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Cholinergic modulation of disorder-relevant human defensive behaviour in generalised anxiety disorder

  • Department of Psychological Medicine
  • King's College London
  • National Institute for Health Research Mental Health Biomedical Research Centre
  • SLaM South London and Maudsley NHS Foundation Trust
  • Neuroimaging Department
  • Wellcome Trust Centre for Neuroimaging
  • St George's, University of London
  • Max Planck UCL Centre for Computational Psychiatry and Ageing Research
  • Department of Psychology, Szkoła Wyzsza Psychologii Społeczne, University of Social Sciences and Humanities, Warsaw, Poland.
  • California Institute for Telecommunications and Information Technology (Calit2), University of California San Diego, La Jolla, California, USA.
  • Department of Psychosis Studies
  • Leiden University
  • Biotrial, Paris, France.
  • Bionomics Ltd
  • Guilford Pharmaceuticals Inc

Research output: Contribution to journalArticlepeer-review

13 Citations (Scopus)

Abstract

Drugs that are clinically effective against anxiety disorders modulate the innate defensive behaviour of rodents, suggesting these illnesses reflect altered functioning in brain systems that process threat. This hypothesis is supported in humans by the discovery that the intensity of threat-avoidance behaviour is altered by the benzodiazepine anxiolytic lorazepam. However, these studies used healthy human participants, raising questions as to their validity in anxiety disorder patients, as well as their generalisability beyond GABAergic benzodiazepine drugs. BNC210 is a novel negative allosteric modulator of the alpha 7 nicotinic acetylcholine receptor and we recently used functional Magnetic Resonance Imaging to show it reduced amygdala responses to fearful faces in generalised anxiety disorder patients. Here we report the effect of BNC210 on the intensity of threat-avoidance behaviour in 21 female GAD patients from the same cohort. We used the Joystick Operated Runway Task as our behavioural measure, which is a computerised human translation of the Mouse Defense Test Battery, and the Spielberger state anxiety inventory as our measure of state affect. Using a repeated-measures, within-subjects design we assessed the effect of BNC210 at two dose levels versus placebo (300 mg and 2000 mg) upon two types of threat-avoidance behaviour (Flight Intensity and Risk Assessment Intensity). We also tested the effects of 1.5 mg of the benzodiazepine lorazepam as an active control. BNC210 significantly reduced Flight Intensity relative to placebo and the low dose of BNC210 also significantly reduced self-reported state anxiety. Risk Assessment Intensity was not significantly affected. Results show both human defensive behaviour and state anxiety are influenced by cholinergic neurotransmission and there provide converging evidence that this system has potential as a novel target for anxiolytic pharmacotherapy.

Original languageEnglish
Article number13
Pages (from-to)13
JournalTranslational psychiatry
Volume11
Issue number1
DOIs
Publication statusPublished - Jun 2021

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