The Psychoactive Designer Drug and Bath Salt Constituent MDPV Causes Widespread Disruption of Brain Functional Connectivity

The abuse of ‘bath salts’ has raised concerns because of their adverse effects, which include delirium, violent behavior, and suicide ideation in severe cases. The bath salt constituent 3,4-methylenedioxypyrovalerone (MDPV) has been closely linked to these and other adverse effects. The abnormal behavioral pattern produced by acute high-dose MDPV intake suggests possible disruptions of neural communication between brain regions. Therefore, we determined if MDPV exerts disruptive effects on brain functional connectivity, particularly in areas of the prefrontal cortex. Male rats were imaged following administration of a single dose of MDPV (0.3, 1.0, or 3.0 mg/kg) or saline. Resting state brain blood oxygenation level-dependent (BOLD) images were acquired at 4.7 T. To determine the role of dopamine transmission in MDPV-induced changes in functional connectivity, a group of rats received the dopamine D1/D2 receptor antagonist cis-flupenthixol (0.5 mg/kg) 30 min before MDPV. MDPV dose-dependently reduced functional connectivity. Detailed analysis of its effects revealed that connectivity between frontal cortical and striatal areas was reduced. This included connectivity between the prelimbic prefrontal cortex and other areas of the frontal cortex and the insular cortex with hypothalamic, ventral, and dorsal striatal areas. Although the reduced connectivity appeared widespread, connectivity between these regions and somatosensory cortex was not as severely affected. Dopamine receptor blockade did not prevent the MDPV-induced decrease in functional connectivity. The results provide a novel signature of MDPV’s in vivo mechanism of action. Reduced brain functional connectivity has been reported in patients suffering from psychosis and has been linked to cognitive dysfunction, audiovisual hallucinations, and negative affective states akin to those reported for MDPV-induced intoxication. The present results suggest that disruption of functional connectivity networks involving frontal cortical and striatal regions could contribute to the adverse effects of MDPV.

[1]  Brittany L. Murray,et al.  Death Following Recreational Use of Designer Drug “Bath Salts” Containing 3,4-Methylenedioxypyrovalerone (MDPV) , 2012, Journal of Medical Toxicology.

[2]  M. Forster,et al.  Locomotor stimulant and discriminative stimulus effects of ‘bath salt’ cathinones , 2013, Behavioural pharmacology.

[3]  M. Liechti,et al.  Pharmacological characterization of designer cathinones in vitro , 2013, British journal of pharmacology.

[4]  B. Rosen,et al.  Cocaine Activation Discriminates Dopaminergic Projections by Temporal Response: An fMRI Study in Rat , 2000, NeuroImage.

[5]  Nikos K Logothetis,et al.  Laminar specificity in monkey V1 using high-resolution SE-fMRI. , 2006, Magnetic resonance imaging.

[6]  M. E. John,et al.  Bath Salts Abuse Leading to New-Onset Psychosis and Potential for Violence. , 2017, Clinical schizophrenia & related psychoses.

[7]  Yihong Yang,et al.  fMRI response in the medial prefrontal cortex predicts cocaine but not sucrose self-administration history , 2012, NeuroImage.

[8]  R. Glennon,et al.  Abuse-related and abuse-limiting effects of methcathinone and the synthetic “bath salts” cathinone analogs methylenedioxypyrovalerone (MDPV), methylone and mephedrone on intracranial self-stimulation in rats , 2013, Psychopharmacology.

[9]  Luca Passamonti,et al.  Atomoxetine Enhances Connectivity of Prefrontal Networks in Parkinson's Disease , 2016, Neuropsychopharmacology.

[10]  R. Gerona,et al.  Psychosis from a Bath Salt Product Containing Flephedrone and MDPV with Serum, Urine, and Product Quantification , 2012, Journal of Medical Toxicology.

[11]  Govind Nair,et al.  The Neural Consequences of Repeated Cocaine Exposure Revealed by Functional MRI in Awake Rats , 2005, Neuropsychopharmacology.

[12]  Christian Grefkes,et al.  Functional localization in the human brain: Gradient‐echo, spin‐echo, and arterial spin‐labeling fMRI compared with neuronavigated TMS , 2011, Human brain mapping.

[13]  David G Norris,et al.  Fast spin echo sequences for BOLD functional MRI , 2007, Magnetic Resonance Materials in Physics, Biology and Medicine.

[14]  A. Ruoho,et al.  Inhibition of plasma membrane monoamine transporters by β-ketoamphetamines , 1999 .

[15]  A. Ettenberg,et al.  The dopamine antagonist cis-flupenthixol blocks the expression of the conditioned positive but not the negative effects of cocaine in rats , 2013, Pharmacology Biochemistry and Behavior.

[16]  G. Koob,et al.  Changes in response to a dopamine receptor antagonist in rats with escalating cocaine intake , 2004, Psychopharmacology.

[17]  A. Friedhoff,et al.  Inactivation of D1 and D2 dopamine receptors by N-ethoxycarbonyl-2-ethoxy-1,2-dihydroquinoline in vivo: selective protection by neuroleptics. , 1985, The Journal of pharmacology and experimental therapeutics.

[18]  Brent G. Nelson,et al.  Frontal Hyperconnectivity Related to Discounting and Reversal Learning in Cocaine Subjects , 2011, Biological Psychiatry.

[19]  A. Grace,et al.  Long-Term High Frequency Deep Brain Stimulation of the Nucleus Accumbens Drives Time-Dependent Changes in Functional Connectivity in the Rodent Limbic System , 2013, Brain Stimulation.

[20]  T. Penders,et al.  Hallucinatory delirium following use of MDPV: "Bath Salts". , 2011, General hospital psychiatry.

[21]  A. Ettenberg,et al.  Noradrenergic β-Receptor Antagonism within the Central Nucleus of the Amygdala or Bed Nucleus of the Stria Terminalis Attenuates the Negative/Anxiogenic Effects of Cocaine , 2014, The Journal of Neuroscience.

[22]  Michael Brady,et al.  Improved Optimization for the Robust and Accurate Linear Registration and Motion Correction of Brain Images , 2002, NeuroImage.

[23]  Denis Schluppeck,et al.  Assessing the Spatial Precision of SE and GE-BOLD Contrast at 7 Tesla , 2014, Brain Topography.

[24]  M. Febo,et al.  Estrogen and opioids interact to modulate the locomotor response to cocaine in the female rat , 2002, Brain Research.

[25]  Meredith J. McHugh,et al.  Striatal-insula circuits in cocaine addiction: implications for impulsivity and relapse risk , 2013, The American journal of drug and alcohol abuse.

[26]  P. Kulkarni,et al.  Distinct BOLD Activation Profiles Following Central and Peripheral Oxytocin Administration in Awake Rats , 2015, Front. Behav. Neurosci..

[27]  A. Ruoho,et al.  Inhibition of plasma membrane monoamine transporters by beta-ketoamphetamines. , 1999, European journal of pharmacology.

[28]  Simon B. Eickhoff,et al.  Resting State Functional Connectivity in Patients with Chronic Hallucinations , 2012, PloS one.

[29]  Rafael Delgado y Palacios,et al.  Different anesthesia regimes modulate the functional connectivity outcome in mice , 2014, Magnetic resonance in medicine.

[30]  R. Glennon,et al.  Synthetic cathinones: chemical phylogeny, physiology, and neuropharmacology. , 2014, Life sciences.

[31]  Timothy Q. Duong,et al.  Imaging cocaine-induced changes in the mesocorticolimbic dopaminergic system of conscious rats , 2004, Journal of Neuroscience Methods.

[32]  R W Cox,et al.  AFNI: software for analysis and visualization of functional magnetic resonance neuroimages. , 1996, Computers and biomedical research, an international journal.

[33]  K. Uğurbil,et al.  Spin‐echo fMRI in humans using high spatial resolutions and high magnetic fields , 2003, Magnetic resonance in medicine.

[34]  Elliot A. Stein,et al.  Cortico-Amygdala Coupling as a Marker of Early Relapse Risk in Cocaine-Addicted Individuals , 2014, Front. Psychiatry.

[35]  Samhsa The NSDUH Report: Substance Use and Mental Health Estimates from the 2013 National Survey on Drug Use and Health: Overview of Findings , 2014 .

[36]  L. James,et al.  Forensic investigation of K2, Spice, and "bath salt" commercial preparations: a three-year study of new designer drug products containing synthetic cannabinoid, stimulant, and hallucinogenic compounds. , 2013, Forensic science international.

[37]  Lisa J. Merlo,et al.  Methamphetamine- and Trauma-Induced Brain Injuries: Comparative Cellular and Molecular Neurobiological Substrates , 2009, Biological Psychiatry.

[38]  John D. Storey A direct approach to false discovery rates , 2002 .

[39]  R. Glennon,et al.  "Deconstruction" of the abused synthetic cathinone methylenedioxypyrovalerone (MDPV) and an examination of effects at the human dopamine transporter. , 2013, ACS chemical neuroscience.

[40]  Feng Luo,et al.  Attenuation of brain response to heroin correlates with the reinstatement of heroin-seeking in rats by fMRI , 2004, NeuroImage.

[41]  A. Grace,et al.  Nucleus Accumbens Deep Brain Stimulation Produces Region-Specific Alterations in Local Field Potential Oscillations and Evoked Responses In Vivo , 2009, The Journal of Neuroscience.

[42]  B. Biswal,et al.  Cocaine administration decreases functional connectivity in human primary visual and motor cortex as detected by functional MRI , 2000, Magnetic resonance in medicine.

[43]  J. Camarasa,et al.  Concentrations of MDPV in rat striatum correlate with the psychostimulant effect , 2015, Journal of psychopharmacology.

[44]  Aileen Schroeter,et al.  Optimization of anesthesia protocol for resting-state fMRI in mice based on differential effects of anesthetics on functional connectivity patterns , 2014, NeuroImage.

[45]  Dardo Tomasi,et al.  Effects of methylphenidate on resting-state functional connectivity of the mesocorticolimbic dopamine pathways in cocaine addiction. , 2013, JAMA psychiatry.

[46]  R. Glennon,et al.  Cathinone: An Investigation of Several N-Alkyl and Methylenedioxy-Substituted Analogs , 1997, Pharmacology Biochemistry and Behavior.

[47]  R. Stevenson,et al.  Novel psychoactive substance intoxication resulting in attempted murder. , 2014, Journal of forensic and legal medicine.

[48]  Antonio Ferretti,et al.  Resting State BOLD Functional Connectivity at 3T: Spin Echo versus Gradient Echo EPI , 2015, PloS one.

[49]  M. Febo,et al.  Estrogen‐dependent alterations in D2/D3‐induced G protein activation in cocaine‐sensitized female rats , 2003, Journal of neurochemistry.

[50]  P. Kalivas,et al.  Reduced LTP and LTD in prefrontal cortex synapses in the nucleus accumbens after heroin self-administration. , 2013, The international journal of neuropsychopharmacology.

[51]  K. Uğurbil,et al.  Microvascular BOLD contribution at 4 and 7 T in the human brain: Gradient‐echo and spin‐echo fMRI with suppression of blood effects , 2003, Magnetic resonance in medicine.

[52]  Yihong Yang,et al.  Abstinence from Cocaine and Sucrose Self-Administration Reveals Altered Mesocorticolimbic Circuit Connectivity by Resting State MRI , 2014, Brain Connect..

[53]  X. de la Torre,et al.  Toxicological determination and in vitro metabolism of the designer drug methylenedioxypyrovalerone (MDPV) by gas chromatography/mass spectrometry and liquid chromatography/quadrupole time-of-flight mass spectrometry. , 2010, Rapid communications in mass spectrometry : RCM.

[54]  K. Houseknecht,et al.  Contrasting effects of d-methamphetamine, 3,4-methylenedioxymethamphetamine, 3,4-methylenedioxypyrovalerone, and 4-methylmethcathinone on wheel activity in rats. , 2012, Drug and alcohol dependence.

[55]  C. Schönfeldt-Lecuona,et al.  Dysconnectivity of multiple resting-state networks in patients with schizophrenia who have persistent auditory verbal hallucinations. , 2011, Journal of psychiatry & neuroscience : JPN.

[56]  Frank T Peters,et al.  Beta-keto amphetamines: studies on the metabolism of the designer drug mephedrone and toxicological detection of mephedrone, butylone, and methylone in urine using gas chromatography–mass spectrometry , 2010, Analytical and bioanalytical chemistry.

[57]  A. Riley,et al.  Age-dependent MDPV-induced taste aversions and thermoregulation in adolescent and adult rats. , 2014, Developmental psychobiology.

[58]  L Elliot Hong,et al.  High vs low frequency neural oscillations in schizophrenia. , 2011, Schizophrenia bulletin.

[59]  D. Collier,et al.  Association of cerebral deficits with clinical symptoms in antipsychotic-naive first-episode schizophrenia: an optimized voxel-based morphometry and resting state functional connectivity study. , 2009, The American journal of psychiatry.

[60]  Anderson M. Winkler,et al.  Global Prefrontal and Fronto-Amygdala Dysconnectivity in Bipolar I Disorder with Psychosis History , 2013, Biological Psychiatry.

[61]  Perry F. Renshaw,et al.  Cocaine decreases relative cerebral blood volume in humans: a dynamic susceptibility contrast magnetic resonance imaging study , 1998, Psychopharmacology.

[62]  K. Uğurbil,et al.  High‐resolution, spin‐echo BOLD, and CBF fMRI at 4 and 7 T , 2002, Magnetic resonance in medicine.

[63]  K. Gopinath,et al.  Functional connectivity in frontal-striatal brain networks and cocaine self-administration in female rhesus monkeys , 2014, Psychopharmacology.

[64]  T. Dickerson,et al.  The novel recreational drug 3,4-methylenedioxypyrovalerone (MDPV) is a potent psychomotor stimulant: Self-administration and locomotor activity in rats , 2013, Neuropharmacology.

[65]  Acute Psychosis Induced by Bath Salts: A Case Report with Clinical and Forensic Implications , 2013, Journal of forensic sciences.

[66]  R. Kronstrand,et al.  Mephedrone, Methylone and 3,4‐Methylenedioxypyrovalerone (MDPV) Induce Conditioned Place Preference in Mice , 2014, Basic & clinical pharmacology & toxicology.

[67]  K. T. Wakabayashi,et al.  Methylenedioxypyrovalerone (MDPV) mimics cocaine in its physiological and behavioral effects but induces distinct changes in NAc glucose , 2015, Front. Neurosci..

[68]  Seeking–taking chain schedules of cocaine and sucrose self-administration: effects of reward size, reward omission, and α-flupenthixol , 2011, Psychopharmacology.

[69]  D. Favretto,et al.  A mixed MDPV and benzodiazepine intoxication in a chronic drug abuser: determination of MDPV metabolites by LC-HRMS and discussion of the case. , 2014, Forensic science international.

[70]  Albert-László Barabási,et al.  Statistical mechanics of complex networks , 2001, ArXiv.

[71]  P. Fries Neuronal gamma-band synchronization as a fundamental process in cortical computation. , 2009, Annual review of neuroscience.

[72]  Yihong Yang,et al.  Mesocorticolimbic circuits are impaired in chronic cocaine users as demonstrated by resting-state functional connectivity , 2010, NeuroImage.

[73]  M. Kavanaugh,et al.  Multiple Ionic Conductances of the Human Dopamine Transporter: The Actions of Dopamine and Psychostimulants , 1997, The Journal of Neuroscience.

[74]  Kurt R. Lehner,et al.  Linear pharmacokinetics of 3,4‐methylenedioxypyrovalerone (MDPV) and its metabolites in the rat: relationship to pharmacodynamic effects , 2016, Addiction biology.

[75]  Kurt R. Lehner,et al.  Powerful Cocaine-Like Actions of 3,4-Methylenedioxypyrovalerone (MDPV), a Principal Constituent of Psychoactive ‘Bath Salts’ Products , 2013, Neuropsychopharmacology.

[76]  B. Blough,et al.  Pharmacology of novel synthetic stimulants structurally related to the “bath salts” constituent 3,4-methylenedioxypyrovalerone (MDPV) , 2014, Neuropharmacology.

[77]  M. Olive,et al.  Potent rewarding and reinforcing effects of the synthetic cathinone 3,4‐methylenedioxypyrovalerone (MDPV) , 2014, Addiction biology.

[78]  Lewis S. Nelson,et al.  The Toxicology of Bath Salts: A Review of Synthetic Cathinones , 2011, Journal of Medical Toxicology.

[79]  M. Raichle,et al.  Rat brains also have a default mode network , 2012, Proceedings of the National Academy of Sciences.

[80]  K. Kiehl,et al.  Neural correlates of substance abuse: Reduced functional connectivity between areas underlying reward and cognitive control , 2014, Human brain mapping.

[81]  An assessment of MDPV-induced place preference in adult Sprague-Dawley rats. , 2015, Drug and alcohol dependence.

[82]  Yihong Yang,et al.  Acute Nicotine-Induced Tachyphylaxis Is Differentially Manifest in the Limbic System , 2011, Neuropsychopharmacology.

[83]  M. Fendt,et al.  Noradrenaline Transmission within the Ventral Bed Nucleus of the Stria Terminalis Is Critical for Fear Behavior Induced by Trimethylthiazoline, a Component of Fox Odor , 2005, The Journal of Neuroscience.

[84]  K. T. Wakabayashi,et al.  Effects of Social Interaction and Warm Ambient Temperature on Brain Hyperthermia Induced by the Designer Drugs Methylone and MDPV , 2015, Neuropsychopharmacology.

[85]  R. Malenka,et al.  Simultaneous LTP of non-NMDA- and LTD of NMDA-receptor-mediated responses in the nucleus accumbens , 1994, Nature.

[86]  K. Blum,et al.  Hypothesizing that designer drugs containing cathinones ("bath salts") have profound neuro-inflammatory effects and dangerous neurotoxic response following human consumption. , 2013, Medical hypotheses.

[87]  S. Francis,et al.  Spatial location and strength of BOLD activation in high‐spatial‐resolution fMRI of the motor cortex: a comparison of spin echo and gradient echo fMRI at 7 T , 2012, NMR in biomedicine.

[88]  A. Riley,et al.  3,4-Methylenedioxypyrovalerone (MDPV)-induced conditioned taste avoidance in the F344/N and LEW rat strains , 2014, Pharmacology Biochemistry and Behavior.

[89]  S. Rombouts,et al.  Dopamine-dependent architecture of cortico-subcortical network connectivity. , 2013, Cerebral cortex.

[90]  Seth R. Jones,et al.  Resting‐state functional connectivity of the rat brain , 2008, Magnetic resonance in medicine.