1 803 151 CENTRAL CONTROL OF VISCERAL PAIN AND URINARY TRACT FUNCTION. AFFERENT INPUT FROM ADELTA AND C-FIBRES INNERVATING THE URINARY BLADDER ARE PROCESSED DIFFERENTLY BY THE BRAIN, AND HAVE DIFFERENT ROLES IN SIGNALING BLADDER SENSATION. ADELTA FIBRES THAT SIGNAL BLADDER FILLING ACTIVATE A SPINO-BULBO-SPINAL LOOP, WHICH RELAYS IN THE MIDBRAIN PERIAQUEDUCTAL GREY (PAG) AND PONTINE MICTURITION CENTRE (PMC). THE EXCITABILITY OF THIS CIRCUITRY IS REGULATED BY TONIC GABAERGIC INHIBITORY PROCESSES. IN HUMANS AND SOCIALISED ANIMALS MICTURITION IS NORMALLY UNDER VOLITIONAL CONTROL AND INFLUENCED BY A HOST OF PSYCHOSOCIAL FACTORS. HIGHER NERVOUS DECISION-MAKING IN A SOCIAL CONTEXT TO 'GO NOW' OR 'DO NOT GO' PROBABLY RESIDES IN FRONTAL CORTICAL AREAS, WHICH ACT AS A CENTRAL CONTROL SWITCH FOR MICTURITION. EXPOSURE TO PSYCHOSOCIAL STRESS CAN HAVE PROFOUNDLY DISRUPTIVE INFLUENCE ON THE PROCESS AND LEAD TO MALADAPTIVE CHANGES IN THE BLADDER. DURING SLEEPING THE VOIDING REFLEX THRESHOLD APPEARS TO BE RESET TO A HIGHER LEVEL TO PROMOTE URINARY CONTINENCE. UNDER PHYSIOLOGICAL CONDITIONS C-FIBRE BLADDER AFFERENTS ARE NORMALLY SILENT BUT ARE ACTIVATED IN INFLAMMATORY BLADDER STATES AND BY INTENSE DISTENDING PRESSURE. FOLLOWING PROLONGED STIMULATION VISCERAL NOCICEPTORS SENSITISE, LEADING TO A LOWERED THRESHOLD AND HEIGHTENED SENSITIVITY. IN ADDITION, SENSITIZATION MAY OCCUR WITHIN THE CENTRAL PAIN PROCESSING CIRCUITRY, WHICH OUTLASTS THE ORIGINAL NOCICEPTIVE INSULT. VISCERAL NOCICEPTION MAY ALSO BE INFLUENCED BY GENETIC AND ENVIRONMENTAL INFLUENCES. A PERIOD OF CHRONIC STRESS CAN PRODUCE INCREASED SENSITIVITY TO VISCERAL PAIN THAT LASTS FOR MONTHS. ADVERSE EARLY LIFE EVENTS CAN PRODUCE EVEN LONGER LASTING EPIGENETIC CHANGES, WHICH INCREASE THE INDIVIDUAL'S SUSCEPTIBILITY TO DEVELOPING VISCERAL PAIN STATES IN ADULTHOOD. 2016 2 4424 34 MOLECULAR AND NEUROLOGIC RESPONSES TO CHRONIC ALCOHOL USE. THIS CHAPTER PROVIDES AN OVERVIEW OF CURRENT KNOWLEDGE ON THE MOLECULAR AND CLINICAL ASPECTS OF CHRONIC ALCOHOL EFFECTS ON THE CENTRAL NERVOUS SYSTEM. THIS DRUG IS ALMOST UBIQUITOUS, WIDELY ENJOYED SOCIALLY, BUT PRODUCES A DIVERSE SPECTRUM OF NEUROLOGIC DISEASE WHEN ABUSED. ACUTELY, ALCOHOL INTERACTS PREDOMINANTLY WITH GAMMA-AMINOBUTYRIC ACID-A (GABA-A) AND N-METHYL-D-ASPARTATE (NMDA) RECEPTORS, BUT TRIGGERS DIVERSE SIGNALING EVENTS WITHIN WELL-DEFINED NEURAL PATHWAYS. THESE EVENTS RESULT IN ADAPTIVE CHANGES IN GENE EXPRESSION THAT ULTIMATELY PRODUCE TWO MAJOR STATES: ADDICTION AND TOXICITY. EPIGENETIC MODIFICATIONS OF CHROMATIN COULD LEAD TO LONG-LIVED OR EVEN TRANSGENERATIONAL CHANGES IN GENE EXPRESSION, THUS PRODUCING ASPECTS OF THE HERITABILITY OF ALCOHOL USE DISORDERS (AUD) AND LONG-TERM BEHAVIORS SUCH AS RECIDIVISM. THE DIVERSE CLINICAL SYNDROMES PRODUCED BY CHRONIC ALCOHOL ACTIONS IN THE CENTRAL NERVOUS SYSTEM REFLECT THE MOLECULAR PATHOLOGY AND PREDOMINANTLY INVOLVE ASPECTS OF TOLERANCE/WITHDRAWAL, SELECTIVE VULNERABILITY (MANIFEST AS CENTRAL PONTINE MYELINOLYSIS, MARCHIAFAVA-BIGNAMI DISEASE), AND ADDITIONAL ENVIRONMENTAL FACTORS (E.G., THIAMINE DEFICIENCY IN WERNICKE-KORSAKOFF'S SYNDROME). ADDITIONALLY, DELETERIOUS ASPECTS OF CHRONIC ALCOHOL ON SIGNALING, SYNAPTIC TRANSMISSION, AND CELL TOXICITY LEAD TO PRIMARY ALCOHOLIC DEMENTIA. GENETICALLY DETERMINED ASPECTS OF MYELIN STRUCTURE AND ALCOHOL ACTIONS ON MYELIN GENE EXPRESSION MAY BE A PROMINENT MOLECULAR MECHANISM RESULTING IN A PREDISPOSITION TO, OR CAUSATION OF, AUD AND MULTIPLE OTHER NEUROLOGIC COMPLICATIONS OF CHRONIC ALCOHOL. THE DRAMATIC PROGRESS MADE IN UNDERSTANDING MOLECULAR ACTIONS OF ALCOHOL HOLDS GREAT PROMISE FOR OUR EVENTUAL TREATMENT OR PREVENTION OF AUD AND NEUROLOGIC COMPLICATIONS RESULTING FROM CHRONIC ALCOHOL ABUSE. 2014 3 4261 31 MGMT-METHYLATION IN NON-NEOPLASTIC DISEASES OF THE CENTRAL NERVOUS SYSTEM. QUANTIFYING O(6)-METHYLGUANINE-DNA METHYLTRANSFERASE (MGMT) PROMOTER METHYLATION PLAYS AN ESSENTIAL ROLE IN ASSESSING THE POTENTIAL EFFICACY OF ALKYLATING AGENTS IN THE CHEMOTHERAPY OF MALIGNANT GLIOMAS. MGMT PROMOTER METHYLATION IS CONSIDERED TO BE A CHARACTERISTIC OF SUBGROUPS OF CERTAIN MALIGNANCIES BUT HAS ALSO BEEN DESCRIBED IN VARIOUS PERIPHERAL INFLAMMATORY DISEASES. HOWEVER, MGMT PROMOTER METHYLATION LEVELS HAVE NOT YET BEEN INVESTIGATED IN NON-NEOPLASTIC BRAIN DISEASES. THIS STUDY DEMONSTRATES FOR THE FIRST TIME THAT ONE CAN INDEED DETECT SLIGHTLY ENHANCED MGMT PROMOTER METHYLATION IN INDIVIDUAL CASES OF INFLAMMATORY DEMYELINATING CNS DISEASES SUCH AS MULTIPLE SCLEROSIS AND PROGRESSIVE MULTIFOCAL LEUCENCEPHALOPATHY (PML), AS WELL AS IN OTHER DEMYELINATING DISEASES SUCH AS CENTRAL PONTINE AND EXPTRAPONTINE MYELINOLYSIS, AND DISEASES WITH MYELIN DAMAGE SUCH AS WALLERIAN DEGENERATION. IN THIS CONTEXT, WE IDENTIFIED A REDUCTION IN THE EXPRESSION OF THE DEMETHYLASE TET1 AS A POSSIBLE CAUSE FOR THE ENHANCED MGMT PROMOTER METHYLATION. HENCE, WE SHOW FOR THE FIRST TIME THAT MGMT HYPERMETHYLATION OCCURS IN CHRONIC DISEASES THAT ARE NOT STRICTLY ASSOCIATED TO DISTINCT PATHOGENS, ONCOGENIC VIRUSES OR NEOPLASMS BUT THAT LEAD TO DAMAGE OF THE MYELIN SHEATH IN VARIOUS WAYS. WHILE THIS GIVES NEW INSIGHTS INTO EPIGENETIC AND PATHOPHYSIOLOGICAL PROCESSES INVOLVED IN DE- AND REMYELINATION, WHICH MIGHT OFFER NEW THERAPEUTIC OPPORTUNITIES FOR DEMYELINATING DISEASES IN THE FUTURE, IT ALSO REDUCES THE SPECIFICITY OF MGMT HYPERMETHYLATION AS A TUMOR BIOMARKER. 2021 4 6352 32 THE ROLE OF GABA(A) RECEPTORS IN THE DEVELOPMENT OF ALCOHOLISM. ALCOHOLISM IS A COMMON, HERITABLE, CHRONIC RELAPSING DISORDER. GABA(A) RECEPTORS UNDERGO ALLOSTERIC MODULATION BY ETHANOL, ANESTHETICS, BENZODIAZEPINES AND NEUROSTEROIDS AND HAVE BEEN IMPLICATED IN THE ACUTE AS WELL AS THE CHRONIC EFFECTS OF ETHANOL INCLUDING TOLERANCE, DEPENDENCE AND WITHDRAWAL. MEDICATIONS TARGETING GABA(A) RECEPTORS AMELIORATE THE SYMPTOMS OF ACUTE WITHDRAWAL. ETHANOL INDUCES PLASTICITY IN GABA(A) RECEPTORS: TOLERANCE IS ASSOCIATED WITH GENERALLY DECREASED GABA(A) RECEPTOR ACTIVATION AND DIFFERENTIALLY ALTERED SUBUNIT EXPRESSION. THE DOPAMINE (DA) MESOLIMBIC REWARD PATHWAY ORIGINATING IN THE VENTRAL TEGMENTAL AREA (VTA), AND INTERACTING STRESS CIRCUITRY PLAY AN IMPORTANT ROLE IN THE DEVELOPMENT OF ADDICTION. VTA GABAERGIC INTERNEURONS ARE THE PRIMARY INHIBITORY REGULATORS OF DA NEURONS AND A SUBSET OF VTA GABA(A) RECEPTORS MAY BE IMPLICATED IN THE SWITCH FROM HEAVY DRINKING TO DEPENDENCE. GABA(A) RECEPTORS MODULATE ANXIETY AND RESPONSE TO STRESS; IMPORTANT ELEMENTS OF SUSTAINED DRINKING AND RELAPSE. THE GABA(A) RECEPTOR SUBUNIT GENES CLUSTERED ON CHROMOSOME 4 ARE HIGHLY EXPRESSED IN THE REWARD PATHWAY. SEVERAL RECENT STUDIES HAVE PROVIDED STRONG EVIDENCE THAT ONE OF THESE GENES, GABRA2, IS IMPLICATED IN ALCOHOLISM IN HUMANS. THE INFLUENCE OF THE INTERACTION BETWEEN ETHANOL AND GABA(A) RECEPTORS IN THE REWARD PATHWAY ON THE DEVELOPMENT OF ALCOHOLISM TOGETHER WITH GENETIC AND EPIGENETIC VULNERABILITIES WILL BE EXPLORED IN THIS REVIEW. 2008 5 1179 23 CONVERGENCE AND DIVERGENCE IN THE ETIOLOGY OF MYELIN IMPAIRMENT IN PSYCHIATRIC DISORDERS AND DRUG ADDICTION. IMPAIRMENT OF OLIGODENDROGLIA (OL)-DEPENDENT MYELINATION IN THE CENTRAL NERVOUS SYSTEM (CNS) IS A REMARKABLE PARALLEL RECENTLY IDENTIFIED IN MAJOR PSYCHIATRIC DISORDERS AND CHRONIC DRUG ABUSE. NEUROIMAGING AND NEUROPATHOLOGICAL STUDIES REVEALED MYELIN DEFECTS AND MICROARRAY-PROFILING ANALYSIS DEMONSTRATED ABERRANT EXPRESSION OF MYELIN-RELATED GENES IN SCHIZOPHRENIA (SZ), BIPOLAR DISORDER (BD), MAJOR DEPRESSIVE DISORDER (MDD) AND COCAINE ADDICTION. HOWEVER, THE ETIOLOGY UNDERLYING MYELIN IMPAIRMENT IN THESE CLINICALLY DISTINCT SUBJECTS REMAINS ELUSIVE. THIS ARTICLE REVIEWS MYELIN IMPAIRMENT IN LINE WITH DOPAMINERGIC DYSFUNCTION, A PRIME NEUROPATHOPHYSIOLOGICAL TRAIT SHARED IN PSYCHIATRIC DISORDERS AND DRUG ABUSE, AS WELL AS THE GENETIC AND EPIGENETIC ALTERATIONS ASSOCIATED WITH THESE DISEASES. THE CURRENT FINDINGS SUPPORT THE HYPOTHESIS THAT ABERRANT DOPAMINE (DA) ACTION ON OLS IS A COMMON PATHOLOGIC MECHANISM FOR MYELIN IMPAIRMENT IN THE AFOREMENTIONED MENTAL MORBIDITIES, WHEREAS INHERITED GENETIC VARIATIONS THAT SPECIFICALLY AFFECT OL DEVELOPMENT AND MYELINOGENESIS MAY FURTHER INCREASE MYELIN VULNERABILITY IN PSYCHIATRIC DISORDERS. IMPORTANTLY, OL DEFECT IS NOT ONLY A PATHOLOGICAL CONSEQUENCE BUT ALSO A CAUSATIVE FACTOR FOR DOPAMINERGIC DYSFUNCTION. HENCE, MYELIN IMPAIRMENT IS A KEY FACTOR IN THE PATHOGENIC LOOP OF PSYCHIATRIC DISEASES AND DRUG ADDICTION. 2008 6 4643 33 NEUROPATHIC PAIN AS A TRIGGER FOR HISTONE MODIFICATIONS IN LIMBIC CIRCUITRY. CHRONIC PAIN INVOLVES BOTH CENTRAL AND PERIPHERAL NEURONAL PLASTICITY THAT ENCOMPASSES CHANGES IN THE BRAIN, SPINAL CORD, AND PERIPHERAL NOCICEPTORS. WITHIN THE FOREBRAIN, MESOCORTICOLIMBIC REGIONS ASSOCIATED WITH EMOTIONAL REGULATION HAVE RECENTLY BEEN SHOWN TO EXHIBIT LASTING GENE EXPRESSION CHANGES IN MODELS OF CHRONIC PAIN. TO BETTER UNDERSTAND HOW SUCH ENDURING TRANSCRIPTIONAL CHANGES MIGHT BE REGULATED WITHIN BRAIN STRUCTURES ASSOCIATED WITH PROCESSING OF PAIN OR AFFECT, WE EXAMINED EPIGENETIC MODIFICATIONS INVOLVED WITH ACTIVE OR PERMISSIVE TRANSCRIPTIONAL STATES (HISTONE H3 LYSINE 4 MONO AND TRIMETHYLATION, AND HISTONE H3 LYSINE 27 ACETYLATION) IN PERIAQUEDUCTAL GRAY (PAG), LATERAL HYPOTHALAMUS (LH), NUCLEUS ACCUMBENS (NAC), AND VENTRAL TEGMENTAL AREA (VTA) 5 WEEKS AFTER SCIATIC NERVE INJURY IN MICE TO MODEL CHRONIC PAIN. FOR BOTH MALE AND FEMALE MICE IN CHRONIC PAIN, WE OBSERVED AN OVERALL TREND FOR A REDUCTION OF THESE EPIGENETIC MARKERS IN PERIAQUEDUCTAL GRAY, LH, AND NAC, BUT NOT VTA. MOREOVER, WE DISCOVERED THAT SOME EPIGENETIC MODIFICATIONS EXHIBITED CHANGES ASSOCIATED WITH PAIN HISTORY, WHILE OTHERS WERE ASSOCIATED WITH INDIVIDUAL DIFFERENCES IN PAIN SENSITIVITY. WHEN TAKEN TOGETHER, THESE RESULTS SUGGEST THAT NERVE INJURY LEADS TO CHRONIC CHROMATIN-MEDIATED SUPPRESSION OF TRANSCRIPTION IN KEY LIMBIC BRAIN STRUCTURES AND CIRCUITS, WHICH MAY UNDERLIE ENDURING CHANGES IN PAIN PROCESSING AND SENSITIVITY WITHIN THESE SYSTEMS. 2023 7 5408 30 REGULATION AND SIGNALING OF THE GPR17 RECEPTOR IN OLIGODENDROGLIAL CELLS. REMYELINATION, NAMELY, THE FORMATION OF NEW MYELIN SHEATHS AROUND DENUDED AXONS, COUNTERACTS AXONAL DEGENERATION AND RESTORES NEURONAL FUNCTION. CONSIDERABLE ADVANCES HAVE BEEN MADE IN UNDERSTANDING THIS REGENERATIVE PROCESS THAT OFTEN FAILS IN DISEASES LIKE MULTIPLE SCLEROSIS, LEAVING AXONS DEMYELINATED AND VULNERABLE TO DAMAGE, THUS CONTRIBUTING TO DISEASE PROGRESSION. THE IDENTIFICATION OF THE MEMBRANE RECEPTOR GPR17 ON A SUBSET OF OLIGODENDROCYTE PRECURSOR CELLS (OPCS), WHICH MEDIATE REMYELINATION IN THE ADULT CENTRAL NERVOUS SYSTEM (CNS), HAS LED TO A HUGE AMOUNT OF EVIDENCE THAT VALIDATED THIS RECEPTOR AS A NEW ATTRACTIVE TARGET FOR REMYELINATING THERAPIES. HERE, WE SUMMARIZE THE ROLE OF GPR17 IN OPC FUNCTION, MYELINATION AND REMYELINATION, DESCRIBING ITS ATYPICAL PHARMACOLOGY, ITS DOWNSTREAM SIGNALING, AND THE GENETIC AND EPIGENETIC FACTORS MODULATING ITS ACTIVITY. WE ALSO HIGHLIGHT CRUCIAL INSIGHTS INTO GPR17 PATHOPHYSIOLOGY COMING FROM THE DEMONSTRATION THAT OLIGODENDROCYTE INJURY, ASSOCIATED WITH INFLAMMATION IN CHRONIC NEURODEGENERATIVE CONDITIONS, IS INVARIABLY CHARACTERIZED BY ABNORMAL AND PERSISTENT GPR17 UPREGULATION, WHICH, IN TURN, IS ACCOMPANIED BY A BLOCK OF OPCS AT IMMATURE PREMYELINATING STAGES. FINALLY, WE DISCUSS THE CURRENT LITERATURE IN LIGHT OF THE POTENTIAL EXPLOITMENT OF GPR17 AS A THERAPEUTIC TARGET TO PROMOTE REMYELINATION. 2020 8 2259 26 EPIGENETIC PRIMING IN DRUG ADDICTION. DRUG ADDICTION IS A CHRONIC RELAPSING BRAIN DISORDER THAT IS CHARACTERIZED BY COMPULSIVE DRUG SEEKING AND CONTINUED USE DESPITE NEGATIVE OUTCOMES. CURRENT PHARMACOLOGICAL THERAPIES TARGET NEURONAL RECEPTORS OR TRANSPORTERS UPON WHICH DRUGS OF ABUSE ACT INITIALLY, YET THESE TREATMENTS REMAIN INEFFECTIVE FOR MOST INDIVIDUALS AND DO NOT PREVENT DISEASE RELAPSE AFTER ABSTINENCE. DRUGS OF ABUSE, IN ADDITION TO THEIR ACUTE EFFECTS, CAUSE PERSISTENT PLASTICITY AFTER REPEATED USE, INVOLVING DYSREGULATED GENE EXPRESSION IN THE BRAIN'S REWARD REGIONS, WHICH ARE THOUGHT TO MEDIATE THE PERSISTENT BEHAVIORAL ABNORMALITIES THAT CHARACTERIZE ADDICTION. EMERGING EVIDENCE IMPLICATES EPIGENETIC PRIMING AS A KEY MECHANISM THAT UNDERLIES THE LONG-LASTING ALTERATIONS IN NEURONAL GENE REGULATION, WHICH CAN REMAIN LATENT UNTIL TRIGGERED BY RE-EXPOSURE TO DRUG-ASSOCIATED STIMULI OR THE DRUG ITSELF. THUS, TO EFFECTIVELY TREAT DRUG ADDICTION, WE MUST IDENTIFY THE PRECISE EPIGENETIC MECHANISMS THAT ESTABLISH AND PRESERVE THE DRUG-INDUCED PATHOLOGY OF THE BRAIN REWARD CIRCUITRY. 2018 9 4639 41 NEURONAL EXTRACELLULAR SIGNAL-REGULATED KINASE (ERK) ACTIVITY AS MARKER AND MEDIATOR OF ALCOHOL AND OPIOID DEPENDENCE. EARLY PIONEERING WORK IN THE FIELD OF BIOCHEMISTRY IDENTIFIED PHOSPHORYLATION AS A CRUCIAL POST-TRANSLATIONAL MODIFICATION OF PROTEINS WITH THE ABILITY TO BOTH INDICATE AND ARBITRATE COMPLEX PHYSIOLOGICAL PROCESSES. MORE RECENT INVESTIGATIONS HAVE FUNCTIONALLY LINKED PHOSPHORYLATION OF EXTRACELLULAR SIGNAL-REGULATED KINASE (ERK) TO A VARIETY OF NEUROPHYSIOLOGICAL MECHANISMS RANGING FROM ACUTE NEUROTRANSMITTER ACTION TO LONG-TERM GENE EXPRESSION. ERK PHOSPHORYLATION SERVES AS AN INTRACELLULAR BRIDGING MECHANISM THAT FACILITATES NEURONAL COMMUNICATION AND PLASTICITY. DRUGS OF ABUSE, INCLUDING ALCOHOL AND OPIOIDS, ACT AS ARTIFICIAL YET POWERFUL REWARDS THAT IMPINGE UPON NATURAL REINFORCEMENT PROCESSES CRITICAL FOR SURVIVAL. THE GRADED PROGRESSION FROM INITIAL EXPOSURE TO ADDICTION (OR SUBSTANCE DEPENDENCE) IS BELIEVED TO RESULT FROM DRUG- AND DRUG CONTEXT-INDUCED ADAPTATIONS IN NEURONAL SIGNALING PROCESSES ACROSS BRAIN REWARD AND STRESS CIRCUITS FOLLOWING EXCESSIVE DRUG USE. IN THIS REGARD, COMMONLY ABUSED DRUGS AS WELL AS DRUG-ASSOCIATED EXPERIENCES ARE CAPABLE OF MODIFYING THE PHOSPHORYLATION OF ERK WITHIN CENTRAL REINFORCEMENT SYSTEMS. IN ADDITION, CHRONIC DRUG AND ALCOHOL EXPOSURE MAY DRIVE ERK-REGULATED EPIGENETIC AND STRUCTURAL ALTERATIONS THAT UNDERLIE A LONG-TERM PROPENSITY FOR ESCALATING DRUG USE. UNDER THE INFLUENCE OF SUCH A NEUROBIOLOGICAL VULNERABILITY, ENCOUNTERING DRUG-ASSOCIATED CUES AND CONTEXTS CAN PRODUCE SUBSEQUENT ALTERATIONS IN ERK SIGNALING THAT DRIVE RELAPSE TO DRUG AND ALCOHOL SEEKING. CURRENT STUDIES ARE DETERMINING PRECISELY WHICH MOLECULAR AND REGIONAL ERK PHOSPHORYLATION-ASSOCIATED EVENTS CONTRIBUTE TO THE ADDICTION PROCESS, AS WELL AS WHICH NEUROADAPTATIONS NEED TO BE TARGETED IN ORDER TO RETURN DEPENDENT INDIVIDUALS TO A HEALTHY STATE. 2014 10 5812 41 STRESS AND ANXIETY: STRUCTURAL PLASTICITY AND EPIGENETIC REGULATION AS A CONSEQUENCE OF STRESS. THE BRAIN IS THE CENTRAL ORGAN OF STRESS AND ADAPTATION TO STRESS BECAUSE IT PERCEIVES AND DETERMINES WHAT IS THREATENING, AS WELL AS THE BEHAVIORAL AND PHYSIOLOGICAL RESPONSES TO THE STRESSOR. THE ADULT, AS WELL AS DEVELOPING BRAIN, POSSESS A REMARKABLE ABILITY TO SHOW REVERSIBLE STRUCTURAL AND FUNCTIONAL PLASTICITY IN RESPONSE TO STRESSFUL AND OTHER EXPERIENCES, INCLUDING NEURONAL REPLACEMENT, DENDRITIC REMODELING, AND SYNAPSE TURNOVER. THIS IS PARTICULARLY EVIDENT IN THE HIPPOCAMPUS, WHERE ALL THREE TYPES OF STRUCTURAL PLASTICITY HAVE BEEN RECOGNIZED AND INVESTIGATED, USING A COMBINATION OF MORPHOLOGICAL, MOLECULAR, PHARMACOLOGICAL, ELECTROPHYSIOLOGICAL AND BEHAVIORAL APPROACHES. THE AMYGDALA AND THE PREFRONTAL CORTEX, BRAIN REGIONS INVOLVED IN ANXIETY AND FEAR, MOOD, COGNITIVE FUNCTION AND BEHAVIORAL CONTROL, ALSO SHOW STRUCTURAL PLASTICITY. ACUTE AND CHRONIC STRESS CAUSE AN IMBALANCE OF NEURAL CIRCUITRY SUBSERVING COGNITION, DECISION MAKING, ANXIETY AND MOOD THAT CAN INCREASE OR DECREASE EXPRESSION OF THOSE BEHAVIORS AND BEHAVIORAL STATES. IN THE SHORT TERM, SUCH AS FOR INCREASED FEARFUL VIGILANCE AND ANXIETY IN A THREATENING ENVIRONMENT, THESE CHANGES MAY BE ADAPTIVE; BUT, IF THE DANGER PASSES AND THE BEHAVIORAL STATE PERSISTS ALONG WITH THE CHANGES IN NEURAL CIRCUITRY, SUCH MALADAPTATION MAY NEED INTERVENTION WITH A COMBINATION OF PHARMACOLOGICAL AND BEHAVIORAL THERAPIES, AS IS THE CASE FOR CHRONIC OR MOOD ANXIETY DISORDERS. WE SHALL REVIEW CELLULAR AND MOLECULAR MECHANISMS, AS WELL AS RECENT WORK ON INDIVIDUAL DIFFERENCES IN ANXIETY-LIKE BEHAVIOR AND ALSO DEVELOPMENTAL INFLUENCES THAT BIAS HOW THE BRAIN RESPONDS TO STRESSORS. FINALLY, WE SUGGEST THAT SUCH AN APPROACH NEEDS TO BE EXTENDED TO OTHER BRAIN AREAS THAT ARE ALSO INVOLVED IN ANXIETY AND MOOD. THIS ARTICLE IS PART OF A SPECIAL ISSUE ENTITLED 'ANXIETY AND DEPRESSION'. 2012 11 23 36 60 YEARS OF NEUROENDOCRINOLOGY: REDEFINING NEUROENDOCRINOLOGY: STRESS, SEX AND COGNITIVE AND EMOTIONAL REGULATION. THE DISCOVERY OF STEROID HORMONE RECEPTORS IN BRAIN REGIONS THAT MEDIATE EVERY ASPECT OF BRAIN FUNCTION HAS BROADENED THE DEFINITION OF 'NEUROENDOCRINOLOGY' TO INCLUDE THE RECIPROCAL COMMUNICATION BETWEEN THE BRAIN AND THE BODY VIA HORMONAL AND NEURAL PATHWAYS. THE BRAIN IS THE CENTRAL ORGAN OF STRESS AND ADAPTATION TO STRESS BECAUSE IT PERCEIVES AND DETERMINES WHAT IS THREATENING, AS WELL AS THE BEHAVIORAL AND PHYSIOLOGICAL RESPONSES TO THE STRESSOR. THE ADULT AND DEVELOPING BRAIN POSSESS REMARKABLE STRUCTURAL AND FUNCTIONAL PLASTICITY IN RESPONSE TO STRESS, INCLUDING NEURONAL REPLACEMENT, DENDRITIC REMODELING, AND SYNAPSE TURNOVER. STRESS CAUSES AN IMBALANCE OF NEURAL CIRCUITRY SUBSERVING COGNITION, DECISION-MAKING, ANXIETY AND MOOD THAT CAN ALTER EXPRESSION OF THOSE BEHAVIORS AND BEHAVIORAL STATES. THIS IMBALANCE, IN TURN, AFFECTS SYSTEMIC PHYSIOLOGY VIA NEUROENDOCRINE, AUTONOMIC, IMMUNE AND METABOLIC MEDIATORS. IN THE SHORT TERM, AS FOR INCREASED FEARFUL VIGILANCE AND ANXIETY IN A THREATENING ENVIRONMENT, THESE CHANGES MAY BE ADAPTIVE. BUT, IF THE DANGER PASSES AND THE BEHAVIORAL STATE PERSISTS ALONG WITH THE CHANGES IN NEURAL CIRCUITRY, SUCH MALADAPTATION MAY NEED INTERVENTION WITH A COMBINATION OF PHARMACOLOGICAL AND BEHAVIORAL THERAPIES, AS IS THE CASE FOR CHRONIC ANXIETY AND DEPRESSION. THERE ARE IMPORTANT SEX DIFFERENCES IN THE BRAIN RESPONSES TO STRESSORS THAT ARE IN URGENT NEED OF FURTHER EXPLORATION. MOREOVER, ADVERSE EARLY-LIFE EXPERIENCE, INTERACTING WITH ALLELES OF CERTAIN GENES, PRODUCE LASTING EFFECTS ON BRAIN AND BODY OVER THE LIFE-COURSE VIA EPIGENETIC MECHANISMS. WHILE PREVENTION IS MOST IMPORTANT, THE PLASTICITY OF THE BRAIN GIVES HOPE FOR THERAPIES THAT TAKE INTO CONSIDERATION BRAIN-BODY INTERACTIONS. 2015 12 2670 32 ETHANOL ACTIONS ON THE VENTRAL TEGMENTAL AREA: NOVEL POTENTIAL TARGETS ON REWARD PATHWAY NEURONS. THE VENTRAL TEGMENTAL AREA (VTA) EVALUATES SALIENCE OF ENVIRONMENTAL STIMULI AND PROVIDES DOPAMINERGIC INNERVATION TO MANY BRAIN AREAS AFFECTED BY ACUTE AND CHRONIC ETHANOL EXPOSURE. WHILE PRIMARILY ASSOCIATED WITH REWARDING AND REINFORCING STIMULI, RECENT EVIDENCE INDICATES A ROLE FOR THE VTA IN AVERSION AS WELL. ETHANOL ACTIONS IN THE VTA MAY TRIGGER NEUROADAPTATION RESULTING IN REDUCTION OF THE AVERSIVE RESPONSES TO ALCOHOL AND A RELATIVE INCREASE IN THE REWARDING RESPONSES. IN SEARCHING FOR EFFECTIVE PHARMACOTHERAPIES FOR THE TREATMENT OF ALCOHOL ABUSE AND ALCOHOLISM, RECOGNITION OF THIS IMBALANCE MAY REVEAL NOVEL STRATEGIES. IN ADDITION TO CONVENTIONAL RECEPTOR/ION CHANNEL PHARMACOTHERAPIES, EPIGENETIC FACTORS THAT CONTROL NEUROADAPTATION TO CHRONIC ETHANOL TREATMENT CAN BE TARGETED AS AN AVENUE FOR DEVELOPMENT OF THERAPEUTIC APPROACHES TO RESTORE THE BALANCE. FURTHERMORE, WHEN EXPLORING THERAPIES TO ADDRESS REWARD/AVERSION IMBALANCE IN THE ACTION OF ALCOHOL IN THE VTA, SEX DIFFERENCES HAVE TO BE TAKEN INTO ACCOUNT TO ENSURE EFFECTIVE TREATMENT FOR BOTH MEN AND WOMEN. THESE PRINCIPLES APPLY TO A VTA-CENTRIC APPROACH TO THERAPIES, BUT SHOULD HOLD TRUE WHEN THINKING ABOUT THE OVERALL APPROACH IN THE DEVELOPMENT OF NEUROACTIVE DRUGS TO TREAT ALCOHOL USE DISORDERS. ALTHOUGH THE FUNCTIONS OF THE VTA ITSELF ARE COMPLEX, IT IS A USEFUL MODEL SYSTEM TO EVALUATE THE REWARD/AVERSION IMBALANCE THAT OCCURS WITH ETHANOL EXPOSURE AND COULD BE USED TO PROVIDE NEW LEADS IN THE EFFORTS TO DEVELOP NOVEL DRUGS TO TREAT ALCOHOLISM. 2018 13 4909 30 PAIN AND STRESS IN A SYSTEMS PERSPECTIVE: RECIPROCAL NEURAL, ENDOCRINE, AND IMMUNE INTERACTIONS. THIS PAPER ADVANCES A PSYCHOPHYSIOLOGICAL SYSTEMS VIEW OF PAIN IN WHICH PHYSICAL INJURY, OR WOUNDING, GENERATES A COMPLEX STRESS RESPONSE THAT EXTENDS BEYOND THE NERVOUS SYSTEM AND CONTRIBUTES TO THE EXPERIENCE OF PAIN. THROUGH A COMMON CHEMICAL LANGUAGE COMPRISING NEUROTRANSMITTERS, PEPTIDES, ENDOCANNABINOIDS, CYTOKINES, AND HORMONES, AN ENSEMBLE OF INTERDEPENDENT NERVOUS, ENDOCRINE, AND IMMUNE PROCESSES OPERATES IN CONCERT TO COPE WITH THE INJURY. THESE PROCESSES ACT AS A SINGLE AGENT AND COMPRISE A SUPERSYSTEM. ACUTE PAIN IN ITS MULTIPLE DIMENSIONS, AND THE RELATED SYMPTOMS THAT COMMONLY OCCUR WITH IT, ARE PRODUCTS OF THE SUPERSYSTEM. CHRONIC PAIN CAN DEVELOP AS A RESULT OF UNUSUAL STRESS. SOCIAL STRESSORS CAN COMPOUND THE STRESS RESULTING FROM A WOUND OR ACT ALONE TO DYSREGULATE THE SUPERSYSTEM. WHEN THE SUPERSYSTEM SUFFERS DYSREGULATION, HEALTH, FUNCTION, AND SENSE OF WELL-BEING SUFFER. SOME CHRONIC PAIN CONDITIONS ARE THE PRODUCT OF SUPERSYSTEM DYSREGULATION. INDIVIDUALS VARY AND ARE VULNERABLE TO DYSREGULATION AND DYSFUNCTION IN PARTICULAR ORGAN SYSTEMS DUE TO THE UNIQUE INTERACTIONS OF GENETIC, EPIGENETIC AND ENVIRONMENTAL FACTORS, AS WELL AS THE PAST EXPERIENCES THAT CHARACTERIZE EACH PERSON. PERSPECTIVE: ACUTE TISSUE INJURY ACTIVATES AN ENSEMBLE OF INTERDEPENDENT NERVOUS, ENDOCRINE, AND IMMUNE PROCESSES THAT OPERATE IN CONCERT AND COMPRISE A SUPERSYSTEM. SOME CHRONIC PAIN CONDITIONS RESULT FROM SUPERSYSTEM DYSREGULATION. INDIVIDUALS VARY AND ARE VULNERABLE TO DYSREGULATION DUE TO THE UNIQUE INTERACTIONS OF GENETIC, EPIGENETIC, AND ENVIRONMENTAL FACTORS AND PAST EXPERIENCES THAT CHARACTERIZE EACH PERSON. THIS PERSPECTIVE CAN POTENTIALLY ASSIST CLINICIANS IN ASSESSING AND MANAGING CHRONIC PAIN PATIENTS. 2008 14 6626 35 UNDERSTANDING RESILIENCE. RESILIENCE IS THE ABILITY TO ADAPT SUCCESSFULLY IN THE FACE OF STRESS AND ADVERSITY. STRESSFUL LIFE EVENTS, TRAUMA, AND CHRONIC ADVERSITY CAN HAVE A SUBSTANTIAL IMPACT ON BRAIN FUNCTION AND STRUCTURE, AND CAN RESULT IN THE DEVELOPMENT OF POSTTRAUMATIC STRESS DISORDER (PTSD), DEPRESSION AND OTHER PSYCHIATRIC DISORDERS. HOWEVER, MOST INDIVIDUALS DO NOT DEVELOP SUCH ILLNESSES AFTER EXPERIENCING STRESSFUL LIFE EVENTS, AND ARE THUS THOUGHT TO BE RESILIENT. RESILIENCE AS SUCCESSFUL ADAPTATION RELIES ON EFFECTIVE RESPONSES TO ENVIRONMENTAL CHALLENGES AND ULTIMATE RESISTANCE TO THE DELETERIOUS EFFECTS OF STRESS, THEREFORE A GREATER UNDERSTANDING OF THE FACTORS THAT PROMOTE SUCH EFFECTS IS OF GREAT RELEVANCE. THIS REVIEW FOCUSES ON RECENT FINDINGS REGARDING GENETIC, EPIGENETIC, DEVELOPMENTAL, PSYCHOSOCIAL, AND NEUROCHEMICAL FACTORS THAT ARE CONSIDERED ESSENTIAL CONTRIBUTORS TO THE DEVELOPMENT OF RESILIENCE. NEURAL CIRCUITS AND PATHWAYS INVOLVED IN MEDIATING RESILIENCE ARE ALSO DISCUSSED. THE GROWING UNDERSTANDING OF RESILIENCE FACTORS WILL HOPEFULLY LEAD TO THE DEVELOPMENT OF NEW PHARMACOLOGICAL AND PSYCHOLOGICAL INTERVENTIONS FOR ENHANCING RESILIENCE AND MITIGATING THE UNTOWARD CONSEQUENCES. 2013 15 4470 34 MOLECULAR NEUROPATHOLOGY OF ASTROCYTES AND OLIGODENDROCYTES IN ALCOHOL USE DISORDERS. POSTMORTEM STUDIES REVEAL STRUCTURAL AND MOLECULAR ALTERATIONS OF ASTROCYTES AND OLIGODENDROCYTES IN BOTH THE GRAY AND WHITE MATTER (GM AND WM) OF THE PREFRONTAL CORTEX (PFC) IN HUMAN SUBJECTS WITH CHRONIC ALCOHOL ABUSE OR DEPENDENCE. THESE GLIAL CELLULAR CHANGES APPEAR TO PARALLEL AND MAY LARGELY EXPLAIN STRUCTURAL AND FUNCTIONAL ALTERATIONS DETECTED USING NEUROIMAGING TECHNIQUES IN SUBJECTS WITH ALCOHOL USE DISORDERS (AUDS). MOREOVER, DUE TO THE CRUCIAL ROLES OF ASTROCYTES AND OLIGODENDROCYTES IN NEUROTRANSMISSION AND SIGNAL CONDUCTION, THESE CELLS ARE VERY LIKELY MAJOR PLAYERS IN THE MOLECULAR MECHANISMS UNDERPINNING ALCOHOLISM-RELATED CONNECTIVITY DISTURBANCES BETWEEN THE PFC AND RELEVANT INTERCONNECTING BRAIN REGIONS. THE GLIA-MEDIATED ETIOLOGY OF ALCOHOL-RELATED BRAIN DAMAGE IS LIKELY MULTIFACTORIAL SINCE METABOLIC, HORMONAL, HEPATIC AND HEMODYNAMIC FACTORS AS WELL AS DIRECT ACTIONS OF ETHANOL OR ITS METABOLITES HAVE THE POTENTIAL TO DISRUPT DISTINCT ASPECTS OF GLIAL NEUROBIOLOGY. STUDIES IN ANIMAL MODELS OF ALCOHOLISM AND POSTMORTEM HUMAN BRAINS HAVE IDENTIFIED ASTROCYTE MARKERS ALTERED IN RESPONSE TO SIGNIFICANT EXPOSURES TO ETHANOL OR DURING ALCOHOL WITHDRAWAL, SUCH AS GAP-JUNCTION PROTEINS, GLUTAMATE TRANSPORTERS OR ENZYMES RELATED TO GLUTAMATE AND GAMMA-AMINOBUTYRIC ACID (GABA) METABOLISM. CHANGES IN THESE PROTEINS AND THEIR REGULATORY PATHWAYS WOULD NOT ONLY CAUSE GM NEURONAL DYSFUNCTION, BUT ALSO DISTURBANCES IN THE ABILITY OF WM AXONS TO CONVEY IMPULSES. IN ADDITION, ALCOHOLISM ALTERS THE EXPRESSION OF ASTROCYTE AND MYELIN PROTEINS AND OF OLIGODENDROCYTE TRANSCRIPTION FACTORS IMPORTANT FOR THE MAINTENANCE AND PLASTICITY OF MYELIN SHEATHS IN WM AND GM. THESE CHANGES ARE CONCOMITANT WITH EPIGENETIC DNA AND HISTONE MODIFICATIONS AS WELL AS ALTERATIONS IN REGULATORY MICRORNAS (MIRNAS) THAT LIKELY CAUSE PROFOUND DISTURBANCES OF GENE EXPRESSION AND PROTEIN TRANSLATION. KNOWLEDGE IS ALSO AVAILABLE ABOUT INTERACTIONS BETWEEN ASTROCYTES AND OLIGODENDROCYTES NOT ONLY AT THE NODES OF RANVIER (NR), BUT ALSO IN GAP JUNCTION-BASED ASTROCYTE-OLIGODENDROCYTE CONTACTS AND OTHER FORMS OF CELL-TO-CELL COMMUNICATION NOW UNDERSTOOD TO BE CRITICAL FOR THE MAINTENANCE AND FORMATION OF MYELIN. CLOSE INTERACTIONS BETWEEN ASTROCYTES AND OLIGODENDROCYTES ALSO SUGGEST THAT THERAPIES FOR ALCOHOLISM BASED ON A SPECIFIC GLIAL CELL TYPE PATHOLOGY WILL REQUIRE A BETTER UNDERSTANDING OF MOLECULAR INTERACTIONS BETWEEN DIFFERENT CELL TYPES, AS WELL AS CONSIDERING THE POSSIBILITY OF USING COMBINED MOLECULAR APPROACHES FOR MORE EFFECTIVE THERAPIES. 2018 16 4848 27 OPIOID-INDUCED STRUCTURAL AND FUNCTIONAL PLASTICITY OF MEDIUM-SPINY NEURONS IN THE NUCLEUS ACCUMBENS. OPIOID USE DISORDER (OUD) IS A CHRONIC RELAPSING CLINICAL CONDITION WITH TREMENDOUS MORBIDITY AND MORTALITY THAT FREQUENTLY PERSISTS, DESPITE TREATMENT, DUE TO AN INDIVIDUAL'S UNDERLYING PSYCHOLOGICAL, NEUROBIOLOGICAL, AND GENETIC VULNERABILITIES. EVIDENCE SUGGESTS THAT THESE VULNERABILITIES MAY HAVE NEUROCHEMICAL, CELLULAR, AND MOLECULAR BASES. KEY NEUROPLASTIC EVENTS WITHIN THE MESOCORTICOLIMBIC SYSTEM THAT EMERGE THROUGH CHRONIC EXPOSURE TO OPIOIDS MAY HAVE A DETERMINATIVE INFLUENCE ON BEHAVIORAL SYMPTOMS ASSOCIATED WITH OUD. IN PARTICULAR, STRUCTURAL AND FUNCTIONAL ALTERATIONS IN THE DENDRITIC SPINES OF MEDIUM SPINY NEURONS (MSNS) WITHIN THE NUCLEUS ACCUMBENS (NAC) AND ITS DOPAMINERGIC PROJECTIONS FROM THE VENTRAL TEGMENTAL AREA (VTA) ARE BELIEVED TO FACILITATE THESE BEHAVIORAL SEQUELAE. ADDITIONALLY, GLUTAMATERGIC NEURONS FROM THE PREFRONTAL CORTEX, THE BASOLATERAL AMYGDALA, THE HIPPOCAMPUS, AND THE THALAMUS PROJECT TO THESE SAME MSNS, PROVIDING AN ENRICHED TARGET FOR SYNAPTIC PLASTICITY. HERE, WE REVIEW LITERATURE RELATED TO NEUROADAPTATIONS IN NAC MSNS FROM DOPAMINERGIC AND GLUTAMATERGIC PATHWAYS IN OUD. WE ALSO DESCRIBE NEW FINDINGS RELATED TO TRANSCRIPTIONAL, EPIGENETIC, AND MOLECULAR MECHANISMS IN MSN PLASTICITY IN THE DIFFERENT STAGES OF OUD. 2021 17 6139 31 THE ETIOLOGICAL CONTRIBUTION OF GABAERGIC PLASTICITY TO THE PATHOGENESIS OF NEUROPATHIC PAIN. NEUROPATHIC PAIN DEVELOPING AFTER PERIPHERAL OR CENTRAL NERVE INJURY IS THE RESULT OF PATHOLOGICAL CHANGES GENERATED THROUGH COMPLEX MECHANISMS. DISRUPTION IN THE HOMEOSTASIS OF EXCITATORY AND INHIBITORY NEURONS WITHIN THE CENTRAL NERVOUS SYSTEM IS A CRUCIAL FACTOR IN THE FORMATION OF HYPERALGESIA OR ALLODYNIA OCCURRING WITH NEUROPATHIC PAIN. THE CENTRAL GABAERGIC PATHWAY HAS RECEIVED ATTENTION FOR ITS EXTENSIVE DISTRIBUTION AND FUNCTION IN NEURAL CIRCUITS, INCLUDING THE GENERATION AND DEVELOPMENT OF NEUROPATHIC PAIN. GABAERGIC INHIBITORY CHANGES THAT OCCUR IN THE INTERNEURONS ALONG DESCENDING MODULATORY AND NOCICEPTIVE PATHWAYS IN THE CENTRAL NERVOUS SYSTEM ARE BELIEVED TO GENERATE NEURONAL PLASTICITY, SUCH AS SYNAPTIC PLASTICITY OR FUNCTIONAL PLASTICITY OF THE RELATED GENES OR PROTEINS, THAT IS THE FOUNDATION OF PERSISTENT NEUROPATHIC PAIN. THE PRIMARY GABAERGIC PLASTICITY OBSERVED IN NEUROPATHIC PAIN INCLUDES GABAERGIC SYNAPSE HOMO- AND HETEROSYNAPTIC PLASTICITY, DECREASED SYNTHESIS OF GABA, DOWN-EXPRESSION OF GLUTAMIC ACID DECARBOXYLASE AND GABA TRANSPORTER, ABNORMAL EXPRESSION OF NKCC1 OR KCC2, AND DISTURBED FUNCTION OF GABA RECEPTORS. IN THIS REVIEW, WE DESCRIBE POSSIBLE MECHANISMS ASSOCIATED WITH GABAERGIC PLASTICITY, SUCH AS CENTRAL SENSITIZATION AND GABAERGIC INTERNEURON APOPTOSIS, AND THE EPIGENETIC ETIOLOGIES OF GABAERGIC PLASTICITY IN NEUROPATHIC PAIN. MOREOVER, WE SUMMARIZE POTENTIAL THERAPEUTIC TARGETS OF GABAERGIC PLASTICITY THAT MAY ALLOW FOR SUCCESSFUL RELIEF OF HYPERALGESIA FROM NERVE INJURY. FINALLY, WE COMPARE THE EFFECTS OF THE GABAERGIC SYSTEM IN NEUROPATHIC PAIN TO OTHER TYPES OF CHRONIC PAIN TO UNDERSTAND THE CONTRIBUTION OF GABAERGIC PLASTICITY TO NEUROPATHIC PAIN. 2019 18 1677 31 DRUG ADDICTION: HYPERKATIFEIA/NEGATIVE REINFORCEMENT AS A FRAMEWORK FOR MEDICATIONS DEVELOPMENT. COMPULSIVE DRUG SEEKING THAT IS ASSOCIATED WITH ADDICTION IS HYPOTHESIZED TO FOLLOW A HEURISTIC FRAMEWORK THAT INVOLVES THREE STAGES (BINGE/INTOXICATION, WITHDRAWAL/NEGATIVE AFFECT, AND PREOCCUPATION/ANTICIPATION) AND THREE DOMAINS OF DYSFUNCTION (INCENTIVE SALIENCE/PATHOLOGIC HABITS, NEGATIVE EMOTIONAL STATES, AND EXECUTIVE FUNCTION, RESPECTIVELY) VIA CHANGES IN THE BASAL GANGLIA, EXTENDED AMYGDALA/HABENULA, AND FRONTAL CORTEX, RESPECTIVELY. THIS REVIEW FOCUSES ON NEUROCHEMICAL/NEUROCIRCUITRY DYSREGULATIONS THAT CONTRIBUTE TO HYPERKATIFEIA, DEFINED AS A GREATER INTENSITY OF NEGATIVE EMOTIONAL/MOTIVATIONAL SIGNS AND SYMPTOMS DURING WITHDRAWAL FROM DRUGS OF ABUSE IN THE WITHDRAWAL/NEGATIVE AFFECT STAGE OF THE ADDICTION CYCLE. HYPERKATIFEIA PROVIDES AN ADDITIONAL SOURCE OF MOTIVATION FOR COMPULSIVE DRUG SEEKING VIA NEGATIVE REINFORCEMENT. NEGATIVE REINFORCEMENT REFLECTS AN INCREASE IN THE PROBABILITY OF A RESPONSE TO REMOVE AN AVERSIVE STIMULUS OR DRUG SEEKING TO REMOVE HYPERKATIFEIA THAT IS AUGMENTED BY GENETIC/EPIGENETIC VULNERABILITY, ENVIRONMENTAL TRAUMA, AND PSYCHIATRIC COMORBIDITY. NEUROBIOLOGICAL TARGETS FOR HYPERKATIFEIA IN ADDICTION INVOLVE NEUROCIRCUITRY OF THE EXTENDED AMYGDALA AND ITS CONNECTIONS VIA WITHIN-SYSTEM NEUROADAPTATIONS IN DOPAMINE, ENKEPHALIN/ENDORPHIN OPIOID PEPTIDE, AND GAMMA-AMINOBUTYRIC ACID/GLUTAMATE SYSTEMS AND BETWEEN-SYSTEM NEUROADAPTATIONS IN PROSTRESS CORTICOTROPIN-RELEASING FACTOR, NOREPINEPHRINE, GLUCOCORTICOID, DYNORPHIN, HYPOCRETIN, AND NEUROIMMUNE SYSTEMS AND ANTISTRESS NEUROPEPTIDE Y, NOCICEPTIN, ENDOCANNABINOID, AND OXYTOCIN SYSTEMS. SUCH NEUROCHEMICAL/NEUROCIRCUITRY DYSREGULATIONS ARE HYPOTHESIZED TO MEDIATE A NEGATIVE HEDONIC SET POINT THAT GRADUALLY GAINS ALLOSTATIC LOAD AND SHIFTS FROM A HOMEOSTATIC HEDONIC STATE TO AN ALLOSTATIC HEDONIC STATE. BASED ON PRECLINICAL STUDIES AND TRANSLATIONAL STUDIES TO DATE, MEDICATIONS AND BEHAVIORAL THERAPIES THAT RESET BRAIN STRESS, ANTISTRESS, AND EMOTIONAL PAIN SYSTEMS AND RETURN THEM TO HOMEOSTASIS WOULD BE PROMISING NEW TARGETS FOR MEDICATION DEVELOPMENT. SIGNIFICANCE STATEMENT: THE FOCUS OF THIS REVIEW IS ON NEUROCHEMICAL/NEUROCIRCUITRY DYSREGULATIONS THAT CONTRIBUTE TO HYPERKATIFEIA, DEFINED AS A GREATER INTENSITY OF NEGATIVE EMOTIONAL/MOTIVATIONAL SIGNS AND SYMPTOMS DURING WITHDRAWAL FROM DRUGS OF ABUSE IN THE WITHDRAWAL/NEGATIVE AFFECT STAGE OF THE DRUG ADDICTION CYCLE AND A DRIVING FORCE FOR NEGATIVE REINFORCEMENT IN ADDICTION. MEDICATIONS AND BEHAVIORAL THERAPIES THAT REVERSE HYPERKATIFEIA BY RESETTING BRAIN STRESS, ANTISTRESS, AND EMOTIONAL PAIN SYSTEMS AND RETURNING THEM TO HOMEOSTASIS WOULD BE PROMISING NEW TARGETS FOR MEDICATION DEVELOPMENT. 2021 19 6617 29 UNDERPINNING THE NEUROBIOLOGICAL INTRICACIES ASSOCIATED WITH OPIOID TOLERANCE. THE OPIOID CRISIS IS A MAJOR THREAT OF THE 21ST CENTURY, WITH A REMARKABLE JUXTAPOSITION OF USE AND ABUSE. OPIOIDS ARE THE MOST POTENT AND EFFICACIOUS CLASS OF ANALGESICS, BUT DESPITE THEIR PROVEN THERAPEUTIC EFFICACY, THEY HAVE RECENTLY BEEN DEGRADED TO THIRD-LINE THERAPY FOR THE MANAGEMENT OF CHRONIC PAIN IN CLINICS. THE REASON BEHIND THIS IS THE DEVELOPMENT OF POTENTIAL SIDE EFFECTS AND TOLERANCE AFTER REPEATED DOSING. OPIOID TOLERANCE IS THE MAJOR LIMITING FACTOR LEADING TO THE WITHDRAWAL OF TREATMENT, SEVERE SIDE EFFECTS DUE TO DOSE ESCALATION, AND SOMETIMES EVEN DEATH OF THE PATIENTS. EVERY DAY MORE THAN 90 PEOPLE DIE DUE TO OPIOIDS OVERDOSE IN AMERICA, AND A SIMILAR TREND HAS BEEN SEEN ACROSS THE GLOBE. OVER THE PAST TWO DECADES, RESEARCHERS HAVE BEEN TRYING TO DISSECT THE NEUROBIOLOGICAL MECHANISM OF OPIOID TOLERANCE. RESEARCH ON OPIOID TOLERANCE SHIFTED TOWARD CENTRAL NERVOUS SYSTEM-BASED ADAPTATIONS BECAUSE TOLERANCE IS MUCH MORE THAN JUST A CELLULAR PHENOMENON. THUS, NEUROBIOLOGICAL ADAPTATIONS ASSOCIATED WITH OPIOID TOLERANCE ARE IMPORTANT TO UNDERSTAND IN ORDER TO FIND NEWER PAIN THERAPEUTICS. THESE ADAPTATIONS ARE ASSOCIATED WITH ALTERATIONS IN ASCENDING AND DESCENDING PAIN PATHWAYS, REWARD CIRCUITRY MODULATIONS, RECEPTOR DESENSITIZATION AND DOWN-REGULATION, RECEPTOR INTERNALIZATION, HETERODIMERIZATION, AND ALTERED EPIGENETIC REGULATION. THE PRESENT REVIEW IS FOCUSED ON NOVEL CIRCUITRIES ASSOCIATED WITH OPIOID TOLERANCE IN DIFFERENT AREAS OF THE BRAIN, SUCH AS PERIAQUEDUCTAL GRAY, ROSTRAL VENTROMEDIAL MEDULLA, DORSAL RAPHE NUCLEUS, VENTRAL TEGMENTAL AREA, AND NUCLEUS ACCUMBENS. UNDERSTANDING THE NEUROBIOLOGICAL MODULATIONS ASSOCIATED WITH CHRONIC OPIOID EXPOSURE AND TOLERANCE WILL PAVE THE WAY FOR THE DEVELOPMENT OF NOVEL PHARMACOLOGICAL TOOLS FOR SAFER AND BETTER MANAGEMENT OF CHRONIC PAIN IN PATIENTS. 2020 20 4621 39 NEUROBIOLOGICAL AND SYSTEMIC EFFECTS OF CHRONIC STRESS. THE BRAIN IS THE CENTRAL ORGAN OF STRESS AND ADAPTATION TO STRESS BECAUSE IT PERCEIVES AND DETERMINES WHAT IS THREATENING, AS WELL AS THE BEHAVIORAL AND PHYSIOLOGICAL RESPONSES TO THE STRESSOR, WHICH PROMOTE ADAPTATION ("ALLOSTASIS") BUT ALSO CONTRIBUTE TO PATHOPHYSIOLOGY ("ALLOSTATIC LOAD/OVERLOAD") WHEN OVERUSED AND DYSREGULATED. THE ADULT AS WELL AS DEVELOPING BRAIN POSSESSES A REMARKABLE ABILITY TO SHOW STRUCTURAL AND FUNCTIONAL PLASTICITY IN RESPONSE TO STRESSFUL AND OTHER EXPERIENCES, INCLUDING NEURONAL REPLACEMENT, DENDRITIC REMODELING AND SYNAPSE TURNOVER. STRESS CAN CAUSE AN IMBALANCE OF NEURAL CIRCUITRY SUBSERVING COGNITION, DECISION MAKING, ANXIETY AND MOOD THAT CAN INCREASE OR DECREASE EXPRESSION OF THOSE BEHAVIORS AND BEHAVIORAL STATES. THIS IMBALANCE, IN TURN, AFFECTS SYSTEMIC PHYSIOLOGY VIA NEUROENDOCRINE, AUTONOMIC, IMMUNE AND METABOLIC MEDIATORS. IN THE SHORT TERM, THESE CHANGES MAY BE ADAPTIVE; BUT, IF THE THREAT PASSES AND THE BEHAVIORAL STATE PERSISTS ALONG WITH THE CHANGES IN NEURAL CIRCUITRY, SUCH MALADAPTATION REQUIRES INTERVENTION WITH A COMBINATION OF PHARMACOLOGICAL AND BEHAVIORAL THERAPIES. THERE ARE IMPORTANT SEX DIFFERENCES IN HOW THE BRAIN RESPONDS TO STRESSORS. MOREOVER, ADVERSE EARLY LIFE EXPERIENCE, INTERACTING WITH ALLELES OF CERTAIN GENES, PRODUCES LASTING EFFECTS ON BRAIN AND BODY VIA EPIGENETIC MECHANISMS. WHILE PREVENTION IS KEY, THE PLASTICITY OF THE BRAIN GIVES HOPE FOR THERAPIES THAT UTILIZE BRAIN-BODY INTERACTIONS. POLICIES OF GOVERNMENT AND THE PRIVATE SECTOR ARE IMPORTANT TO PROMOTE HEALTH AND INCREASE "HEALTHSPAN." 2017