Translational assessment of cognitive impairments in depression models

Abstract

Major depressive disorder (MDD) affects 300 million people worldwide and is a major contributor to the global burden of disease. The aetiology of depression, emerging through a gene x environment interaction, is still incompletely understood which prevents tailoring of treatment approaches. In addition to MDD core symptoms, such as anhedonia (a diminished anticipation or experience of pleasure), depressed patients suffer from a plethora of manifestations including cognitive impairments, which occur primarily in the domains of executive function, attention and memory. Patients remitted from affective symptoms of MDD often continue to display cognitive impairments. These cognitive deficits are the longest present residual symptom, predict treatment response and increase risk of relapse. Consequently, cognitive impairments need to be targeted more effectively by antidepressants for complete remission from MDD. Clinically relevant animal models are essential for developing, tailoring and testing such novel, pro-cognitive antidepressants. This PhD project aimed to establish a preclinical screening platform for the testing of pro-cognitive antidepressants, to improve understanding of MDD risk factors and consequent symptom development, and finally, to focus on clinical relevance of the applied techniques. The chronic mild stress (CMS) rodent model of depression was used, known for displaying the core symptom anhedonia, but also for a high construct, face and predictive validity. The environmental MDD risk factor ‘stress’ induces an anhedonic-like phenotype in a subgroup of exposed rats, whereas another subgroup of rats is resilient, as determined by the sucrose consumption test. The cognitive performance of different rat strains, including CMS anhedonic-like and resilient rats, was assessed employing the touchscreen operant platform, which was developed based on the Cambridge neuropsychological test automated battery (CANTAB) for assessing cognition in humans. Furthermore, a group of anhedonic-like rats was treated with the antidepressant vortioxetine, which acts as both a pro-cognitive and antidepressant treatment. Our results showed that stress exposure induced anhedonia in albino and pigmented rat strains, although stress did not affect cognitive performance of pigmented rats in a simple pairwise discrimination touchscreen task. Applying a more complex pairedassociates learning touchscreen task revealed impaired cognitive performance in the CMS anhedonic-like but not in the resilient phenotype. Furthermore, vortioxetine treatment reversed anhedonia in the CMS model and altered executive functions in treated rats. The expression of genes involved in the stress response, affective disorders and neuronal plasticity was altered in the prefrontal cortex and hippocampus owned to treatment and hedonic state. Thus, we have demonstrated that the CMS model exhibits both stress-induced cognitive alterations and depression-associated cognitive impairments in touchscreen tasks. Furthermore, touchscreen testing was sufficiently sensitive to detect alterations in cognitive performance due to pharmacological intervention. Overall, we established a potential platform for pro-cognitive antidepressant drug screening. Furthermore, brain derived neurotrophic factor (BDNF), involved in learning and memory, was examined in the context of depression. BDNF is reduced in MDD patients as well as in preclinical models in response to stress. Although this suggests that BDNF contributes to the aetiology of depression, studies including mice heterozygous for BDNF (BDNF+/-) have generated conflicting results. BDNF+/- rats may provide a more suitable model as (1) rats have a greater behavioural repertoire than mice, (2) classical behaviour tests are designed for rats, and (3) rats, like humans, produce peripheral BDNF. We found anhedonia and mild signs of anxiety in BDNF+/- rats, accompanied by prefrontal and hippocampal changes in expression of genes relevant in psychiatric disorders and underpinning learning. Thus, behavioural and molecular findings in BDNF+/- rats complement existing literature and suggest that rats are a more suitable model in BDNF research than mice. Overall, the project uncovered environmental and genetic manifestations of risk factors in translational models and established a novel tool for translational pro-cognitive antidepressant drug screening.