title: Pregabalin influences insula and amygdala activation during anticipation of emotional images.
abstract: Pregabalin (PGB) has shown potential as an anxiolytic for treatment of generalized and social anxiety disorder. PGB binds to voltage-dependent calcium channels, leading to upregulation of GABA inhibitory activity and reduction in the release of various neurotransmitters. Previous functional magnetic resonance imaging (fMRI) studies indicate that selective serotonin reuptake inhibitors and benzodiazepines attenuate amygdala, insula, and medial prefrontal cortex activation during anticipation and emotional processing in healthy controls. The aim of this study was to examine whether acute PGB administration would attenuate activation in these regions during emotional anticipation. In this double-blind, placebo-controlled, randomized crossover study, 16 healthy controls completed a paradigm involving anticipation of negative and positive affective images during fMRI approximately 1 h after administration of placebo, 50, or 200 mg PGB. Linear mixed model analysis revealed that PGB was associated with (1) decreases in left amygdala and anterior insula activation and (2) increases in anterior cingulate (ACC) activation, during anticipation of positive and negative stimuli. There was also a region of the anterior amygdala in which PGB dose was associated with increased activation during anticipation of negative and decreased activation during anticipation of positive stimuli. Attenuation of amygdala and insula activation during anticipatory or emotional processing may represent a common regional brain mechanism for anxiolytics across drug classes. PGB induced increases in ACC activation could be a unique effect related to top-down modulation of affective processing. These results provide further support for the viability of using pharmaco-fMRI to determine the anxiolytic potential of pharmacologic agents.
authors: Department of Psychiatry, University of California San Diego (UCSD), La Jolla, CA 92037-0985, USA. raupperle@ucsd.edu
authors: Robin L
authors: RL
authors: Aupperle
authors: Lakshmi
authors: L
authors: Ravindran
authors: Dharol
authors: D
authors: Tankersley
authors: Taru
authors: T
authors: Flagan
authors: Nathan R
authors: NR
authors: Stein
authors: Alan N
authors: AN
authors: Simmons
authors: Murray B
authors: MB
authors: Stein
authors: Martin P
authors: MP
authors: Paulus
mesh_terms: D000328:Adult; D000679:Amygdala / Q000098:blood supply / Q000187:drug effects*; D000700:Analgesics / Q000494:pharmacology*; D001288:Attention / Q000187:drug effects*; D001931:Brain Mapping; D002540:Cerebral Cortex / Q000098:blood supply / Q000187:drug effects*; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D004644:Emotions / Q000187:drug effects*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D010100:Oxygen / Q000097:blood; D010775:Photic Stimulation / Q000379:methods; D000069583:Pregabalin; D055815:Young Adult; D005680:gamma-Aminobutyric Acid / Q000031:analogs & derivatives* / Q000494:pharmacology
chemical_list: D000700:Analgesics; D000069583:Pregabalin; D005680:gamma-Aminobutyric Acid; D010100:Oxygen