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Vol. 282, Issue 3, 1213-1218, 1997
Max Planck Institute of Psychiatry, Clinical Institute, Munich, Germany (M.L., J.F., T.S., F.H., R.R.), and Universita' Tor Vergata, Dipartimento di Medicina Sperimentale, Rome, Italy (E.R., F. di M.)
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Abstract |
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Recent research in rats and humans has shown that exogenous
progesterone evokes a sleep profile similar to that induced by agonistic modulators of
-aminobutyric acidA
receptors, such as benzodiazepines. This finding suggests the
involvement of the neuroactive metabolite of progesterone,
allopregnanolone. In the vehicle-controlled study reported here, we
assessed the sleep effects of two doses of allopregnanolone (7.5 and 15 mg/kg), mixed with oil, administered intraperitoneally at light onset
in 8 rats. The electroencephalogram (EEG) and electromyogram were
recorded during the first 6 postinjection hr. Compared with vehicle,
both doses of allopregnanolone reduced the latency to non-rapid eye movement sleep (non-REMS) and 15 mg/kg allopregnanolone significantly increased the time spent in pre-REMS, an intermediate state between non-REMS and REMS. Furthermore, allopregnanolone dose-dependently influenced EEG activity during non-REMS and REMS. In non-REMS, EEG
activity was decreased in the lower frequencies (
7 Hz) and enhanced
in the frequencies of
13 Hz. In REMS, allopregnanolone enhanced
high-frequency EEG activity (
17 Hz). The effects were most pronounced
during the first postinjection hours and gradually diminished
thereafter. Analysis of the plasma and brain concentrations of
allopregnanolone in 45 rats revealed long-lasting increases, which
reached maximal levels during the first postinjection hour. The sleep
effects of allopregnanolone are very similar to those elicited by
larger doses of progesterone, which produce comparable brain levels of
allopregnanolone. These data indicate that the steroid allopregnanolone
has benzodiazepine-like effects on sleep.
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Introduction |
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The
hormone progesterone, which is present in both females and males
(Corpéchot et al., 1993
), is not only produced in
peripheral steroidogenic organs but also synthesized de novo
in the central nervous system (for a review, see Robel and Baulieu,
1994
). Progesterone is known to exert multiple effects on brain
functioning, including a rapid depression of neuronal excitability, as
reflected by its anesthetic (Korneyev and Costa, 1996
; Selye, 1942
),
anxiolytic (Bitran et al., 1993
; Picazo and
Fernández-Guasti, 1995
), anticonvulsant (Landgren et
al., 1987
) and antinociceptive (Frey and Duncan, 1994
) properties.
Several lines of evidence indicate that the central-depressant action
of progesterone is due not so much to the binding of progesterone to
intracellular steroid receptors but rather is chiefly mediated by the
action of its 5
-reduced metabolite 3
-hydroxy-5
-pregnan-20-one
(allopregnanolone) at the membrane-bound GABAA
receptors. Both endogenous and exogenous increases in the level of
progesterone result in rapid elevations of allopregnanolone
concentrations in plasma and brain (Barbaccia et al., 1996
;
Korneyev and Costa, 1996
; Lancel et al., 1996b
; Paul and
Purdy, 1992
). Electrophysiological and biochemical experiments showed
that allopregnanolone is a potent allosteric agonistic modulator of
GABAA receptors (for a review, see Majewska,
1992
), but it may also regulate gene expression via the progesterone receptor after intracellular oxidation (Rupprecht et al.,
1993
). Previous research revealed that the anxiolytic behavior evoked by progesterone is not affected by the progesterone receptor antagonist RU 38486 but is effectively prevented by picrotoxin, an antagonist of
GABAA receptor-associated chloride channels
(Bitran et al., 1995
). Furthermore, 5
-reductase
inhibitors, which block the conversion of progesterone to
allopregnanolone, were found to decrease the anxiolytic and anesthetic
action of P (Bitran et al., 1995
; Korneyev and Costa, 1996
).
Finally, administration of allopregnanolone induces anesthesia
(Korneyev and Costa, 1996
; Mok et al., 1993
) and anxiolytic
behavior (Picazo and Fernández-Guasti, 1995
; Wieland et
al., 1995
) and reduces seizure activity (Belelli et
al., 1989
; Landgren et al., 1987
) and pain sensitivity
(Frey and Duncan, 1994
) at much lower doses than progesterone.
It has recently been shown in the rat that intraperitoneal
administration of progesterone has dose-dependent hypnotic effects: it
shortens sleep latency, decreases time spent in wakefulness and REMS
and selectively promotes pre-REMS, also called intermediate-stage (Gandolfo et al., 1994
) or transition-type sleep (Neckelmann
and Ursin, 1993
). Moreover, spectral analysis of the EEG signals
between 0.5 and 25 Hz revealed that progesterone also affects the EEG activity during non-REMS and REMS in a dose-related manner. During non-REMS progesterone decreases low-frequency (
7 Hz) EEG activity and
enhances EEG activity in the spindle (~11-16 Hz) and
higher-frequency bands. During REMS, it shifts the dominant theta
frequency from 8 Hz to 5 to 6 Hz and elicits a general increase in the
higher frequencies (Lancel et al., 1996b
). In agreement with
these findings in the rat, a dose of 300 mg of micronized progesterone
given orally to male subjects has been shown to reduce non-REMS
latency, to promote stage 2 sleep, to slightly suppress slow-wave sleep and to decrease EEG activity in the lower frequencies and enhance activity in the frequencies >15 Hz during non-REMS (Friess et al., 1997
). Two observations suggest that allopregnanolone is implicated in the influence of progesterone on sleep. First, in both
studies cited, the temporal development of the sleep alterations induced by progesterone is highly correlated with the time course of
the elevations in brain and/or plasma levels of allopregnanolone (Friess et al., 1997
; Lancel et al., 1996b
).
Second, the changes in the time spent in each vigilance state as well
as in sleep state-specific EEG activity after administration of
progesterone are reminiscent of those evoked by benzodiazepine
agonistic modulators of GABAA receptors
(Borbély et al., 1985
; Gandolfo et al.,
1994
; Lancel et al., 1996a
). However, an earlier study in
which two doses (5 and 10 mg/kg) of allopregnanolone were administered
intraperitoneal to male rats failed to show significant effects on
sleep latency and time spent in the sleep states (Mendelson et
al., 1987
).
In the present study, we investigated the influence of allopregnanolone on sleep by injecting male rats with two doses of allopregnanolone, which were mixed with oil to achieve a slower release from the injection site, and by assessing the effects both on sleep duration and on the sleep EEG. To compare the magnitude of the changes in allopregnanolone concentrations with those observed previously after the administration of progesterone, we determined the plasma and brain levels of allopregnanolone at several time points after the administration of vehicle and the two doses of allopregnanolone in a separate group of male rats.
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Methods |
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Influence of allopregnanolone administration on sleep.
The
experiments were approved by the local commission for animal welfare.
Allopregnanolone (Sigma; Deisenhofen, Germany) was dissolved in 35%
hydroxypropyl-
-cyclodextrin (1.5 ml/kg b.wt.), which was kindly
provided by Besins Iscovesco Laboratories (Paris), and thereafter mixed
with corn oil (3 ml/kg b.wt.).
3 days. The treatments consisted of an
intraperitoneal injection of vehicle (35%
hydroxypropyl-
-cyclodextrin and corn oil) and 7.5 mg/kg and 15 mg/kg
allopregnanolone at the beginning of the light period.
The EEG and EMG were continuously recorded during the 12-hr dark period
preceding each treatment and during the first 6 postinjection hr. The
signals were amplified and filtered (EEG: high-pass 0.3 Hz and low-pass
59.5 Hz, 49 dB/oct; EMG: high-pass 16 Hz and low-pass 3000 Hz, 6 dB/oct). Both the EEG and the rectified and integrated EMG were
digitized with a sampling rate of 128 Hz. The EEG recordings were
subjected to an on-line fast Fourier transform routine (cosine taper).
A power spectrum was computed for 2-sec windows in 0.5-Hz bins for the
frequencies between 0.5 and 4.5 Hz and in 1-Hz bins for the frequencies
between 5 and 40.5 Hz. Power spectra were averaged over 10-sec epochs.
An off-line program displayed the 10-sec epochs of raw EEG and of the
rectified and integrated EMG on screen for the manual scoring of the
vigilance states wakefulness, non-REMS, pre-REMS and REMS (for scoring
criteria, see Neckelmann and Ursin, 1993Influence of allopregnanolone administration on its plasma and
brain levels.
Forty-five adult male Wistar rats weighing 310 to
380 g were housed in groups of 5 animals under conditions as
described. Each animal was injected intraperitoneally with vehicle
(n = 5) or 7.5 (n = 20) or 15 (n = 20) mg/kg allopregnanolone at light onset. Under
deep inhalation halothane (Hoechst AG, Frankfurt am Main, Germany)
anesthesia, trunk blood was collected in heparinized tubes and
centrifuged over ice. After decapitation, the entire brain was quickly
removed, divided sagittally into two parts and quick-frozen. Plasma and
brain samples were stored at
80°C. Samples were taken 15 min after
the administration of vehicle (n = 5) and 15 min and 1, 3 and 5 hr after the administration of 7.5 and 15 mg/kg
allopregnanolone (n = 5 each). The values for one
plasma and one brain sample taken 3 hr after the injection of 7.5 mg/kg allopregnanolone and for one plasma sample taken 3 hr after the administration of 15 mg/kg allopregnanolone are missing.
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Results |
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Vigilance states. ANOVA yielded a significant treatment effect on non-REMS latency [F(2,14) = 4.8, P < .04]. Compared with vehicle, both 7.5 and 15 mg/kg allopregnanolone reduced non-REMS latency, the lower dose did so significantly and the higher dose as a tendency (table 1). Allopregnanolone did not significantly influence the frequency or average duration of the non-REMS and REMS episodes.
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EEG power densities during non-REMS.
ANOVA run on the
normalized and log-transformed non-REMS-specific EEG power densities
revealed a significant treatment effect for the frequencies between 1 and 7 Hz and for almost all frequencies
20 Hz (see bars below
the top plot of fig. 1 for results of the
ANOVA). Over the 6-hr recording period, allopregnanolone
dose-dependently decreased low-frequency EEG activity and enhanced EEG
activity in the higher-frequency region (fig. 1, top). Post
hoc testing showed that these changes were most prominent during
the first 2-hr interval and gradually diminished thereafter (fig.
2). After 15, mg/kg allopregnanolone
decreases in low-frequency EEG activity persisted throughout the entire
recording period (fig. 2, bottom). ANOVA also yielded significant
interaction effects between the factors treatment and time for the
frequencies 1.5 to 7, 13 to 17 and 19 to 40 Hz. Due to reductions in
low-frequency EEG activity and short-lasting elevations of EEG activity
in the spindle and higher-frequency bands, both doses of
allopregnanolone affected the time course of EEG power density in the
respective frequency ranges.
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EEG power densities during REMS.
Analysis of the EEG power
densities during REMS showed significant treatment and interaction
effects for most frequencies of
17 Hz (see bars below the bottom of
fig. 1 for results of the ANOVA). Over the 6-hr recording period, 7.5 mg/kg allopregnanolone slightly enhanced EEG activity in some of these
frequency bands, whereas 15 mg/kg allopregnanolone markedly elevated
EEG power density in all frequencies of
17 Hz (fig. 1, bottom). The
elevations were maximal during the first 2 hr postinjection but were
still present during the second 2-hr interval after the higher dose of
allopregnanolone (fig. 3).
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Plasma and brain concentrations of allopregnanolone.
The
levels of allopregnanolone measured in the plasma and brain 15 min
after the vehicle injection were generally low, 9.1 ± 7.4 SD
pmol/ml and 15.4 ± 9.8 SD pmol/g, respectively. Administration of
allopreganolone resulted in dose-dependent elevations in both plasma
(computed over all samples: 34.9 ± 26.7 pmol/ml for 7.5 mg/kg and
43.0 ± 29.0 for 15 mg/kg allopregnanolone) and brain (54.3 ± 30.9 pmol/g for 7.5 mg/kg and 64.5 ± 40.3 for 15 mg/kg allopregnanolone). The increases in allopregnanolone concentrations were maximal after 15 min and gradually declined thereafter (fig. 4).
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Discussion |
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The plasma and brain concentrations of allopregnanolone in our
vehicle-treated male Wistar rats (fig. 4) are comparable to values
observed earlier in male Sprague-Dawley rats (Paul and Purdy, 1992
) and
ovariectomized female Long-Evans rats (Bitran et al., 1993
).
The present data show that systemic administration of allopregnanolone
mixed with oil produced rapid, long-lasting (>5 hr), seemingly
dose-dependent increases in the levels of allopregnanolone in both
plasma and brain. Reportedly, allopregnanolone induces a loss of the
righting reflex when brain content exceeds 3000 pmol/g (Korneyev and
Costa, 1996
). Thus, the allopregnanolone levels attained in the present
study are far below the anesthetic range.
The present study shows for the first time that exogenous
allopregnanolone significantly influences sleep. Both doses tended to
reduce non-REMS latency (table 1), which indicates a rapid hypnotic
action. The higher dose significantly promoted pre-REMS, which occurred
mainly during the first 2 postinjection hr (table 2). Furthermore,
spectral analysis of the EEG yielded dose-related changes in non-REMS
and REMS. During non-REMS, 15 mg/kg and, to a lesser extent, 7.5 mg/kg
allopregnanolone persistently decreased the EEG activity in the lower
frequency region (
7 Hz) and initially enhanced the EEG activity in
the spindle frequency range as well as in most higher-frequency bands
(fig. 1, top, 2). The lower dose of allopregnanolone had only minor
effects on EEG during REMS, whereas the higher dose elicited a
significant, overall enhancement of EEG activity in all frequencies of
17 Hz (fig. 1, bottom), which was evident during the first two 2-hr
intervals (fig. 3, bottom) and, although not statistically significant, transiently elevated EEG activity in the lower theta frequencies (5-6
Hz) and reduced high-frequency theta activity (8-9 Hz).
The most extensively studied agonistic modulators of
GABAA receptors, the benzodiazepines, are known
to shorten non-REMS latency and selectively increase the time spent in
pre-REMS and, at higher doses, tend to inhibit REMS in the rat
(Gandolfo et al., 1994
; Lancel et al., 1996a
,
1997
). Moreover, the benzodiazepine midazolam has been shown to
decrease low-frequency EEG activity and enhance spindling during
non-REMS, to shift the dominant theta frequency from 8 Hz to 5 to 6 Hz
during REMS and to nonspecifically enhance EEG activity in the higher
frequencies (Lancel et al., 1996a
, 1997
). The influence of
allopregnanolone both on the amount of time spent in the different
vigilance states and on EEG activity during non-REMS and REMS is
reminiscent of the effects induced by benzodiazepines, which suggests
that the influence of allopregnanolone on sleep is mediated by
GABAA receptors. In almost all previous sleep
studies, analysis of EEG activity was limited to the frequency bands
between 0.5 and 25 Hz. In the present study, in which we investigated
EEG changes up to 40 Hz, we showed that the allopregnanolone-induced increase in high-frequency EEG activity during both sleep states is not
limited to 25 Hz but is still evident in 40 Hz (fig. 1). This indicates
that agonistic modulators of GABAA receptors
induce a general enhancement of fast-frequency EEG signals.
As expected, the kinetics of the increases in allopregnanolone
concentrations after administration of allopregnanolone mixed with oil
(fig. 4) and of progesterone differ in that progesterone administration
results in larger increases that decline more steeply (Lancel et
al., 1996b
). Nevertheless, the comparison of the sleep changes
induced by allopregnanolone with those observed earlier after the
administration of various doses of progesterone (Lancel et
al., 1996b
) shows that the overall effects of 15 mg/kg
allopregnanolone are similar to those evoked by 90 mg/kg progesterone.
As with the higher dose of allopregnanolone, 90 mg/kg progesterone
shortened sleep latency, significantly increased the time spent in
pre-REMS and was too low to suppress REMS or affect the number and
average duration of the sleep episodes. The effects on sleep
state-specific EEG activity are also similar in that this dose of
progesterone evoked a decrease in EEG activity in the frequencies of
7 Hz and enhanced EEG activity in the spindle and all higher
frequencies during non-REMS and lowered the dominant theta frequency,
while elevating high-frequency (
11 Hz) EEG activity during REMS.
Furthermore, in both studies, pre-REMS was increased only shortly after
the administration of progesterone and allopregnanolone, when brain levels of allopregnanolone were very high (>100 pmol/g), whereas EEG
activity in non-REMS and REMS was affected as long as the brain content
exceeded 35 pmol/g. The findings that allopregnanolone influences sleep
in a manner similar to progesterone and at comparable brain
concentrations of allopregnanolone indicate that the hypnotic effects
of progesterone are to a large extent mediated by the positive
allosteric interaction of its metabolite allopregnanolone with
GABAA receptors.
The role of endogenous allopregnanolone in the modulation of sleep has
yet to be investigated. Previous research on physiological increases in
the level of allopregnanolone in rats showed that brain concentrations
of ~19 pmol/g are attained during estrus, whereas levels around 40 pmol/g can easily be reached during pregnancy and immediately after
acute stress (Paul and Purdy, 1992
). The only change in the amount of
time spent in the different vigilance states, the increase in pre-REMS
after the administration of 15 mg/kg allopregnanolone, was limited to
the first 2-hr interval, when the brain levels of allopregnanolone were
supranormal. However, non-REMS-specific decreases in low-frequency EEG
activity and state-independent enhancements in high-frequency EEG
activity were still present after the brain levels of allopregnanolone fell within the physiological range (from the third postinjection hour
on). Our results thus suggest that allopregnanolone may modulate sleep
under physiological conditions. From the pharmacological point of view,
steroids related to allopregnanolone, known as epalons, are likely to
affect sleep in a benzodiazepine-like fashion.
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Acknowledgments |
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We are grateful to Arnold Höhne for his technical assistance and to Bettina Hermann and Bianca Abstreiter for their help in preparation of the plasma and brain samples.
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Footnotes |
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Accepted for publication May 14, 1997.
Received for publication January 21, 1997.
1
This study was supported by grants from the Deutsche
Forschungsgemeinschaft (M.L.) and the Gerhard-He
-Programm of the
Deutsche Forschungsgemeinschaft (R.R.).
Send reprint requests to: Dr. Marike Lancel, Max Planck Institute of Psychiatry, Clinical Institute, Kraepelinstrasse 2, 80804 Munich, Germany. E-mail: lancel{at}mpipsykl.mpg.de
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Abbreviations |
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GABA,
-aminobutyric acid;
EEG, electroencephalogram;
EMG, electromyogram;
REMS, rapid eye movement
sleep;
ANOVA, analysis of variance;
HFBAA, heptafluorobutyric acid
anhydride.
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