The present study shows that early-life stress as a result of parental deprivation affects 5-HT1ARs density and radioligand affinity. In both males and females, peer-rearing induced an overall decrease in Bmax and in KDapp. The exception was the dmPFC in females, where Bmax values were elevated. Our results are consistent with the hypothesis that exposure to an adverse environment during infancy has long-term consequences on the 5-HT system. To our knowledge, these findings provide the first evidence in nonhuman primates for such developmental changes in an aspect of the 5-HT system that has been strongly linked to anxiety and depression.
Overall our findings in nonhuman primates are consistent with and extend the data from human PET and
in vitro binding studies of post mortem brain tissue suggesting a down-regulation of 5-HT
1ARs associated with anxiety disorders (
39,
40). The present results are also consistent with previous evidence indicating decreased 5-HT
1AR availability using PET in adult females macaques with signs of behavioral “depression”(
41), and decreased 5-HT
1AR binding and mRNA expression
in vitro in the HC in marmoset monkeys exposed to early-life stress (
42). Moreover, low 5-HT
1AR binding in the HC and ACC was found in male rats exposed to early-life stress (
43).
Surprising, early-life stress was associated with increased 5-HT
1AR density the in the dmPFC in female monkeys. Using structural MRI in the same cohort of monkeys, we recently reported (
34) increased volume of the dmPFC and cingulate cortex in male and female PR animals. As such, it is possible that partial volume effect contributed to the present result. However, lower B
max values in females PR monkeys were found in the ACC, a region that also showed increased gray matter volume in PR animals, suggesting that any structural changes in the dmPFC may not fully account for the present B
max differences. Gender differences in PFC 5-HT
1AR density have been observed in humans using
in vitro binding assays from postmortem brain tissue (
44). Moreover, specific changes in 5-HT
1AR protein levels were found in PFC of depressed female patients (
45). As a part of the ‘medial prefrontal network’, the dmPFC, together with the cingulate cortex, is thought to modulate activity in limbic structures (e.g. AMY and HC) known to be important for the processing of emotional information (
46,
47). Taken together, these data suggest that gender differences in brain regions involved in the cognitive control of emotional regulation are present on a molecular level, and may contribute to the increased vulnerability to affective disorders in women.
In addition to the tendency for an overall decrease in B
max values, we also found an increased radioligand affinity for 5-HT
1AR in PR animals, as shown by the decreased K
Dapp values, particularly in the HC. Reduced K
Dapp values reflect less competition between radioligand and endogenous 5-HT at the receptor sites, which could be related to one or more of the following: lower baseline 5-HT levels, reduced 5-HT affinity for 5-HT
1AR as a result of conformational receptor alterations, or such other factors as receptor internalization (
48). Unfortunately, PET analysis limitations do not allow us to define the exact reason for the observed changes in radioligand affinity. Nevertheless, the decreased CSF 5-HIAA concentrations found in PR animals in the present study, and throughout development by earlier findings (
24,
26), support the hypothesis of lower brain 5-HT levels in PR animals. However, since neither K
Dapp nor CSF 5-HIAA concentrations represent direct measures of 5-HT levels in the brain, future investigations using other techniques, such as microdialysis, are warranted to confirm that early-life stress affects endogenous 5-HT in PR animals. In rodents, early-life stress has been shown to affect both basal 5-HT and 5-HIAA levels in several brain regions (
49), and previous data obtained by
in vitro assays in rodents exposed to chronic stress showed decreased 5-HT
1AR density and increased 5-HT
1AR affinity in the HC (
50), indicating that stress might induce transcriptional or post-transcriptional effects on 5-HT
1AR in this region.
Our results on 5-HT
1AR availability calculated as BP
ND (and BP
F, see
Supplement 1) indicate that the effect of peer-rearing on BP
ND was different in males and females. B
max values were decreased in most brain regions in male and female PR animals. However, while overall lower 5-HT
1AR availability was found in PR males, it was increased in PR females compared to control MR animals. These gender differences in receptor availability may be related to reported differences in SSRI efficacy between men and women (
51). As mentioned in the Introduction, differences in 5-HT
1AR availability can be linked to changes in receptor density, radioligand apparent affinity (1/K
Dapp) or both as demonstrated in the current study. Our results further emphasize the importance of considering changes in receptor availability along with concomitant changes in 5-HT
1AR density and
in vivo affinity.
Consequences of the findings
Overall these data suggest that early-life stress is associated with changes in the development of the 5-HT system in brain regions considered to be critically involved in major depression and to be modulated by antidepressant treatment (
47). An impaired interaction between neural networks involved in emotional and cognitive processing is proposed as a key dysfunction in mood disorders (
46,
47). Specifically, it is suggested that the dmPFC, dorsal ACC and posterior cingulate cortex are part of a “dorsal network” involved in emotional and cognitive deficits, while the HC and the AMY are part of a “ventral network” associated with vegetative and somatic symptoms of mood disorders; the (rostral) ACC, which is connected to both networks, is thought to have a more regulatory function (
46). Moreover, antidepressant treatment, known to increase 5-HT levels, is known to modulate neural activity in these regions/networks (
52).
In this context, our data indicate that peer-rearing stress affects 5-HT
1AR density and
in vivo affinity in brain regions known to play a key role in affective disorders. Affinity changes, particularly in the HC, may be important considering that the SSRI efficacy seems to be mediated by 5-HT
1AR and by neurogenesis in the HC (
53). It is also possible that region- and sex-specific changes in 5-HT
1AR function during development have important consequences on cognitive abilities (
54). The 5-HT system is implicated in the behavioral and brain responsiveness to punishment (
55). Modulation of the 5-HT system has been shown to affect neural activity in dmPFC during negative feedback processing in humans (
56) and a disrupted top-down control by dmPFC over AMY has been proposed to underlie some of the negative feedback deficits reported in depression (
57). Recently, increased responding to threat (and reward) has been reported specifically in two-year old PR males (
58), supporting the hypothesis that 5-HT changes may affect the processing of negative information. However, it is unclear if and how 5-HT
1AR alterations during development may be related to cognitive differences in humans and potentially to increased vulnerability for affective disorders later in life.
Limitations of the study
We found no differences in B
max values between male and female monkeys in either the MR or PR group. Although the number of subjects (n=21) was relatively high for a nonhuman primate study, it may still not have been sufficient to demonstrate more subtle differences between males and females. Previous PET studies in humans showed either no changes or elevated 5-HT
1AR availability in healthy adult women (
16–
18). Conversely, there are as yet no data regarding the levels of brain 5-HT
1AR in children, which due to issues of radioactivity administration, are not likely to be easily obtained. Gender differences in 5-HT
1AR in the adult nonhuman primate brain is also not available at this point in time. However, since
in vitro data from rodents show sex differences in 5-HT
1AR binding both in adults and throughout development (
59,
60), it is possible that sex specific differences are also present during development in nonhuman primates. Thus, future
in vitro binding and microdialysis studies will be important to confirm our PET results and to investigate possible sex differences in 5-HT
1AR density and 5-HT levels occurring during development.
In conclusion, we provide the first evidence in nonhuman primates that a model of early-life stress affects 5-HT1AR density and in vivo affinity in juvenile monkeys. Specifically, we found decreased 5-HT1AR density and KDapp in PR animals. However, in females, early-life stress induced an increase in 5-HT1AR density in the dmPFC, a brain region involved in emotional regulation. Overall these findings support the hypothesis that low 5-HT1AR density during development may be related to an increased risk for affective disorders. Moreover, sex difference may be present early in development and need to be considered in the context of the increased vulnerability for mood and anxiety disorders reported in women.