Chapter 26 Adolescent dopamine development: connecting experience with vulnerability or resilience to psychiatric disease Lauren M. Reynolds1, 2, 3 and Cecilia Flores3 1 McGill University, Integrated Program in Neuroscience, Montreal, QC, Canada; 2Sorbonne Université, CNRS UMR 8246, INSERM U1130, Neuroscience Paris Seine - Institut de Biologie Paris Seine, Paris, France; 3McGill University, Department of Psychiatry, Douglas Mental Health University Institute, Montreal, QC, Canada List of abbreviations DCC Deleted in colorectal cancer GWAS Genome-wide association studies MRI Magnetic resonance imaging mRNA Messenger RNA NAc Nucleus accumbens PFC Prefrontal cortex PND Postnatal day SNP Single nucleotide polymorphism VTA Ventral tegmental area Mini-dictionary of terms Adolescence A developmental period marking the transition from a juvenile state to independence/adulthood. Axon Long neurite extending from the soma of one neuron to its signaling partner. Dopamine A chemical neurotransmitter with a modulatory effect over postsynaptic neurons. Guidance cue Secreted or cell-bound molecules that exist in the extracellular environment. Axons navigate to their destination by interpreting the guidance cues in their environment, a process that depends on the guidance cue receptors each axon expresses. Mesocortical dopamine projection Dopaminergic neurons with cell bodies in the ventral tegmental area and axons that project to the prefrontal cortex. Mesolimbic dopamine projection Dopaminergic neurons with cell bodies in the ventral tegmental area and axons that project to limbic regions, including the nucleus accumbens. microRNA A small noncoding RNA molecule that represses the expression of specific target genes. Psychostimulant drugs A class of drugs that produce a temporary increase in motor activity, mental processing, attention, and/or euphoria. Psychostimulant drugs are used medically or recreationally, and the effects of this class of drugs generally depend on the dose taken. Adolescence is a critical period for prefrontal cortex development Psychiatric diseases are more likely to emerge during adolescence than during any other period of life (Fig. 26.1; Kessler et al., 2007; Lee et al., 2014; Paus, Keshavan, & Giedd, 2008). A common denominator of disorders that have an adolescent onset, particularly drug addiction, depression, and schizophrenia, are deficits in the function of the prefrontal cortex (PFC) and cognitive impairments (Goldstein & Volkow, 2011; Rice et al., 2019; Tan, Callicott, & Weinberger, 2009). The PFC and cognitive behaviors continue to mature across adolescence (Liston et al., 2006; Diagnosis, Management and Modeling of Neurodevelopmental Disorders. https://doi.org/10.1016/B978-0-12-817988-8.00026-9 Copyright © 2021 Elsevier Inc. All rights reserved. 295 296 PART | II Impairments and diseases Adolescent PFC development Synaptogenesis Synapse pruning Myelination Psychiatric disease onset Addiction Depression Schizophrenia Age (years) 0 5 10 15 20 25+ FIGURE 26.1 Psychiatric disease onset coincides with adolescent prefrontal cortex development. During adolescence, the prefrontal cortex undergoes a dynamic period of development including synaptogenesis, synaptic pruning, and myelination. This critical developmental period coincides with the onset of psychiatric disorders marked by prefrontal cortex dysfunction, including addiction, depression, and schizophrenia (Kessler et al., 2007; Lee et al., 2014; Paus et al., 2008). Somerville, Hare, & Casey, 2011), and variations in their developmental trajectories likely contribute to individual differences in vulnerability to psychopathology. Environmental factors, such as drug use, are known to increase the risk of later psychiatric disease and may do so by interfering with PFC development (Andréasson, Engström, Allebeck, & Rydberg, 1987; Anthony & Petronis, 1995; Brook, Brook, Zhang, Cohen, & Whiteman, 2002; French et al., 2015; Hallfors, Waller, Bauer, Ford, & Halpern, 2005; Weiser, Knobler, Noy, & Kaplan, 2002). The PFC is among the final brain regions to fully develop (Fig. 26.1). Longitudinal and cross-sectional magnetic resonance imaging (MRI) studies have mapped the trajectory of human brain development and found dynamic changes in the PFC during adolescence. Gray matter thickness in the PFC decreases across adolescence before stabilizing in adulthood, while white matter volume increases (Gogtay et al., 2004; Sowell et al., 2003). Postmortem human brain analysis further suggests that these macroscale changes likely result from modifications at the cellular level, with dramatic developmental changes in neuronal architecture, synapse density, and neurotransmitter concentration occurring across the adolescent period (Catts et al., 2013; Fung et al., 2010; Petanjek et al., 2011). Since the PFC is essential for cognitive function, including behavioral inhibition and flexibility, motivation, and reward processing, cognitive ability matures in parallel to PFC structural development (Larsen & Luna, 2018). Sex differences in brain structure emerge across human adolescence (Ingalhalikar et al., 2014; Lenroot & Giedd, 2010; Sowell et al., 2007); however, this dimorphism does not translate into pronounced cognitive performance disparities between adult men and women. Instead, research indicates that men and women engage different cognitive strategies in order to produce similarly advantageous behavioral outcomes (Grissom & Reyes, 2018; Lenroot & Giedd, 2010). It is therefore critical to understand adolescent neurodevelopment in both sexes, as exposure to the same risk factors for psychopathologies targeting PFC function may lead to divergent outcomes. Developmental rodent models for psychiatric-like traits are valuable for research. However, defining the adolescent period in rodents can prove challenging, as there are not clear-cut boundaries. While puberty and adolescence necessarily overlap temporally, the terms are not interchangeable. Puberty is defined by the onset of sexual maturity, while adolescence is a more diffuse period representing the gradual transition from a juvenile state to independence. Work from our group and others suggests that adolescence extends from the age of weaning (postnatal day (PND) 21) until adulthood (PND 60) and can be further subdivided into early, middle, and late periods that represent discrete developmental timepoints (Fig. 26.2; Adolescence Developmental period Age (PND) 0 Early 21 28 Mid 35 42 Late 49 56 Adulthood 60+ FIGURE 26.2 Defining adolescence in rodent models. Adolescence in rodents can be considered to extend from postnatal day (PND) 21 (weaning) until PND 60 (the start of adulthood) and can be further subdivided into early (PND 21 e 34), mid (PND 35 e 46) and late (PND 47 e 59) adolescent periods. Adolescence, dopamine, and mental health Chapter | 26 297 Hoops & Flores, 2017; Reynolds, Pokinko, et al., 2018; Reynolds, Yetnikoff, et al., 2018; Schneider, 2013; Spear, 2000; Tirelli, Laviola, & Adriani, 2003). The maturational trajectory of the PFC in rodents is similar to humans, with cortical thickness peaking around 30 days of age and stabilizing after PND 60 in both rats and mice (Hammelrath et al., 2016; Mengler et al., 2014). These macroscale changes are also linked to alterations to the structure of PFC neurons, synaptic density, and myelination of axons (Caballero, Granberg, & Tseng, 2016; Delevich, Thomas, & Wilbrecht, 2019; Juraska & Willing, 2017). Cognitive and goal-directed behaviors in rodents are likewise refined across adolescence, mirroring what has been observed in humans (Andrzejewski et al., 2011; Naneix, Marchand, Scala, Pape, & Coutureau, 2012). Mesocortical dopamine development drives prefrontal cortex maturation Adult Dopamine innervation PFC excitatory neuron maturity PFC inhibitory neuron maturity Juvenile PFC functional maturity Dopaminergic input to the PFC is a driver of PFC development. In contrast to other neurotransmitter systems innervating this region, dopamine axons continue to grow from the ventral tegmental area (VTA) to the PFC during adolescence (Reynolds, Pokinko, et al., 2018), resulting in a progressive increase in innervation between PNDs 21 and 60 (Fig. 26.3; Hoops & Flores, 2017). During this protracted process, growing dopamine axons undergo substantial modifications in fiber density, shape, and organization (Hoops & Flores, 2017). Prolonged development of PFC dopamine connectivity extrapolates to primates, including humans (Rosenberg & Lewis, 1995; Rothmond, Weickert, & Webster, 2012; Weickert et al., 2007). PFC neurons receiving dopamine input, pyramidal neurons in particular, also undergo a dynamic period of structural changes during adolescence in both rodents and primates, including humans (Juraska & Willing, 2017; Lambe, Krimer, & Goldman-Rakic, 2000; Manitt et al., 2011; Petanjek et al., 2011). This structural development is linked to the maturation of their intrinsic electrophysiological properties (Manitt et al., 2013). The expression and functionality of dopamine receptors in the PFC change across adolescence in rats (Fig. 26.3; Caballero et al., 2016; Jordan & Andersen, 2017; Naneix, Marchand, Scala, Pape, & Coutureau, 2012), although this age-dependent expression pattern is less apparent in mice (Cullity, Madsen, Perry, & Kim, 2018; Pokinko et al., 2017). The changing influence of dopamine over PFC neurons is proposed to establish the precise balance of excitation and inhibition necessary for information processing (Caballero et al., 2016). In fact, we have recently confirmed that dopamine development in the PFC drives the establishment of local networks because alterations to the extent and/or organization of dopamine input to the PFC result in significant reorganization of postsynaptic pyramidal neuron morphology and function, ultimately manifesting as changes in the performance of PFC-dependent cognitive tasks (Reynolds, Pokinko, et al., 2018). The same developmental pattern of PFC dopamine receptor expression seen in rodents has been observed in humans (Rothmond, Weickert, & Webster, 2012; Weickert et al., 2007), suggesting that the role of dopamine as a driver of PFC development is conserved. The maturation of dopamine input to the PFC has indeed been proposed to drive both dendritic spine pruning from pyramidal neurons across human adolescence (Petanjek et al., 2011) and adolescent cognitive development (Galvan, 2017; Luciana, Wahlstrom, Porter, & Collins, 2012; Wahlstrom, White, & Luciana, 2010). While an adolescent increase in PFC dopamine innervation density has been observed in both male and female rodents (Willing, Cortes, Brodsky, Kim, & Juraska, 2017), the extent of sex differences in this process remains understudied. Age (PND) 0 21 35 49 60 75 90 FIGURE 26.3 Dopaminergic maturation of the prefrontal cortex in adolescence. In primates and in rodents (highlighted here), dopamine innervation density increases across adolescence before stabilizing in adulthood (>PND 60). Postsynaptic neurons mature across the same timeline, with mature responses to dopaminergic modulation emerging over the adolescent period. Together, these maturation changes are thought to calibrate cognitive function in adolescence (Caballero et al., 2016). 298 PART | II Impairments and diseases Given that sex hormone receptor expression by dopamine neurons differs significantly between male and female rodents (Kritzer & Creutz, 2008), whether the adolescent development of PFC dopamine innervation is a puberty-dependent or puberty-independent process remains a key question (Juraska & Willing, 2017; Walker et al., 2017). The Netrin-1/DCC guidance cue system is a molecular regulator of PFC dopamine development In the search for molecular mechanisms controlling adolescent brain development, the Netrin-1/DCC guidance cue system has emerged as a critical regulator of the establishment of dopamine input to the PFC in adolescence. Guidance cues are secreted soluble or cell-bound molecules in the extracellular environment that act as a signal for growing axons. Dopamine neurons highly and conspicuously express DCC receptors from embryonic life to adulthood across species including humans (Flores, 2011), whereas its ligand Netrin-1 is expressed in the terminal regions that dopamine axons innervate, including nucleus accumbens (NAc) and PFC (Manitt et al., 2011). Expression levels of DCC and Netrin-1 are high during embryonic and early postnatal development and wane across adolescence until reaching a plateau in adulthood (Cuesta et al., 2018; Manitt et al., 2010). Their function also seems to change from early life to adulthood: once axon growth is completed, they contribute to synaptic plasticity and maintenance (Glasgow et al., 2018; Horn et al., 2013; Yetnikoff, Labelle-Dumais, & Flores, 2007). Netrin-1 signaling through DCC receptors mediates guidance “decisions” that axons make at intermediate choice points along their pathfinding trajectory or once they reach their target (Deiner et al., 1997; Nelson & Colón-Ramos, 2013). During adolescence, DCC signaling within dopamine neurons actively segregates between axons that will innervate the NAc (mesolimbic) and those that will grow to the PFC (mesocortical) (Fig. 26.4; Manitt et al., 2013, 2011; Reynolds, Pokinko, et al., 2018). Reduced DCC function within dopamine neurons during adolescence induces targeting errors in mesolimbic dopamine axons, leading to their ectopic growth to the PFC (Reynolds, Pokinko, et al., 2018). Shifting the balance of DCC-dependent dopamine axon growth to the PFC in adolescence leads to profound changes in the structure and function of postsynaptic neurons, altered sensitivity to psychostimulant drugs of abuse, and enduring changes to performance on PFC-dependent cognitive tasks that persist into adulthood (Manitt et al., 2013, 2011; Pokinko, Moquin, Torres-Berrío, Gratton, & Flores, 2015; Reynolds, Pokinko, et al., 2018). DCC haploinsufficiency also occurs in humans and results in altered VTA-PFC connectivity and behavioral phenotypes related to addiction (Vosberg et al., 2018). Prefrontal cortex Dopamine neuron DCC receptor Netrin-1 expression Ventral tegmental area Nucleus Accumbens FIGURE 26.4 Netrin-1/DCC signaling in dopamine neurons determines their targeting in adolescence. Dopamine neurons with high DCCexpressing axons innervate the nucleus accumbens (NAc), a region of low Netrin-1 expression. Dopamine neurons that express little or no DCC in their axons do not recognize the NAc as their final target and instead continue to grow toward the prefrontal cortex (PFC). DCC receptors actively segregate axons into the mesocortical (PFC-projecting) and mesolimbic (NAc- projecting) pathways during adolescence. Adolescence, dopamine, and mental health Chapter | 26 299 Evidence for the involvement of DCC signaling in psychopathologies is rapidly exploding (Vosberg, Leyton, & Flores, 2019). Multiple independent genome-wide association studies (GWAS) have linked polymorphisms in the human DCC gene to psychopathologies marked by PFC dysfunction and adolescent onset. Single nucleotide polymorphisms (SNPs) in DCC have been found in patients suffering from major depressive disorder (Vosberg et al., 2019), and both postmortem and translational studies suggest a causal role for PFC DCC in depression-like behaviors (Manitt et al., 2013; Torres-Berrío et al., 2017). SNPs in the DCC gene have also been identified in schizophrenia, Parkinson’s disease, and addiction patient populations (Grant, Fathalli, Rouleau, Joober, & Flores, 2012; Kim et al., 2011; Li et al., 2016; Smeland et al., 2017). Drugs of abuse alter adolescent dopamine development via DCC signaling During adolescence organisms are often navigating complex environments alone for the first time, setting the occasion for a unique period of sensitivity to environmental influence over PFC development (Kolb et al., 2012). Among environmental factors, drug use in adolescence is common and is known to increase vulnerability to later psychiatric diseases, particularly those involving PFC impairments such as addiction (Anthony & Petronis, 1995; Grant & Dawson, 2003; Robins & Przybeck, 1985), schizophrenia (Andréasson et al., 1987; French et al., 2015; Weiser, Knobler, Noy, & Kaplan, 2002), and depression (Brook et al., 2002; Hallfors et al., 2005). Despite this risk, adolescence remains a period of drug experimentation, and over half of drug use initiates in any given year are under the age of 18 years old (SAMHSA, 2012; Swendsen et al., 2012). Because this time of high likelihood to begin taking drugs overlaps with ongoing PFC development, drug use in adolescence has been suggested to confer later addiction risk by disrupting ongoing cortical and cognitive maturation. Individuals struggling with addiction in adulthood show deficits in cognitive behaviors and PFC function (Goldstein & Volkow, 2011), and PFC activation during a cognitive task in adolescence is associated with later substance use level, particularly when that individual is already a drug user (Mahmood et al., 2013). However, the causal relationship between cognitive function, adolescent drug use, and later addiction cannot be determined from clinical studies. Preclinical studies have shed light into this matter, indicating that adolescent exposure to drugs alters the development and function of the mesocorticolimbic dopamine system and the PFC in particular (Gulley & Juraska, 2013; Jordan & Andersen, 2017). While many classes of drugs may impact adolescent development, the stimulant drug amphetamine is of particular translational relevance: it is taken for therapeutic purposes, but also prescription drug misuse by adolescents is an increasingly common pathway to drug abuse (McCabe, West, Morales, Cranford, & Boyd, 2007). Exposure to amphetamine at recreational-like doses in adolescent rats has been shown to alter PFC dopamine receptor levels, change the electrophysiological properties of pyramidal neurons, and lead to cognitive impairments (Gulley & Juraska, 2013). Until recently, the molecular mechanisms by which amphetamine interferes with adolescent PFC development remained unknown. We have found that repeated exposure to a recreational-like dose of amphetamine downregulates the expression of DCC only during early adolescence (Cuesta et al., 2019, 2018; Yetnikoff, Almey, Arvanitogiannis, & Flores, 2011; Yetnikoff et al., 2007; Yetnikoff, Pokinko, Arvanitogiannis, & Flores, 2014). We also showed that early adolescence is a critical period where exposure to amphetamine leads to long-term impairments in cognitive function and dopamine function in the PFC of mice (Reynolds & Flores, 2019; Reynolds et al., 2015; Reynolds, Yetnikoff, et al., 2018). These negative long-term effects of exposure to amphetamine in early adolescence are limited to doses corresponding to those taken recreationally by humans, as exposure to a dose that reaches a therapeutic-like plasma concentration upregulates DCC protein expression in the VTA (Cuesta et al., 2019). In turn, therapeutic-like exposure in adolescence does not disrupt PFC dopamine organization and leads to improved cognitive performance in adulthood (Cuesta et al., 2019), in line with studies in nonhuman primates (Soto et al., 2012). Thus, the type of the experience, positive or negative, can bidirectionally regulate DCC expression, suggesting that DCC functions as a plasticity gene rather than a vulnerability gene (Barth, Portella, Dubé, Meaney, & Silveira, 2019; Belsky, Jonassaint, Pluess, antonBrummett, & Williams, 2009). MicroRNAs: linking experience, DCC expression, and adolescent dopamine development Experiences in adolescence can regulate Dcc messenger RNA (mRNA) and protein expression by recruiting the microRNA, miR-218 (Cuesta et al., 2018; Torres-Berrío et al., 2017, 2019). MicroRNAs are potent regulators of mRNA stability and translation and can link experience to alterations in protein expression, neuronal structure, and function across development (Hollins & Cairns, 2016). We identified miR-218 as a powerful repressor of DCC expression in mouse and human adult PFC pyramidal neurons and showed that it mediates stress-induced dysregulation of DCC expression and 300 PART | II Impairments and diseases Normal Adolescent Development Dopamine neuron Amphetamine exposure in adolescence DCC receptor miR-218 expression Low / therapeutic dose High / recreational dose FIGURE 26.5 Amphetamine in adolescence regulates DCC expression in dopamine neurons via microRNA miR-218. The microRNA miR-218 is a posttranscriptional repressor of Dcc and is differentially expressed across the lifetime. Amphetamine in adolescence regulates DCC expression in a miR218-dependent manner as a function of drug dose. Low doses that produce a therapeutic-like plasma amphetamine concentration do not regulate miR-218 expression, but increase DCC protein expression most likely via posttranslational mechanisms. In contrast, high doses that reach a recreational use-like plasma amphetamine concentration upregulate miR-218 expression and, in turn, decrease DCC mRNA and protein levels. Thus, positive and negative experiences can bidirectionally regulate DCC expression via miR-218. depression-like outcomes (Torres-Berrío et al., 2017), acting as a molecular switch of susceptibility and resilience (TorresBerrío et al., 2019). MiR-218 is expressed in dopamine neurons at levels inversely correlated with DCC expression across the lifetime (Cuesta et al., 2018), and amphetamine in adolescence recruits miR-218 to decrease DCC levels in dopamine neurons in an age- and dose-dependent manner (Fig. 26.5; Cuesta et al., 2019). Thus, miR-218/DCC interaction may be a molecular mechanism by which adolescent experiences program adult brain structure, regulating vulnerability or resilience to psychiatric disease. Conclusion Adolescence is a dynamic developmental period defined in part by a changing PFC. The extended maturation of the PFC is a unique window of plasticity for environmental factors to confer risk for, or protection from, psychiatric disorders. The gradual unfolding of dopamine connectivity dictates PFC development and is controlled by Netrin-1/ DCC guidance cue signaling. Susceptibility factors, such as abused drugs, regulate Netrin-1/DCC function via posttranscriptional mechanisms, influencing PFC and cognitive trajectories. Micro-RNA regulation of Dcc expression in adolescence controls PFC development allowing experience to construct adult networks. Emerging evidence that both positive and negative interventions regulate DCC levels, albeit in an opposite manner, suggests that DCC is a plasticity gene rather than a vulnerable gene. This molecular pathway represents an opportunity to develop interventions aimed at reducing the incidence of psychiatric disease by promoting healthy brain development and cognitive maturation in adolescence. Applications to other areas of development Here we reviewed the role of dopamine innervation in organizing the maturation of the prefrontal cortex, identified a key molecular pathway regulating adolescent dopamine development, and described how environmental factors impact the molecular, anatomical, and functional development of the adolescent brain conferring either susceptibility or resilience to psychiatric disease. We focus on the mesocortical dopamine pathway; however, recent evidence also suggests that later postnatal axon growth may extend to other pathways (Arruda-Carvalho, Wu, Cummings, & Clem, 2017; Yetnikoff, Reichard et al., 2014). Adolescence, dopamine, and mental health Chapter | 26 301 Key facts Key facts of axon growth l l l l l Axons are the projections of neurons that conduct action potentials away from the soma toward downstream signaling partners. Axons grow long distances to reach their targets using guidance cues to navigate their path. Most long-distance axonal growth occurs during embryonic and early postnatal development. Mesocortical dopamine axons continue to grow long distances across adolescence, undergoing targeting “decisions” along their path. Adolescent axon growth is particularly vulnerable to environmental insult. Summary points l l l l l l l l Adolescence is a period of dynamic physical, hormonal, and behavioral changes. Psychiatric conditions, including major depression, addiction, and schizophrenia, are most likely to emerge in adolescence. The prefrontal cortex continues to develop in adolescence and is dysfunctional in psychiatric disease. Experience in adolescence shapes prefrontal cortex development. Dopamine input to the prefrontal cortex drives its maturation. Guidance cue genes organize the targeting and growth of dopamine pathways, are regulated by experience in adolescence, and are altered in psychiatric disorders. 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