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The Journal of Neuroscience, January 1, 2003, 23(1):12-16
BRIEF COMMUNICATION
Chronic Cocaine Self-Administration Upregulates the
Norepinephrine Transporter and Alters Functional Activity in the
Bed Nucleus of the Stria Terminalis of the Rhesus Monkey
Darrel J.
Macey,
Hilary R.
Smith,
Michael A.
Nader, and
Linda J.
Porrino
Center for the Neurobiological Investigation of Drug Abuse,
Department of Physiology and Pharmacology, Wake Forest University
Health Sciences, Winston-Salem, North Carolina 27157
 |
ABSTRACT |
The bed nucleus of the stria terminalis (BNST) is in a key position
to influence the integration of motivational and visceral functions,
receiving inputs from limbic regions, including the amygdala, and
sending projections to areas central to reward processing, including
the ventral tegmental area and nucleus accumbens. The BNST also
possesses a high density of noradrenergic fibers. The purpose of the
present studies was to characterize the effects of cocaine
self-administration on the regulation of norepinephrine transporter
(NET) distribution and functional activity in the BNST of rhesus
monkeys in the initial (5 d) or chronic (100 d) phases of cocaine
self-administration. NET binding site densities in the BNST were
assessed with quantitative in vitro receptor autoradiography using [3H]nisoxetine, and rates of
local cerebral glucose utilization in the BNST were measured in
the same monkeys using the 2-[14C]deoxyglucose
method. Chronic exposure to cocaine self-administration resulted in
significantly higher NET binding site densities (up to 52% relative to
controls) throughout the BNST. Furthermore, cerebral metabolism was
depressed significantly in a time-dependent manner with larger
decreases after 100 d of cocaine self-administration. These data
represent the first report of significant changes in the regulation of
the NET resulting from cocaine exposure in primates. Furthermore, given
the role of the BNST in cocaine withdrawal and stress-related
reinstatement of self-administration, the changes reported here may
provide a substrate for these phenomena.
Key words:
cocaine; self-administration; bed nucleus of the
stria terminalis; norepinephrine; receptor autoradiography; local
cerebral glucose utilization
 |
Introduction |
Cocaine is a powerful psychomotor
stimulant known to be one of the most strongly reinforcing drugs of
abuse. Cocaine binds to dopamine, serotonin, and norepinephrine (NE)
transporters (NET) (Ritz et al., 1990 ; Florin et al., 1994 ), blocking
the reuptake of these monoamines into presynaptic terminals, thereby
increasing neurotransmitter concentrations. The interaction of cocaine
with dopamine systems has been considered critical to its reinforcing effects (Roberts et al., 1980 ; Goeders and Smith, 1983 ; Ritz et al.,
1987 ; Giros et al., 1996 ); therefore, much attention has been paid to
alterations in the regulation of dopamine (DA) transporters and
receptors as a result of long-term exposure to cocaine (Farfel et al.,
1992 ; Volkow et al., 1993 , 1999 ; Letchworth et al., 2001 ; Nader et al.,
2002 ; Porrino et al., 2002a ).
Far less attention has been paid, however, to the role of
noradrenergic systems as mediators of the acute or chronic actions of cocaine, although cocaine accumulates in high concentrations in
NE-rich brain regions (Madras and Kaufman, 1994 ). Several
reports, however, have documented altered noradrenergic tone during
cocaine withdrawal in human cocaine abusers (McDougle et al., 1994 ;
Kampman et al., 2001 ). The administration of the 2-adrenergic
receptor antagonist yohimbine immediately after the cessation of
cocaine use produced an increased susceptibility to panic anxiety
(McDougle et al., 1994 ), suggesting that dysregulation of the
noradrenergic system may accompany long-term cocaine exposure.
The bed nucleus of the stria terminalis (BNST), a key component of the
extended amygdala, contains one of the highest regional densities of
noradrenergic fiber inputs (Brownstein and Palkovits, 1984 ) and NET
binding sites (Tejani-Butt, 1992 ), receiving projections primarily from the noradrenergic cell-containing regions of the caudal medulla (Roder and Ciriello, 1994 ). Recent reports have suggested that the BNST plays a role in drug reinforcement processes. The dopamine D1 receptor antagonist
SCH 23390 administered bilaterally into the rat BNST effectively
reduces the reinforcing effects of cocaine (Epping-Jordan et al.,
1998 ), and the BNST has been shown to be critical in mediating
stress-induced reinstatement of cocaine self-administration in rodent
models (Shaham et al., 2000 ; Leri et al., 2002 ).
Given the role of the BNST in mediating the effects of cocaine, in
conjunction with dense noradrenergic innervation of the BNST, the
purpose of the present study was to investigate in monkeys the effects
of chronic cocaine self-administration in the BNST on both functional
activity, as measured with the
2-[14C]deoxyglucose (2-DG) method, and
the concentration of the NET, measured autoradiographically in the same
animals. To this end, a nonhuman primate model of self-administration
was used in which the effects of increasing durations of cocaine
exposure on both glucose utilization and NET density were measured
within the BNST.
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Materials and Methods |
Subjects. Fourteen experimentally naive adult male
rhesus monkeys (Macaca mulatta), 6-13 years old and
weighing 7.5-13.0 kg under free-feeding conditions at the inception of
the study, were housed individually in stainless steel cages and
maintained in temperature- and humidity-controlled colony rooms on a
14/10 hr light/dark cycle (lights on at 6:00 A.M.). Monkeys were
maintained at 90-95% of their free-feeding weights, and water was
available ad libitum. All procedures were performed in
accordance with established practices as described in the NIH
Guide for Care and Use of Laboratory Animals. Protocols were
reviewed and approved by the Animal Care and Use Committee of Wake
Forest University.
Cocaine self-administration. Training and
self-administration procedures have been described previously (Nader et
al., 2002 ). Monkeys were trained initially to respond under a
fixed-interval 3 min schedule of food presentation. When
food-maintained responding was stable, responding was extinguished for
five consecutive sessions. After food-maintained responding was
reestablished, indwelling intravenous catheters and vascular access
ports for drug delivery were implanted. Control monkeys (5 d,
n = 4; 100 d, n = 2) continued to
respond under the same food presentation schedule for the duration of testing.
Cocaine self-administration under the fixed-interval 3 min schedule was
established in two groups of monkeys (n = 4 per group) by substituting cocaine (0.3 mg/kg per injection) for food. The cocaine
groups differed by length of cocaine exposure: 5 d was chosen to
represent a model of the earliest stages of cocaine exposure, and
100 d represented chronic cocaine exposure. All sessions ended
after 30 reinforcer presentations. Experimental sessions were conducted
7 d/week at approximately the same time each day. Total lifetime
cocaine intake was 45 and 900 mg/kg for the 5 and 100 d groups,
respectively. The average weekly cocaine intake of the chronic monkeys
(63 mg/kg) was within the range of reported weekly intakes of human
cocaine addicts (43-329 mg/kg on the basis of the average 70 kg man)
(Volkow et al., 1993 , 1999 ). A detailed analysis of the behavioral data
has been reported previously (Nader et al., 2002 ).
Measurement of local cerebral glucose utilization. The
animals' catheters exited through an opening in the rear of the
chamber, allowing all infusions and sampling to be accomplished
remotely with minimal disruption to the animal. The 2-DG procedure has been described in detail previously (Porrino et al., 2002b ). Briefly, a
pulse of 75 µCi/kg
2-deoxy-D-[14C]glucose
(specific activity, 50-55 mCi/mmol; DuPont NEN, Boston, MA) was
infused intravenously, followed by the collection of timed arterial
blood samples drawn at a schedule sufficient to define the time course
of the arterial 2-[14C]deoxyglucose and
glucose concentrations. At ~45 min after tracer injection, the
animals were killed by an intravenous overdose of sodium pentobarbital
(100 mg/kg). Brains were removed rapidly, blocked, frozen in
isopentane, and stored at 70°C until processed. Coronal sections
(20 µm) were cut in a cryostat, thaw mounted on glass coverslips, and
apposed to Kodak MR-1 film (Eastman Kodak, Rochester, NY) for 15-30 d,
along with a set of
[14C]methylmethacrylate standards
(Amersham Biosciences, Arlington Heights, IL) calibrated previously for
their equivalent 14C concentration in 20 µm brain sections.
[3H]nisoxetine
autoradiography. Coronal sections (20 µm) adjacent to sections
used for 2-DG autoradiography were thaw mounted onto
chrome-alum-gelatin-subbed slides or electrostatically charged slides,
desiccated, and stored at 80°C until processed.
The distribution of [3H]nisoxetine
binding sites was assessed with quantitative in vitro
receptor autoradiography according to procedures adapted from previous
research (Tejani-Butt, 1992 ). Tissue sections were preincubated at room
temperature in buffer (in mM: 50 Tris, 300 NaCl,
and 5 KCl, pH 7.4) for 20 min to remove any residual cocaine and
[14C]2-DG. Sections were then incubated
for 4 hr at 4°C in buffer containing 3.0 nM
[3H]nisoxetine (80 Ci/mmol) (PerkinElmer
Life Sciences, Boston, MA) in the presence (nonspecific binding) or
absence (total binding) of 1 µM mazindol.
Sections were rinsed three times (5 min each) in buffer at 4°C, with
a final 10 sec rinse in ice-cold water. Sections were dried immediately
under a stream of cold air and placed on
Hyperfilm-3H in the presence of
[3H] standards (Amersham Biosciences).
After exposure times of 2-6 weeks, films were developed with Kodak GBX
developer, fixed, and rinsed.
Measurement of rates of glucose utilization and
[3H]nisoxetine binding was conducted by
quantitative densitometry with a computerized image processing system
(MCID; Imaging Research, St. Catharines, Ontario) as described
previously (Porrino et al., 2002b ). Nomenclature and identification of
the BNST subdivisions measured for optical densities were according to
the work of Martin et al. (1991) in thionin-stained sections. Tissue
equivalent values (2-DG, µmol/100 gm per minute; NET, femtomoles per
milligram of wet weight tissue) were determined from the optical
densities and from a calibration curve obtained by densitometric
analysis of 14C or tritium standards,
respectively. Specific binding was determined by subtracting
nonspecific binding values from total binding values measured in
adjacent sections.
Statistical analysis. Statistical analyses
(SPSS, Chicago, IL) of rates of glucose utilization and specific
binding values were performed for each BNST subdivision by means of a
one-way ANOVA, followed by least-significant difference multiple
comparisons of cocaine self-administration groups to controls.
 |
Results |
No significant differences in metabolism or NET
density were observed between the 5 and 100 d control subjects
(n = 4 and n = 2, respectively);
therefore, their results were combined throughout.
Cocaine self-administration produced large duration-dependent
reductions in cerebral glucose utilization throughout all segments of
the BNST (Fig. 1). After 5 d of
self-administration, glucose utilization was altered, compared with
controls, in the lateral subdivision of the BNST (BNSTL) ( 17.5%),
ventral subdivision of the BNST (BNSTV) ( 15.6%), and lateral dorsal
BNST (BNSTLD) ( 20.3%). After chronic exposure, alterations in
cerebral metabolism were of a greater magnitude and included the entire
BNST-BNSTL ( 26.8%), medial subdivision of the BNST (BNSTM)
( 27.7%), BNSTV ( 31.6%), and the BNSTLD ( 30.8%).

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Figure 1.
The effect of cocaine self-administration on
cerebral metabolism in the BNST. Monkeys with 100 d of cocaine
self-administration experience exhibited significantly reduced glucose
utilization in the BNST compared with food controls
(*p < 0.05; **p < 0.01) and
monkeys with 5 d of exposure to cocaine (#p < 0.05).
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|
The binding pattern of [3H]nisoxetine to
NET in control animals was highly heterogeneous (Fig.
2). The highest NET binding densities
were observed in the BNSTLD (45.6 fmol/mg wet weight tissue) and the
BNSTV (35.0 fmol/mg). Concentrations of
[3H]nisoxetine binding were lower in the
BNSTM (25.9 fmol/mg) and the BNSTL (23.2 fmol/mg).

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Figure 2.
The effect of cocaine self-administration on NET
distribution in the BNST. In most of the subregions of the BNST,
monkeys with 100 d of cocaine self-administration experience
exhibited significantly greater [3H]nisoxetine
binding densities than food controls (*p < 0.05;
**p 0.01) and monkeys with 5 d of exposure
to cocaine (#p < 0.05; ##p < 0.01).
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|
Cocaine self-administration induced duration-dependent increases in
[3H]nisoxetine binding site densities in
all BNST subregions examined (Figs. 2,
3). Although 5 d of cocaine
self-administration did not significantly alter the density of
[3H]nisoxetine binding sites, 100 d
of cocaine exposure resulted in significantly higher
[3H]nisoxetine binding site densities
compared with controls. After chronic self-administration, the
increases in NET density were significant in the BNSTL (+52%), the
BNSTM (+38%), and the BNSTV (+46%).

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Figure 3.
Comparison of [3H]nisoxetine
binding in the BNST of representative control and chronic cocaine
self-administration monkeys. Shown are coronal sections through the
BNST. At left is a schematic diagram depicting the
spatial organization of subregions within the BNST in which the
densities of [3H]nisoxetine binding sites were
quantified. At right are color-coded transformations of
autoradiograms of [3H]nisoxetine binding sites in
the BNST of a food control (left) and chronic (100 d)
cocaine monkey (right). Each color
represents a range of values expressed as femtomoles per milligram of
wet weight tissue. Higher levels of [3H]nisoxetine
binding are visible throughout the BNST of the chronic cocaine monkey.
ac, Anterior commissure; amy, amygdala;
cc, central commissure; Cd, caudate
nucleus; GP, globus pallidus; Hyp,
hypothalamus; ic, internal capsule; ot,
optic tract; SFi, septofimbrial nucleus;
SId, dorsal substantia innominata; SIv,
ventral substantia innominata.
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|
 |
Discussion |
The present data demonstrate that profound structural and
functional alterations develop throughout all portions of the BNST as a
result of chronic cocaine self-administration. Cerebral metabolism in
the BNST was changed even in the earliest stages of cocaine exposure.
These changes intensified over time, suggesting that information
processing in this brain region, critical to stress and autonomic
function, is disrupted increasingly over the course of cocaine
self-administration experience. In addition to these functional
alterations, changes in the regulation of the NET within the BNST
developed in response to continued cocaine self-administration, with
apparent upregulation evident in all of the subdivisions of the BNST.
The changes in NET density reported here were particularly profound,
larger in percentage than any changes in DA transporter or the density
of DA D1 or D2 receptors
reported within the striatum of the same monkeys (Letchworth et al.,
2001 ; Nader et al., 2002 ; Porrino et al., 2002a ) or in studies of the
DA system in human cocaine abusers (Volkow et al., 1993 , 1999 ; Staley
et al., 1994 ; Staley and Mash, 1996 ; Little et al., 1999 ). Although
many of the behavioral effects of cocaine have generally been
attributed to its actions on the DA system, the robust changes in the
distribution of the NET reported here, along with the increasing
magnitude of the functional alterations that accompany them, suggest
that the noradrenergic system of the BNST may be an important component in the development of the neuroadaptations that accompany chronic cocaine use. The BNST in humans can be difficult to distinguish with
most neuroimaging techniques but was readily visualized
autoradiographically in the present study of nonhuman primates. These
data, then, represent the first report of significant changes in either
functional activity or the regulation of the noradrenergic system in a
primate species.
Several reports have demonstrated an altered responsiveness to acute
administration of cocaine in NET (Xu et al., 2000 ) and 1b-adrenergic
receptor (Drouin et al., 2002 ) knock-out mice, supporting the potential
importance of central NE systems in the effects of cocaine. It is,
however, with chronic cocaine treatment that the role of NE systems in
the BNST is most apparent. Antagonism of NE function by the activation
of 2-adrenergic receptors in the amygdala and
prefrontal cortex and by the blockade of -adrenergic receptors in
the ventrolateral BNST, for example, has been reported to prevent the
stress-mediated reinstatement of cocaine seeking in abstinent rats
while not altering reinstatement induced by cocaine itself (Shaham et
al., 2000 ; Leri et al., 2002 ). Moreover, noradrenergic function during
cocaine withdrawal in rats has been implicated pharmacologically in
brain stimulation reward threshold elevations, changes indicative of
"anhedonia" (Markou et al., 1992 ). The role for the noradrenergic
system in cocaine withdrawal is consistent with findings of similar
noradrenergic involvement in opiate withdrawal (Aston-Jones et al.,
1999 ). The upregulation of the NET reported here may provide a
substrate for the involvement of NE systems in the BNST after long-term
exposure to cocaine.
The BNST is an important substrate of autonomic and visceral
functions, including autonomic responses to stressors (Roder and Ciriello, 1994 ; Koob, 1999 ). In addition to possessing one of
the highest densities of cerebral noradrenergic fiber inputs, the BNST
exhibits immunolabeling for corticotropin-releasing factor (CRF) and
contains a dense population of CRF receptors (Brownstein and Palkovits,
1984 ; Shaham et al., 2000 ; Van Bockstaele et al., 2001 ). CRF injected
into the BNST in the absence of external stressors can induce the
reinstatement of cocaine seeking in rats, whereas administration of a
CRF receptor antagonist into the BNST attenuates stress-induced
reinstatement (Shaham et al., 2000 ; Erb et al., 2001 ). In turn, the
BNST in both nonhuman primates and rodents has been shown to have
strong inputs to dopaminergic populations in the ventral tegmental area
(VTA) and substantia nigra (Krettek and Price, 1978 ; Fudge and Haber,
2001 ), and its stimulation can activate DA neurons in the VTA
(Aston-Jones et al., 1999 ; Georges and Aston-Jones, 2001 , 2002 ). The
increasing reductions in functional activity in the BNST as reported
here, then, may inhibit activation of DA neurons throughout the reward
circuitry. Such suppression may lead to the perpetuation of drug taking
as a means to compensate for this deficit. Furthermore, because NE
release in the BNST stimulates release of the stress hormone CRF in
this region (Koob, 1999 ) and because anhedonia, as measured by elevated
intra-VTA self-stimulation reward thresholds, is accompanied by
profound increases in CRF concentrations in the BNST (Stout et al.,
2000 ), it is conceivable that elevated CRF levels in the BNST
associated with increased noradrenergic tone may also dysregulate brain
reward function. Behaviorally and anatomically, then, the BNST acts as an interface between stress and reward systems.
In human cocaine abusers, high levels of anxiety are a frequent symptom
of the early phases of drug abstinence. During this time, panic attacks
can be elicited by the 2-adrenergic receptor antagonist yohimbine in
cocaine-dependent subjects, and the -adrenergic antagonist
propranolol was shown recently to both ameliorate cocaine withdrawal
symptom severity effectively in early abstinence and improve treatment
outcome (McDougle et al., 1994 ; Kampman et al., 2001 ). The present
findings may provide a mechanism for the heightened reactivity of the
noradrenergic system that accompanies cocaine withdrawal.
However, the finding that the NET removes both NE and DA from the
synaptic space makes it difficult to determine with certainty the
specificity of the cause and function of NET upregulation during
chronic cocaine exposure. In fact, in this regard, the NET possesses an
even higher affinity for DA than for NE (Pacholczyk et al., 1991 ).
Therefore, DA binding to the NET may also contribute to the chronic
effects of cocaine. In vivo microdialysis studies have shown
that cocaine dose dependently elevates extracellular DA levels in the
BNST (Carboni et al., 2000 ). It is not clear, therefore, whether NET
upregulation in the BNST results from altered dopaminergic or
noradrenergic function, or both, and which neurotransmitter system is
most influenced by this upregulation. Additional experimentation is
necessary to address this question.
A number of studies have demonstrated that cocaine dose dependently
increases extracellular NE in the rat hippocampus, prefrontal cortex,
and nucleus accumbens (Florin et al., 1994 ; Li et al., 1996 ). In turn,
NE appears to suppress neuronal firing in the BNST (Casada and Dafny,
1993 ), thereby inhibiting the release of the excitatory transmitter
glutamate in the BNST (Forray et al., 1999 ). This cocaine-induced tonic
inhibition may translate into depressed cerebral metabolic rates
(Porrino et al., 2002b ). Consequently, prolonged presence of cocaine
could account for both increased NET binding densities (neuroadaptive
upregulation caused by increased NE concentrations) and reduced
cerebral metabolism (caused by noradrenergic inhibition of
glutamatergic activity) in the BNST.
The BNST and central nucleus of the amygdala are both components of the
"extended amygdala" and share similar morphology, connectivity, and
function (including involvement in stress-induced reinstatement of
cocaine-seeking behavior) (Alheid and Heimer, 1988 ; Leri et al., 2002 ).
Although rates of glucose utilization were reduced similarly in both
regions after chronic cocaine self-administration (27-32 vs 26%,
respectively), the levels of NET binding in the central nucleus of the
amygdala were unaltered at this time point (our unpublished
observations). Changes in the density of the NET consequent to chronic
cocaine are therefore highly selective within the extended amygdala.
In conclusion, the results of this study suggest that chronic cocaine
exposure leads to significant functional neuroadaptations in the BNST,
accompanied by a profound upregulation in NET binding site density.
Given the stress- and reward-related functions of the BNST in the CNS
and the recent findings that the noradrenergic system can possess
reinforcing properties, the presence of long-term neuroadaptations in
this region may contribute to the manifestation of cocaine
withdrawal-induced stress and reduced reward function.
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FOOTNOTES |
Received Aug. 2, 2002; revised Oct. 15, 2002; accepted Oct. 17, 2002.
This work was supported by United States Public Health Service Grants
DA-09085 and DA-06634 from the National Institute on Drug Abuse. We
thank Susan Nader, Clifford Hubbard, and Tonya Moore for assistance in
the conduct of these experiments.
Correspondence should be addressed to Dr. Linda Porrino, Department of
Physiology and Pharmacology, Wake Forest University School of Medicine,
Medical Center Boulevard, Winston-Salem, NC 27157. E-mail:
lporrino{at}wfubmc.edu.
 |
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