Prenatal exposure to opioids may alter brain function in babies

According to the Radiological Society of North America (RSNA), use of opioids during pregnancy can have a significant effect on infant brain activity. With the current ongoing opioid crisis, this issue is quite prevalent and important to study further. Infants exposed to opioids can suffer from neonatal abstinence syndrome (NAS) and experience drug withdrawal effects. A team of researchers from Indiana School of Medicine, led by Dr. Radhakrishnan, wanted to learn more about the effects of this opioid exposure on neurological processes in the babies of these infants, so they studied the brain of 16 infants, half exposed to opioids in utero, and half that were not exposed to opioids. They used fMRI and brain mapping to evaluate brain activity and functional connectivity to the amygdala which is linked to regulation of emotions and feelings such as fear and aggression. Significant differences were found between the two groups in terms of how the amygdala showed connectivity to other brain regions. They stated however, that further work needed to be done to better establish the nature of this difference. It is important to continue studying these issues to learn how to better improve outcomes for infants with NAS and to develop treatments for babies that have been prenatally exposed to opioids.

 

Radiological Society of North America, sciencedaily.com (From November 25, 2019)

 

Istradefylline: FDA Approved in August 2019

Istradefylline, sold under the trade name Nourianz, was approved by the U.S. Food and Drug Administration in August of 2019. It is an adenosine receptor (A2) antagonist used as an adjunctive treatment to Levodopa/Carbidopa in patients with Parkinson’s Disease who are experiencing “off” episodes. As we know, Parkinson’s Disease is a neurodegenerative disorder traditionally characterized by hypodopaminergia in the central nervous system, specifically in the substantia nigra. The symptoms include motor impairment such as rigidity, shuffling gait, tremors, and in the long-term can even lead to dementia. Current treatments (L-Dopa & Carbidopa) are aimed at increasing levels of dopamine in the brain by either acting as a precursor to DA or by inhibiting its decarboxylation, thereby increasing its overall levels. Patients with Parkinson’s can also experience “off” episodes, in which the medication eventually stops working and wears off, and symptoms can recur. The A2 adenosine receptors (GPCRs that increase cAMP) are co-expressed with DA receptors in the striatum and oppose each other’s effects via downstream intracellular signaling mechanisms. Therefore an antagonist of the A2 receptor stops the inhibition of dopamine’s effects in the brain. This is an important therapeutic because it is a distinct mechanism of action (non-dopaminergic approach) aimed at improving dopaminergic function to increase the time patients remain in the “on” phase. Further, PD manifests differently in every patient and often treatments are not aimed at the “off” episodes that have the potential to significantly affect quality of life in patients undergoing chronic treatment.

Fun fact: caffeine is also an A2 receptor antagonist… (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3414662/)

References:

https://www.nourianzhcp.com/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2583202/

 

Journal Club Presentation 11/01

PHTX 639 Journal Club Presentation 11.01.19

 
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