Aromatase and its inhibition in behaviour, obsessive compulsive disorder and parkinsonism

Oestrogens regulate normal behaviour and have been implicated in modulating pathological behaviour such as obsessive compulsive disorder and neurological disorder such as Parkinsonism. Therefore, by regulating the expression of the oestrogen-synthesising enzyme, aromatase, we may identify what behaviour is regulated by oestrogen. Inhibition of aromatase either genetically or pharmacologically has been reported to induce sexual behaviour impairment, compulsive behaviour and susceptibility to neurodegeneration.     

Emerging experience with selected new categories in the ICD‐11: complex PTSD,prolonged grief disorder,gaming disorder,and compulsive sexual behaviour disorder

Among the important changes in the ICD‐11 is the addition of 21 new mental disorders. New categories are typically proposed to: a) improve the usefulness of morbidity statistics; b) facilitate recognition of a clinically important but poorly classified mental disorder in order to provide appropriate management; and c) stimulate research into more effective treatments. Given the major implications for the field and for World Health Organization (WHO) member states, it is important to examine the impact of these new categories during the early phase of the ICD‐11 implementation. This paper focuses on four disorders: complex post‐traumatic stress disorder, prolonged grief disorder, gaming disorder, and compulsive sexual behaviour disorder. These categories were selected because they have been the focus of considerable activity and/or controversy and because their inclusion in the ICD‐11 represents a different decision than was made for the DSM‐5. The lead authors invited experts on each of these disorders to provide insight into why it was considered important to add it to the ICD‐11, implications for care of not having that diagnostic category, important controversies about adding the disorder, and a review of the evidence generated and other developments related to the category since the WHO signaled its intention to include it in the ICD‐11. Each of the four diagnostic categories appears to describe a population with clinically important and distinctive features that had previously gone unrecognized as well as specific treatment needs that would otherwise likely go unmet. The introduction of these categories in the ICD‐11 has been followed by a substantial expansion of research in each area, which has generally supported their validity and utility, and by a significant increase in the availability of appropriate services.     

Ethical concerns regarding commercialization of deep brain stimulation for obsessive compulsive disorder

The United States Food and Drug Administration's recent approval of the commercial use of Deep Brain Stimulation (DBS) as a treatment for Obsessive Compulsive Disorder (OCD) will be discussed within the context of the existing USA regulatory framework. The purpose will be to illustrate the current lack of regulation and oversight of the DBS market, which has resulted in the violation of basic ethical norms. The discussion will focus on: 1) the lack of available evidence on procedural safety and efficacy, 2) the numerous conflicts of interest held by research investigators, and 3) the ambiguity of both aforementioned categories due to an inherent lack of transparency in the research. It is argued that in order to address these issues, ethical analyses of DBS for psychiatric disorders must include the role of the industry forces that have become the primary impetus for this research. As such, DBS for OCD serves as an important case example in studies of neurotechnology and innovative surgery.     

Novel selective inhibitors of neutral endopeptidase for the treatment of female sexual arousal disorder

A series of substituted glutaramides were synthesised using Candoxatrilat 1 as a lead and evaluated for potency against neutral endopeptidase (NEP) as a potential treatment for female sexual arousal disorder (FSAD). In this paper, we describe studies in which we were able to increase NEP activity substantially over the levels reported for previous compounds from this programme by appropriate substitution in both the P(1)(') and P(2)(') regions. Optimisation led to the 4-chlorophenpropylamide S-30 which was selected as a candidate for further study.     

Molecular neurogenetics of sexual differentiation and behaviour

Sex and death. Two things that come once in a lifetime. Only after death you're not nauseous. - Woody Allen 'Sleeper'. The brain and nervous system functions that underlie sex-specific behaviour are of obvious importance to all animals, including humans. To understand behaviour related to sex, it is important to distinguish those aspects that are controlled genetically. Much of the recent progress in studies of the molecular neurogenetics of sexual differentiation and behaviour has come from the use of genetically tractable organisms (i.e. fruitflies and nematode worms) that exhibit a full range of sexually dimorphic phenotypes.     

The acceptability of Internet-based treatment and characteristics of an adult sample with obsessive compulsive disorder: an Internet survey

Background

Obsessive-compulsive disorder (OCD) is a disabling anxiety disorder, but most individuals delay seeking treatment. Internet-based cognitive behavioural therapy (iCBT) is an innovative service delivery method that may help to improve access to care, but the acceptability to consumers of such programs has not yet been established.

Methodology

People with symptoms of OCD were invited to complete an online survey enquiring about demographic characteristics, symptom severity, and acceptability of Internet-based treatment. Demographic and symptom severity data were compared with people with OCD identified in a national epidemiological survey and with a sample of patients with OCD from a specialist outpatient anxiety clinic.

Participants

129 volunteers to an online Internet survey, 135 patients at a specialist anxiety disorders outpatient clinic, and 297 cases identified in a national epidemiological survey.

Main Measures

Demographic characteristics, and severity of symptoms as measured by the Kessler 10-Item scale, the 12-item World Health Organisation Disability Assessment Schedule - Second Edition and the Yale Brown Obsessive Compulsive Scale - Self Report Version.

Principal Findings

The Internet sample was similar demographically but reported more severe symptoms than the comparison groups, although had similar severity of symptoms of OCD compared with other clinical samples reported in the literature. Participants reported Internet-based treatment for OCD would be highly acceptable.

Conclusions

Internet-based treatment may reduce barriers to accessing treatment to people with OCD. Individuals in this study were similar demographically to other samples and had similar severity of symptoms as those identified in other clinical samples, suggesting that Internet-based treatment using techniques employed in face-to-face treatment may be effective in this group. Internet-based treatments for OCD need to be developed and evaluated.     

Genetics of sexual behaviour in Drosophila

The analysis of genetics of behaviour within and between species provides important clues about the forces shaping the evolution of behavioural genes. In Drosophila, a number of key processes such as emergence from the pupal case, locomotor activity, feeding, olfaction and aspects of mating behaviour are under circadian regulation. Genes controlling sexual behaviour are likely to control species specific differences in courtship that are involved in reproductive isolation of closely related species. Courtship in Drosophila is characterized by a series of stereotyped behaviours that lead to copulation and more than 30 genes have been identified through mutations that affect one or more of these elements. Although curiosity about behavioural differences between the sexes undoubtedly predates recorded history, little efforts have been made to uncover the molecular basis of male and female courtship. The brain and nervous system functions that underlie sex-specific behaviour are of obvious importance to all animals including humans. To understand behaviour related to sex it is important to distinguish those aspects that are controlled genetically. The isolation and analysis of Drosophila mutants with altered sexual orientation lead to the identification of novel branches in the sex-determination cascade, which govern the sexually dimorphic development of the nervous system.     

Immunocompetence, mast cells and sexual behaviour

This paper reports a provocative and novel observation. Specifically, we have shown that in Ring Doves Streptopelia roseogrisea, following a brief period of courtship, cells of the immune system–mast cells–appear in the brain. This is surprising in that it has long been thought that the blood-brain barrier prevents the movement of blood-borne cells into the parenchyma (neural tissue) of the brain. The conditions under which these cells appear, their chemical and ultrastructural features and their potential in neuroendocrine signalling functions are discussed. The significance of these cells for the expression of behaviour and their specific role in the medial habenula (the brain area to which they migrate) remain to be explored. While our research has focused on a domesticated, laboratory bird species, the relationship between sexual behaviour and immunocompetence has long been of interest in field work and in studies on the evolution of sexual behaviour. It is hoped that this work, now in its infancy, will bridge field and laboratory, as well as providing a forum for integrating mechanistic and evolutionary concepts in neuro-im-muno-endocrinology.     

Immunocompetence, mast cells and sexual behaviour

This paper reports a provocative and novel observation. Specifically, we have shown that in Ring Doves Streptopelia roseogrisea , following a brief period of courtship, cells of the immune system–mast cells–appear in the brain. This is surprising in that it has long been thought that the blood-brain barrier prevents the movement of blood-borne cells into the parenchyma (neural tissue) of the brain. The conditions under which these cells appear, their chemical and ultrastructural features and their potential in neuroendocrine signalling functions are discussed. The significance of these cells for the expression of behaviour and their specific role in the medial habenula (the brain area to which they migrate) remain to be explored. While our research has focused on a domesticated, laboratory bird species, the relationship between sexual behaviour and immunocompetence has long been of interest in field work and in studies on the evolution of sexual behaviour. It is hoped that this work, now in its infancy, will bridge field and laboratory, as well as providing a forum for integrating mechanistic and evolutionary concepts in neuro-immuno-endocrinology.     

Interaction of naltrexone with postnatal administration of testosterone and estrogen on neurobehavioral sexual differentiation in rats

The present study examined whether some effects of gonadal sex hormones on neurobehavioral sexual differentiation might be mediated by endogenous opioids. Male and female pups were administered sesame oil, testosterone propionate (TP; 25 micrograms) or estradiol benzoate (EB; 10 micrograms) on postnatal Days 2 and 3. Half of each group was also administered naltrexone (N; 50 micrograms) twice daily on these two days. Females were studied for effects of the treatments on puberty. Males and females were studied in adulthood for open field behavior, daily water intake, and saccharin consumption and preference for 0.125, 0.25, and 0.50% saccharin solutions. TP treatment significantly delayed the date of vaginal opening, whereas EB treatment significantly accelerated the date. N treatment potentiated this effect of TP, but had no effect in EB treated females, nor did it influence the anovulatory sterility produced by both hormone treatments. N treatment alone had no effect on puberty in females or open field behavior of either sex. The drug produced an overall increase in female saccharin consumption and preference, but no effect was observed in males on these measures. Both TP and EB treatment produced marked increases in daily water consumption in females, an effect which was significantly attenuated by N treatment. Effects of both hormones on saccharin consumption were sex dependent and partially antagonized by N treatment. Finally, we observed a sex difference in daily water intake wherein females were found to consume approximately 20% more water on a body weight basis in a 24-hr period than males. Postnatal TP and EB treatment increased adult daily water consumption in females above the level of controls. This increase was partially antagonized by N. Treatment with N alone had no effect on female water consumption, but produced a small decrease in male consumption. Overall, these results provide preliminary evidence that some organizational effects of TP and EB on nonreproductive sex differences may be mediated by endogenous opioids.