The attrition rate in central nervous system (CNS) drug development has been particularly high, and this is in part due to a poor preclinical to clinical translation, a lack of surrogate biomarkers, and a difficult-to-treat patient population. However, the advancement of new technologies increasingly allows for biomarker-guided drug development in CNS, which shifts attrition to earlier stages of the development process and frees up resources for continued innovation. Developing compounds for which biomarkers are available to demonstrate not only CNS penetration but also target engagement, and a functional effect reflective of clinical outcome is imperative, not only for improving the chances for success but also for early decision-making. To that end, advances in imaging, electrophysiological measurements, and identification of additional biomarkers coupled with an enhanced understanding of the underlying circuity and well-defined patient studies improve the possibility of launching a successful drug.

The 5-HT7 receptor is the most recently identified receptor subtype within a family of 5-HT receptors activated by the neurotransmitter serotonin. There has been significant interest in investigating the potential role of this receptor in psychiatric disorders including depression, anxiety, and schizophrenia. Behaviors of 5-HT7 +/+ (wild-type or WT) and 5-HT7 -/- (receptor knockout or KO) mice were compared across 10 different assays (7 for anxiety, 1 for depression, 2 for psychosis) to identify differences that could indicate clinical potential for 5-HT7 receptor antagonism. Evaluation of KO vs. WT mice demonstrated significant differences between the genotypes in the fear conditioning, shock-probe burying, novelty-suppressed feeding, punishment memory, forced swim test, and d-amphetamine hyperactivity assays. There was not consistency in either the direction of behavioral effects across genotypes or across assays. Thus, data from these behavioral assays did not uniformly support the idea that 5-HT7 receptors constitute an important drug target for these psychiatric disorders. The present findings are generally congruent with the mixed results in the literature on the behaviors of 5-HT7 -/-mice and with the data on effects of 5-HT7 receptor antagonists in rodent models that detect activity of anxiolytic, antidepressant, and antipsychotic effects.

As the nontherapeutic use of prescription medications escalates, serious associated consequences have also increased. This makes it essential to estimate misuse, abuse, and related events (MAREs) in the development and postmarketing adverse event surveillance and monitoring of prescription drugs accurately. However, classifications and definitions to describe prescription drug MAREs differ depending on the purpose of the classification system, may apply to single events or ongoing patterns of inappropriate use, and are not standardized or systematically employed, thereby complicating the ability to assess MARE occurrence adequately. In a systematic review of existing prescription drug MARE terminology and definitions from consensus efforts, review articles, and major institutions and agencies, MARE terms were often defined inconsistently or idiosyncratically, or had definitions that overlapped with other MARE terms. The Analgesic, Anesthetic, and Addiction Clinical Trials, Translations, Innovations, Opportunities, and Networks (ACTTION) public-private partnership convened an expert panel to develop mutually exclusive and exhaustive consensus classifications and definitions of MAREs occurring in clinical trials of analgesic medications to increase accuracy and consistency in characterizing their occurrence and prevalence in clinical trials. The proposed ACTTION classifications and definitions are designed as a first step in a system to adjudicate MAREs that occur in analgesic clinical trials and postmarketing adverse event surveillance and monitoring, which can be used in conjunction with other methods of assessing a treatment's abuse potential.

Blockade of the cannabinoid CB1 receptors (CB1R) has been shown to reduce psychostimulant-induced hyperactivity, an effect that we sought to further characterize here. The CB1R antagonist SR141716A dose-dependently decreased d-amphetamine-induced hyperactivity. Also, d-amphetamine-induced hyperlocomotion was reduced in CB1R knockout (KO) mice. However, CB1R KO and wild-type mice showed a similar d-amphetamine-induced increase in nucleus accumbens DA release. Hence, we investigated whether CB1R antagonism/invalidation reduces d-amphetamine-induced hyperlocomotion through a mechanism involving changes in glutamatergic neurotransmission. Blockade of metabotropic-glutamate-receptors-5 (mGluR5) with MPEP, but not blockade of N-methyl-d-aspartate-receptors (NMDA) with MK-801, restored to a great extent the blunted d-amphetamine-induced hyperlocomotion seen after CB1R antagonism/invalidation. Thus, hyporesponsiveness to the psychostimulant effects of d-amphetamine as a result of CB1R antagonism/invalidation is not due to an ensuing decrease in d-amphetamine-induced DA release in the nucleus accumbens, but rather due to a hyperglutamatergic state and facilitation of glutamatergic neurotransmission at the mGlu5, but not NMDA, receptors.

Evidence indicates that blockade of cannabinoid receptors increases acetylcholine (ACh) release in brain cortical regions. Although it is assumed that this type of effect is mediated through CB1 receptor (CB1R) antagonism, several in vitro functional studies recently have suggested non-CB1R involvement. In addition, neither the precise neuroanatomical site nor the exact mechanisms underlying this effect are known. We thoroughly examined these issues using a combination of systemic and local administration of CB1R antagonists, different methods of in vivo microdialysis, CB1R knockout (KO) mice, tissue measurements of ACh, and immunochemistry. First, we showed that systemic injections of the CB1R antagonists N-(piperidin-1-yl)-5-(4-chlorophenyl)-1-(2,4-dichlorophenyl)-4-methyl-1H-pyrazole-3-carboximide hydrochloride (SR141716A) and N-(piperidin-1-yl)-5-(4-iodophenyl)-1-(2, 4-dichlorophenyl)4-methyl-1H-pyrazole-3-carboxamide (AM251) dose-dependently increased hippocampal ACh efflux. Likewise, local hippocampal, but not septal, infusions of SR141716A or AM251 increased hippocampal ACh release. It is noteworthy that the stimulatory effects of systemically administered CB1R antagonists on hippocampal ACh release were completely abolished in CB1R KO mice. CB1R KO mice had similar basal but higher stress-enhanced hippocampal ACh levels compared with wild-type controls. It is interesting that dopamine D-1 receptor antagonism counteracted the stimulatory effect of CB1R blockade on hippocampal ACh levels. Finally, immunohistochemical methods revealed that a high proportion of CB1R-positive nerve terminals were found in hippocampus and confirmed the colocalization of CB1 receptors with cholinergic and dopaminergic nerve terminals. In conclusion, hippocampal ACh release may specifically be controlled through CB(1)Rs located on both cholinergic and dopaminergic neuronal projections, and CB1R antagonism increases hippocampal ACh release, probably through both a direct disinhibition of ACh release and an indirect increase in dopaminergic neurotransmission at the D-1 receptors.

Neurotropic effects of endo- and exo-cannabinoids are largely caused by their effects on classical neurotransmitter signaling. Pharmacological and molecular tools have been used to selectively target the endocannabinoid system. Endocannabinoids mostly act as retrograde messengers and, upon release from postsynaptic neurons, they modulate neurotransmitter release by activating presynaptic cannabinoid receptors. Generally, increased and decreased endocannabinoid neurotransmission results in decreases and increases in neurotransmitter release, respectively. However, net effects are often pleiotropic, probably owing to the level of regional endogenous tone, transsynaptic mechanisms and cumulative actions. Changes in classical neurotransmitter function can, in turn, modulate endocannabinoid signaling. Importantly, the endocannabinoid system can be altered in response to physiological and pathogenic events and targeted for therapeutic intervention.

Although the involvement of cannabinoids and the endogenous cannabinoid system in the regulation of the hypothalamo-pituitary-adrenal axis in rodents is well documented, the precise role played by the cannabinoid type one (CB(1)) receptor in this effect has not been fully elucidated. Consequently, we investigated the role of CB(1) receptor in modulating plasma corticosterone concentrations through use of the potent and selective CB(1) receptor antagonist SR141716A and CB(1) receptor knockout mice. Rats were administered SR141716A (0.1, 0.3, and 1 mg/kg, i.v.) and blood was sampled at 0, 15, 60, 90 and 120 min postinjection. SR141716A dose- and time-dependently increased plasma corticosterone levels and maximum effects were obtained with the 1 mg/kg dose 60 min postinjection. In mice, SR141716A (0.1, 0.3, 1, 3, and 10 mg/kg, i.p.) also induced a dose-dependent rise in corticosterone levels 60 min postinjection; this rise reached plateau levels with the 0.3-1 mg/kg doses. The stimulatory effect of SR141716A (1 mg/kg, i.p.) on plasma corticosterone 60 min postinjection was abolished in the CB(1) receptor knockout mice, which did not show any difference in basal corticosterone levels as compared to their wild-type controls. Finally, the stimulatory effects of SR141716A (10 mg/kg, i.p.) on plasma corticosterone 60 min postinjection were retained after subchronic dosing (5 days, once daily) in mice. The present results indicate that SR141716A increases plasma corticosterone in rats and mice possibly through blockade of CB(1) receptors, an effect that is retained after subchronic dosing in mice. These data provide support for the notion that changes in plasma corticosterone concentrations may be used in the laboratory and the clinic to assess the effects of CB(1) receptor antagonism.

We used muscarinic M2 and M4 receptor knockout (KO) mice to further explore the role of the cholinergic system in anxiety. Using the shock-probe burying model we were able to both assess anxiety and cognition. In this paradigm, an anxiolytic response is reflected by decreased burying behavior. In addition, retention latency depicts long-term memory performance. Whereas muscarinic M2 receptor KO mice did not differ behaviorally from wild-type mice, muscarinic M4 receptor KO mice showed increased anxiolysis, but normal long-term memory compared to wild-type mice. Therefore, muscarinic M4 receptors are of particular significance in anxiety modulation that seems dissociated from changes in long-term memory.

Environmental enrichment enhances learning and memory in both rodents and man. We examined the effect of active manipulation of a novel object (toy) on cognitive performance and acetylcholine (ACh) efflux in the hippocampus of rats. Animals exposed to the toy showed a significant increase in hippocampal ACh efflux provided that they actively manipulated the object. Similarly, a single 1 h introduction of the novel object (toy) immediately after a training session in a radial arm maze significantly improved memory only if the animals actively manipulated the object. The data suggest that environmental enrichment during a critical period (consolidation) is sufficient to improve learning and memory. This effect is likely mediated through an enhancement of hippocampal cholinergic neurotransmission.

Habituation (a form of non-associative learning) was measured by assessing locomotion in novel activity monitors in CB1 receptor knockout mice and juxtaposed to habituation measured in muscarinic M2, M4, and double M2/M4 receptor knockout mice. M2 and M2/M4, but not M4, receptor knockout mice appeared to have an impaired ability to habituate, whereas CB1 receptor knockout mice showed enhanced habituation compared to wild-type animals. We conclude that CB1 receptor gene invalidation improves habituation tentatively through an increase in cholinergic neurotransmission.

Cannabinoids affect various behavioral processes, including emotion, learning and memory, which may bspecifically regulated through the CB1 receptors. The exact role CB1 receptors play in anxiety remains unclear. Both genetic and pharmacological blockade of CB1 receptors have produced inconsistent effects on anxiety. However, these studies examined passive avoidance as an index of anxiety. In the present study, both active and passive avoidance were examined using the shock-probe burying test while CB1 receptors were blocked genetically or pharmacologically. In the shock-probe burying test, anxiety is reflected by increased burying (increased active avoidance) and increased freezing (increased passive avoidance). In addition, probe-contacts may reflect cognitive performance and/or passive avoidance. As there have been few studies examining mouse behavior in the shock-probe burying test, experiment 1 was designed to pharmacologically validate this model in mice. Our results indicated that administration (i.p.) of chlordiazepoxide (4 mg/kg) or FG7412 (5 mg/kg) decreased and increased burying behavior, respectively, without affecting freezing or the number of probe contacts. Experiments 2 and 3 showed that both CB1 knockout mice and mice injected (i.p.) with 3 or 10 mg/kg, but not 1 mg/kg, of the CB1 receptor antagonist SR141716A had lower burying scores, fewer contacts with the probe and similar freezing times compared with wild-type mice and mice injected with vehicle (experiments 2 and 3). Collectively, these results suggest that CB1 receptor blockade reduces some, but not all, aspects of anxiety. The decrease in probe contacts induced by CB1 receptor blockade may be due to enhanced cognition.

Previous lesion studies have suggested that the septal–hippocampal system is involved in fear and anxiety. In this study we examined the effects on anxiety of temporary neuronal inhibition of various aspects of the septo-hippocampal system in rats. Infusions of tetrodotoxin (TTX) were used to induce reversible lesions in the fimbria fornix, medial septum, dorsal hippocampus, and ventral hippocampus. To assess anxiety we used the elevated plus-maze and the shock-probe burying tests. A reduction in anxiety in the elevated plus-maze is indicated by increased open arm exploration, whereas a reduction in anxiety in the shock-probe burying test is indicated by decreased burying behavior or increased contacts with the shock-probe. The results suggested that inhibition of the septal–hippocampal system induced site-specific anxiolytic effects that vary in nature. Tetrodotoxin lesions of the fimbria fornix increased both open arm exploration and the number of shocks taken by the rats, while having no effect on burying behavior. Both septal and ventral hippocampal lesions increased open arm exploration and decreased burying behavior, but had no effect on the number of probe shocks. Finally, TTX lesions of the dorsal hippocampus increased the number of shocks taken by the rats, but did not affect open arm activity or burying behavior. Neuroanatomical studies indicated that the effect on the number of shocks induced by dorsal hippocampal TTX lesions was not likely mediated by the amygdala. Collectively, the data suggest that the control of specific anxiety reactions is functionally segregated within different aspects of the septo-hippocampal system.

There is evidence that the septohippocampal cholinergic system is activated in response to stressful stimuli. In addition, prior studies indicate that stimulating the hippocampal cholinergic neurotransmission increases open arm exploration in the elevated plus-maze. This raises the possibility that exposing the rat to an elevated platform, which would be similar to confining the animal to the open arms of the plus-maze, would alter hippocampal acetylcholine levels. Results from the present study suggest that an elevated platform can be used as an animal model of stress in that exposure to the platform significantly increased plasma corticosterone levels. Importantly, exposure to a platform significantly increased hippocampal acetylcholine efflux. Interestingly, the increase in plasma corticosterone and hippocampal acetylcholine levels upon exposure to an elevated platform could be prevented by chlordiazepoxide at a dose that had no effect on basal hippocampal acetylcholine or plasma corticosterone levels. However, the elevated platform-induced increase in hippocampal acetylcholine could not be blocked by prior administration of buspirone. These results provide direct evidence for the importance of the hippocampal cholinergic system in stress and provide validation for the elevated platform as a model of stress.

Anxiety disorders may result from an overexpression of aversive memories. Evidence suggests that the hippocampal cholinergic system could be the point of convergence of anxiety and memory. We propose that clinically effective anxiolytics may exert their effect by interfering with this integration mechanism. To assess anxiety and aversive memory, we used the shock-probe burying test. A reduction in anxiety in this test is indicated by decreased burying, whereas impaired cognition is reflected by an increased number of probe-contacts and/or reduced retention latency. Both an aversive stimulus and the memory of that stimulus significantly increased hippocampal acetylcholine (ACh) levels (Experiment 1). In fact, the memory of the event seemed to be more important than the event itself since the aversive memory induced a greater increase in hippocampal ACh. Injections (i.p.) of fluoxetine (Prozac®) reduced burying behavior, while not affecting probe contacts or retention latency (Experiment 2). Although injections of fluoxetine did not affect basal hippocampal ACh efflux (Experiment 3), fluoxetine abolished the increase in ACh induced by the aversive stimulus and the memory of that stimulus (Experiment 4), emphasizing the significance of aversive memories in anxiety disorders. These actions may be mediated by a decrease in the event-related enhancement in cholinergic neurotransmission through M1 cholinergic receptors (Experiment 5). Therefore, anxiety disorders may stem from an unopposed formation of aversive memories and clinically effective anxiolytics hinder the association between emotional and cognitive processing. This reduces the emotional impact of aversive memories, thereby opposing consequent anxiety.

According to Gray [(1982) The neuropsychology of anxiety: an enquiry into the function of the septo-hippocampal system. Oxford: Oxford University Press; (1991) Neural systems, emotion and personality. In: Neurobiology of learning, emotion, and affect (Madden J, ed), pp 273–306. New York: Raven Press; Gray JA, McNaughton N (2000) The neuropsychology of anxiety. Oxford: Oxford University Press], the septum and the hippocampus act in concert to control anxiety. In the present study we examined a possible interaction between septal GABAergic and hippocampal cholinergic systems in the shock-probe burying test, an animal model of anxiety. In experiment 1, we found that a 10-ng infusion of muscimol in the medial septum produced a significant suppression of burying behavior, whereas lower doses (2.5 and 5.0 ng) did not. In experiment 2, we found a significant suppression of burying behavior after a 20-μg infusion of physostigmine into the dorsal hippocampus, but not after lower-dose infusions (5 and 10 μg). In experiment 3, we infused combined sub-effective doses of physostigmine and muscimol in the hippocampus and medial septum respectively. The combination of sub-effective doses of physostigmine (5 μg) and muscimol (2.5 ng) significantly reduced burying of the shock probe. The results indicate that the hippocampal cholinergic and septal GABAergic systems act synergistically in the modulation of anxiety.

Activation of septal GABA receptors impairs learning and memory and this effect likely involves an influence on the hippocampus. We found previously that the memory-impairing effects of septal infusions of the GABA agonist muscimol are reversed by hippocampal infusions of glucose and suggested that glucose reverses these deficits by increasing hippocampal acetylcholine (ACh). In this study, we report that septal infusions of muscimol produce dose-dependent decreases in ACh levels in hippocampal dialysates. Importantly, increasing glucose levels in the hippocampus elevates hippocampal extracellular ACh levels in rats given septal infusions of muscimol, but not in rats given vehicle. Thus, glucose increases hippocampal extracellular ACh levels when the ACh system is inhibited, an effect that likely contributes to the effects of glucose on memory.

Septal γ-aminobutyric acid (GABA) receptor activation is known to disrupt memory formation, although the mechanisms underlying this impairment remain unclear. The present study explored the possibility that high levels of septal GABA receptor activity might impair memory by down-regulating acetylcholine (ACh) function in archicortex and entorhinal cortex. To test this possibility, rats were trained on an avoidance task 15 min after receiving intra-septal infusions of vehicle or muscimol (5 nmol/0.5 μl) combined with unilateral intra-hippocampal (10 μl/1 μl) or intra-entorhinal cortex (1.875 μg/0.25 μl) infusions of vehicle or the acetylcholinesterase inhibitor physostigmine. We demonstrate that these infusions do not alter acquisition performance on a continuous multiple trial inhibitory avoidance task. However, intra-septal infusions of muscimol dramatically impair retention performance 48 h later. More importantly, infusions of physostigmine into the hippocampus or the entorhinal cortex, at doses that do not influence acquisition or retention performance when infused alone, attenuate the impairing effects of the muscimol infusions on retention. We suggest that high levels of septal GABA receptor activity might impair memory by down-regulating ACh levels in the hippocampal region, and that such memory impairments can be ameliorated by increasing ACh levels in the hippocampus or entorhinal cortex.

Selective serotonin (5-hydroxytryptamine; 5-HT) reuptake inhibitors and 5-HT(1A) receptor agonists are believed to reduce anxiety. In the present study we examined the effects of injections of 5-(4-[4-(5-cyano-3-indolyl)-butyl]-1-piperazinyl)-benzofuran-2-carboxamide hydrochloride salt (EMD 68843), a 5-HT(1A) receptor agonist and selective 5-HT reuptake inhibitor, in two animal models of anxiety, plus-maze and shock-probe. Rats received intraperitoneal injections of vehicle, diazepam (2.5 mg/kg), or EMD 68843 (10, 20, or 40 mg/kg) 1 h prior to testing. Diazepam at the single dose tested and EMD 68843 dose-dependently (significantly at 20 and 40 mg/kg) reduced burying in shock-probe. However, only diazepam significantly increased open arm exploration in the plus-maze. Therefore, EMD 68843 has task specific anxiolytic properties.