (i.e. 60 vs. 120 s) and DA depletion, but there was a significant interaction between ratio requirement (i.e. 1 vs. 10) and DA depletion within the first week after surgery. DA depletions substantially impaired performance on the schedules with added FR 10 requirements, an effect that was largely dependent upon a reduction in fast responses (i.e. inter-response times less than 1.0 s). There was little effect of DA depletion on overall responding on VI 60/FR 1 and VI 120/FR 1 schedules. DA depletions also increased the tendency to take long pauses in responding (i.e. > 20.0 s), and this effect was evident across all schedules tested. Thus, accumbens DA depletions interact with work requirements and blunt the rate-enhancing effects of moderate size ratios, and also enhance the tendency to pause. Attachment of ratio requirements to interval schedules is a work-related response cost that provides a challenge to the organism, and DA in nucleus accumbens appears to be necessary for adapting to this challenge.     

Sensitization to the reinforcing effects of cocaine following binge-abstinent self-administration

The process of addiction in humans involves a transition from recreational drug use to compulsive drug-taking. To understand or study this behavioral phenomenon from a neurobiological perspective, behavioral models that reflect this process are necessary. Data from typical (restricted access) self-administration procedures demonstrate a stable pattern of responding over time, and thus fail to capture the transitional phases of this process. Here we describe the development of a model that incorporates self-administration-induced changes in the reinforcing efficacy of cocaine, assessed using a progressive ratio schedule of reinforcement to probe the ‘motivational’ state of the animal. To date we have identified two necessary conditions for the development of this sensitization: extended access to cocaine and a deprivation period. This model, in conjunction with recently developed tools to characterize neurochemical and epigenetic changes, will provide a better understanding of the neurobiological bases of the addiction process.     

Effects of acute and chronic buspirone on impulsive choice and efflux of 5-HT and dopamine in hippocampus, nucleus accumbens and prefrontal cortex

Rationale Reduced central serotonin (5-HT) activity has been associated with impulsive choice behaviour, but there is no consensus about the precise nature of these effects. Behavioural and neurochemical effects of 5-HT_1A agonists such as buspirone depend critically on the dose and the duration of treatment. We thus undertook a parametric study of the effects of acute and chronic buspirone on the performance on a test of delayed gratification, as well as on the efflux of serotonin and dopamine (DA) in cortical and subcortical regions in rats.Objectives Three experiments examined (i) the effects of acute buspirone on impulsive choice and how such effects were modified by prior chronic exposure to buspirone; (ii) the effects of chronic buspirone on impulsive choice; (iii) the effects on impulsive choice of a selective 5-HT_1A antagonist, WAY-100635 tested alone and in combination with buspirone; (iv) the effects of chronic and acute buspirone on 5-HT and DA efflux in anaesthetised rats.Methods In experiment 1, rats previously trained on the delayed gratification task were tested with acute buspirone (0.5, 1 and 2 mg/kg). The same rats were then treated with chronic buspirone (1 mg/kg/day) over the next 65 days, and the effects of acute buspirone (1 mg/kg) re-determined at 20, 45 and 65 days of chronic treatment. In experiment 2, two groups of rats trained on the delayed gratification task were treated either with saline or buspirone (1 mg/kg/day) continually for 65 days before being tested with acute buspirone (1 mg/kg), WAY-100635 (0.08 mg/kg), or a combination of the two drugs. In experiment 3, rats received the same regimen of buspirone dosing as in experiment 2, before receiving in-vivo microdialysis for 5-HT and DA in the ventral hippocampus, nucleus accumbens and medial prefrontal cortex.Results Acute buspirone dose dependently increased the choice for the small, immediate reinforcer (impulsive choice) but the effects of 1 mg/kg were reversed on chronic administration of buspirone. This increased choice of the large, delayed reinforcer, which was not accompanied by any changes in baseline (non-drugged) performance, was blocked by the 5-HT_1A receptor antagonist WAY-100635. The chronic buspirone regimen did not alter buspirone-evoked reductions in 5-HT efflux in hippocampus but did lead to a differential effect of acute buspirone in medial prefrontal cortex, with the chronic buspirone and saline groups exhibiting decreases and increases in efflux, respectively. There were no systematic changes in DA efflux under any condition.Conclusions These findings show that the effects of acute buspirone on impulsive choice are reversed following chronic treatment and are mediated by 5-HT_1A receptors, and suggest, in addition, that the behavioural effects may involve changes in 5-HT functioning in medial prefrontal cortex.     

Reinforcement by orally delivered methadone, cocaine, and methadone-cocaine combinations in rhesus monkeys: are the combinations better reinforcers?

RATIONALE: Polydrug abuse is a problem that has been infrequently examined. In the present study, drug self-administration procedures were used to investigate the reinforcing effects of drug combinations. OBJECTIVES: To determine the absolute and relative response rates maintained by orally delivered methadone, cocaine, and their combinations under sequential and concurrent access. Choice between drug combinations containing different concentrations of cocaine was also determined. METHODS: Oral intake of methadone, cocaine, and their combinations was studied with rhesus monkeys during daily 3-h sessions. Lip contact (the operant response) was reinforced by delivery of liquid contingent upon completion of a fixed-ratio schedule. In one series, the drugs and drug combinations were studied sequentially with the water vehicle concurrently available. In the next series, the drugs and drug combinations were concurrently available. In the third series, pairs of drug combinations containing different concentrations of cocaine were also concurrently available. RESULTS: Methadone, cocaine and their combinations functioned as reinforcers. Under sequential access, response rates for the drug combinations and the component drugs were often similar. However, under concurrent access, response rates for the drug combinations were greater than response rates for the component drugs at the highest FR size for each condition. Also, drug combinations containing higher cocaine concentrations were preferred to combinations containing lower cocaine concentrations. CONCLUSIONS: Combinations of methadone and cocaine have relatively greater reinforcing effects than the component drugs, and these greater reinforcing effects are better detected with concurrent measures than with sequential measures.     

Repeated social-defeat stress, cocaine or morphine

RATIONALE: Repeated social stress experiences engender "behavioral sensitization" and may also increase the potential for abuse of psychomotor stimulants, particularly cocaine use during "binges." OBJECTIVE: Experimental protocols were designed to induce behavioral sensitization through exposures to social-defeat stress or injections of cocaine or morphine. The impact of stress, cocaine or morphine sensitization on cocaine self-administration was assessed using several protocols. METHODS: Behavioral sensitization was induced in male Long-Evans rats by four social-defeat stress episodes, each separated by 72 h. Expression was assessed following a challenge of D-amphetamine (1.0 mg/kg) or cocaine (7.5 mg/kg or 10.0 mg/kg), 10-15 days after the last defeat. Sensitization to cocaine (15.0 mg/kg) or morphine (10.0 mg/kg) was induced via daily administrations for 10 days and later assessed by challenges with cocaine or morphine. Subsequently, i.v. self-administration of cocaine was analyzed for (i) rates of acquisition, (ii) sensitivity to various doses, (iii) "breaking points" during a progressive ratio schedule of cocaine reinforcement, and (iv) patterns of intake during a 24-h binge, in sensitized and control rats. RESULTS: Social-defeat stress, cocaine or morphine administrations increased the locomotor response to stimulant challenges. During 24-h cocaine self-administration binges, sensitization to social-defeat stress or to cocaine prolonged responding, resulting in more cocaine intake. In addition, cocaine sensitization increased the rate of acquisition to cocaine self-administration and the breaking point during a progressive ratio schedule. CONCLUSION: The process of sensitization to social-defeat stress or cocaine intensifies cocaine intake during a binge, supporting the hypothesis that sensitization may facilitate the transition to compulsive drug taking.     

Plasmalemmal mu-opioid receptor distribution mainly in nondopaminergic neurons in the rat ventral tegmental area

Opiate-evoked reward and motivated behaviors reflect, in part, the enhanced release of dopamine produced by activation of the mu-opioid receptor (muOR) in the ventral tegmental area (VTA). We examined the functional sites for muOR activation and potential interactions with dopaminergic neurons within the rat VTA by using electron microscopy for the immunocytochemical localization of antipeptide antisera raised against muOR and tyrosine hydroxylase (TH), the synthesizing enzyme for catecholamines. The cellular and subcellular distribution of muOR was remarkably similar in the two major VTA subdivisions, the paranigral (VTApn) and parabrachial (VTApb) nuclei. In each region, somatodendritic profiles comprised over 50% of the labeled structures. MuOR immunolabeling was often seen at extrasynaptic/perisynaptic sites on dendritic plasma membranes, and 10% of these dendrites contained TH. MuOR-immunoreactivity was also localized to plasma membranes of axon terminals and small unmyelinated axons, none of which contained TH. The muOR-immunoreactive axon terminals formed either symmetric or asymmetric synapses that are typically associated with inhibitory and excitatory amino acid transmitters. Their targets included unlabeled (30%), muOR-labeled (25%), and TH-labeled (45%) dendrites. Our results suggest that muOR agonists in the VTA affect dopaminergic transmission mainly indirectly through changes in the postsynaptic responsivity and/or presynaptic release from neurons containing other neurotransmitters. They also indicate, however, that muOR agonists directly affect a small population of dopaminergic neurons expressing muOR on their dendrites in VTA and/or terminals in target regions.     

国家重点学科临床医师强化培训的探索与实践

医学人才的培养关系到社会的整体医疗水平.我国传统的医师培训模式已不适应当今社会对医疗服务的高质量要求,有必要探索提高我国医师培养的新路子.我们认为,建立住院医师强化培训可以从根本上提高医师的临床工作能力.国家重点学科南京大学医学院临床学院(南京军区南京总医院)全军普通外科研究对此进行了探索与实践,取得了卓越成效.