The present study demonstrated two major findings: the pharmacological profile of
l-THP and its dose-dependent regional activation. Pharmacology profiling has become an invaluable tool in identifying off-target interaction and predicting potential treatment efficacy and safety. The pharmacological profiling of
l-THP, as listed in , indicates its high-affinity binding to α1- and α2-adrenergic receptors; D1, D2, and D3 receptors and several serotonin (5-hydroxytryptamine; 5-HT) receptors (5-HT1A, 5-HT1D, 5-HT4 and 5-HT7). Accordingly, Zhang and colleagues [
20] found that
l-THP behaves as a D1, D2 antagonist for isolated rabbit peripheral artery. Liu et al. [
9] found
l-THP to be monoamine depletor. Future in vitro study of
l-THP on these monoamine systems will confirm its actual functional effects.
With high-field phMRI, acute
l-THP elicited a dose-dependent negative BOLD response in specific regions that are highly addiction related. These include the NAc, SNR, Ins, HIPP, IL, retrosplenium, VTA, Thal, Hypoth and CPu. Current pharmacotherapy concepts related to drug dependence have focused on preventing relapse, rather than disrupting primary reinforcement. Many studies have shown that all these regions play critical roles for drug addiction and behave as key neural substrates involved in drug relapse [
11]. The NAc [
21] appears to be involved in the primary reinforcing effects of drug abuse. The VTA is believed to be extensively involved in mediating the rewarding effects, conscious drug experience and drug-seeking behavior [
22]. The Ins has recently been implied in playing an important role in cue-induced drug craving [
23]. The HIPP takes major responsibility in conditioned learning engaged in the process of addiction [
24]. IL appears to be involved in drug-primed reinstatement in a drug-dependent fashion [
25]. The SNR is particularly important in motor planning, reward-seeking, learning and withdrawal [
26]. The CPu does not seem to have a major role in the acute reinforcing effects of drug abuse, but may be recruited during the development of compulsive drug seeking [
27]. The retrosplenium (posterior cingulate cortex in human) is also involved and implicated in inhibitory control and conflict resolution. Its disruption results in impulsivity [
28]. As drugs with multiple receptor targets have been suggested for the treatment of addiction,
l-THP proves to be unique in that it exclusively binds to major receptors of the dopaminergic, serotonergic and noradrenergic networks. This highlights its great potential as a therapeutic medication for addiction.
Although we did not find significant direct-binding affinity of
l-THP with opioid receptors (as in ), and naloxone (μ-opioid receptor competitive antagonist) did not change the
l-THP -induced BOLD responses, previous studies have demonstrated that the
l-THP can modulate the opioid system indirectly. Jin [
1] and Hu and Jin [
29] found that
l-THP injection significantly increased the amount of endogenous opioids (mainly endorphins, enkephalins and dynorphins), as well as the messenger RNA expression of the opioid precursor in widespread regions of the central nervous system. Therefore,
l-THP may enhance opioid activity through interaction with the above-mentioned monoamine neural substrates.
The functional connectivity analysis results on the dopaminergic, serotonergic and noradrenergic networks support the drug profile of
l-THP binding to those monoamine receptors selectively and provide supplementary network information for the regional patterns of dose-dependent activation of
l-THP. There have been similar methods in many positron emission tomography and recent phMRI studies [
30]. We calculated the acute
l-THP administration-induced pharmacological connectivity maps, as shown in . The results demonstrated that distinctly different neural circuits were depicted when different seed regions were applied. Using the seed region of VTA, the primary source of DA revealed some DA neurons in highly innervated regions, such as the olfactory cortex, insula, CPu, Amy and HIPP. Interestingly, the NAc region was not found in this connective map, although NAc receives innervations from the VTA. The lack of significant correlation between the VTA and NAc may be due to the variability in responses by individual rats and a relatively a small number of subjects. It is also possible that the activity in the NAc may be influenced not only by the VTA, but also by other circuitry. The seed region of raphe nucleus, the primary source of 5-HT, linked the somatosensory cortex, CPu, HIPP, periaqueductal gray matter, etc. Although there are 5-HT projections spread throughout the brain, many of those regions were dominant distribution areas of other circuits. Because our image acquisition did not cover the locus ceruleus, the primary source of norepinephrine, the seed region of BNST instead was used. The BNST is where drug abuse promotes robust rises in extracellular DA levels. It is a corticotrophin-releasing factor-rich component of the extended Amy. The BNST was connected to a series of regions, including the cingulate cortex, motor cortex, somatosensory cortex, NAc, CPu, insula, Amy, Thal, Hypoth, HIPP and retrosplenium cortex. When the primary cholinergic source PPT was chosen as the control seed, only a small area of the somatosensory cortex was revealed. It supports the low-binding activity of
l-THP with all muscarinic receptors. Overall, these results support the pharmacological profile of
l-THP binding with the dopaminergic, serotonergic and noradrenergic receptors and may suggest the network details of its neural substrates revealed with the dose-dependent BOLD changes. However, extra caution should be taken. Although regions, such as the VTA, BNST and raphe nucleus, can be defined as the origins or hubs of their respective neurotransmitter systems, other neural systems, such as glutamergic system, also exist in these regions. Therefore, observed connectivity patterns may reflect the overall activities in these neural systems induced by
l-THP.
In this study, we observed consistent negative BOLD signal changes across all
l-THP dose groups. The underlying mechanisms for the negative BOLD signal observed in this study are not known. In the literature, simultaneous fMRI acquisition and electrophysiological recordings methods suggest that the negative BOLD responses were associated with regional neuronal activity decreases measured by the decreased local field potentials and multiunit activity [
31]. These results are in line with several other findings of negative BOLD signal changes obtained in fMRI experiments, which have reflected functionally effective inhibition or suppression of neuronal firing patterns [
32]. The negative BOLD signal responses found in the human anterior cingulate cortex are reported to be correlated with local GABA concentrations [
33]. Region-specific negative BOLD responses are frequently found in human and animal phMRI studies that use agents such as cocaine, heroin and methylphenidate [
34,
35]. The heroin-induced negative BOLD changes in the NAc were shown to be correlated with heroin-induced inhibitory neural activity measured by the electroencephalograph (EEG) method. The heroin-induced decrease in cerebral blood flow was measured by laser Doppler flowmetry [
36]. It was also suggested that the negative BOLD responses induced by cocaine on human subjects observed in the mesolimbic circuitry may be attributed to DA-induced inhibition [
37]. Other studies [
38] have suggested that synaptic excitation may work as the main driving force for the blood flow or positive BOLD signal, whereas synaptic inhibition may suppress the increase in intracellular calcium that may abolish the activation-induced increases in blood flow and subsequently decrease the BOLD signal. The relationships between the neural activity and the BOLD signal changes can be rather complicated while examining the effects of monosynaptic excitation, disynaptic inhibition and deactivation on neural activity and CBF [
39]. In the present study, we attribute the negative BOLD signals induced by
l-THP administration to the inhibitory functions, because
l-THP induced a decrease in neuronal activity in many subcortical regions, as well as in the spinal cord, according to EEG measurements [
1]. Therefore, the
l-THP -induced negative BOLD responses may contribute to its therapeutic efficacy for addiction in the manner that they decrease the reward output via inhibition at the NAc and VTA. They also disrupt the conditional learning formed by the HIPP. This conditional learning is critical for primary rewarding and relapse. The responses further decrease the reward-seeking behavior via SNR and CPu and disconnect the information relay through the Thal during addiction. In addition, the sedative, but non-abusive properties [
1] of
l-THP, may decrease the anxiety and impulsivity that is associated with addiction.
Of note, the negative BOLD signal may be related to the anesthetic agent urethane as it inhibits multiple cellular-signaling channels [
40]. Although the vehicle study provided control, there is a possibility that the observed negative BOLD profiles may be associated with the combined effects of
l-THP and the anesthetic. As previously demonstrated, the BOLD signal can be affected by the different levels of anesthesia or by different anesthetic agents in functional MRI studies [
41,
42]. In the future, we will address how the
l-THP-induced BOLD signal and connectivity patterns may be altered by different anesthesia.
In conclusion, preclinical and clinical studies have demonstrated great potential for l-THP to treat drug addiction. The present study indicated that the overall pharmacological profile of l-THP showed strong binding to the receptors of the dopaminergic, serotonergic and noradrenergic systems. Furthermore, phMRI experiments detected activation induced by acute l-THP administration in a dose-dependent region-specific manner. It is suggested that l-THP holds great promise to be a therapeutic medication for drug addiction.