| Peer-Reviewed

Neuronal Hyperexcitability: Significance, Cause, and Diversity of Clinical Expression

Received: 8 September 2021    Accepted: 30 September 2021    Published: 15 October 2021
Views:       Downloads:
Abstract

Although the pathophysiology of psychiatric disorders remains unclear, an emerging hypothesis contends that most of the common psychiatric disorders are rooted in an inherent hyperexcitability of the neurological system. Particularly under the influence of stress, too many neurons fire for too long, resulting in pathologically severe and persistent symptoms such as anxiety, depression, irritability, insomnia, inattention, and obsessional thinking. However, these symptoms are just a small sampling of the many ways that neuronal hyperexcitability can be expressed. According to the Multi-Circuit Neuronal (MCNH) Hypothesis of Psychiatric Disorders, the trait can also be expressed as overly aggressive behavior, disruptive behavior, risky behavior, promiscuous behavior, avoidant behavior, self-injurious behavior, deviant behavior, addictive behavior, and criminal behavior. In essence, any behavioral extreme is likely to be rooted in an inherent hyperexcitability of the neurological system. The importance of recognizing this is that the abnormality, though highly treatable, is commonly overlooked and either mismanaged or poorly managed. Also, there is emerging evidence that the neuronal hyperexcitability trait, which appears to be heritable as a single nucleotide polymorphism, may be detectable by simply measuring one’s resting vital signs. If proven to be correct, these findings could incentivize carriers to develop prophylactic strategies early in life. The importance of this is immense, not only because it could reduce the risk of developing psychiatric and substance use disorders but also because it could have a protective effect against developing any of a wide range of general medical conditions, such as diabetes, high blood pressure, heart disease, cancer, and dementia. This article explores the many faces of neuronal hyperexcitability in an effort to increase awareness of this highly prevalent but elusive neurophysiological abnormality.

Published in American Journal of Clinical and Experimental Medicine (Volume 9, Issue 5)
DOI 10.11648/j.ajcem.20210905.16
Page(s) 157-167
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Neuronal Hyperexcitability, Clinical Manifestations, Pathophysiology of Psychiatric Disorders, Bipolar Spectrum Disorders, Psychotic Disorders, Anticonvulsants, Neuroregulators

References
[1] Binder MR. The multi-circuit neuronal hyperexcitability hypothesis of psychiatric disorders. AJCEM 2019; 7 (1): 12-30.
[2] Grunze HCR. The effectiveness of anticonvulsants in psychiatric disorders. Dialogues Clin Neurosci 2008; 10 (1): 77-89.
[3] Binder MR. Gabapentin — The Popular but Controversial Anticonvulsant Drug May Be Zeroing in on the Pathophysiology of Disease. AJCEM 2021; 9 (4): 122-134.
[4] Binder MR. FLASH Syndrome: tapping into the root of chronic illness. AJCEM 2020; 8 (6): 101-109.
[5] Larsen BA, Christenfeld NJS. Cardiovascular disease and psychiatric comorbidity: the potential role of preservative cognition. Cardiovascular Psychiatry and Neurology 2009; Article ID: 791017.
[6] Brainstorm Consortium; Anttila V, Bulik-Sullivan B, Finucane HK, et al. Analysis of shared heritability in common disorders of the brain. Science 2018; 360 (6395): eaap8757.
[7] Beissner F, Meissner K, Bär KJ, Napadow V. The autonomic brain: an activation likelihood estimation meta-analysis for central processing of autonomic function. J Neurosci 2013; 33 (25): 10503-10511.
[8] McEwen BA. Stress, adaptation, and disease allostasis and allostatic load. Annals of the New York Academy of Sciences 1998; 840 (1): 33-44.
[9] Lopez-Santiago LF, Yuan Y, Wagnon JL, et al. Neuronal hyperexcitability in a mouse model of SCN8A epileptic encephalopathy. PNAS 2017; 144 (9): 2383-2388.
[10] Cerf M, Thiruvengadam N, Mormann F, et al. On-line, voluntary control of human temporal lobe neurons. Nature 2010; 467: 1104-1108.
[11] Leuchter AF, Cook IA, Hunter AM, Cai C, Horvath S. (2012) Resting-state quantitative electroencephalography reveals increased neurophysiologic connectivity in depression. 7 (2): 1-13. e32508.
[12] Johnstone T, van Reekum CM, Urry HL, Kalin NH, Davidson, RJ. Failure to regulate: counterproductive recruitment of top-down prefrontal-subcortical circuitry in major depression. J. Neuroscience 2007; 27 (33): 8877-8884.
[13] Rose GM, Diamond DM, Pang K, Dunwiddie TV. Primed Burst Potentiation: lasting synaptic plasticity invoked by physiologically patterned stimulation. In: Haas HL and Buzsàki G. (eds) Synaptic Plasticity in the Hippocampus. Springer, Berlin, Heidelberg, 1988.
[14] Binder MR. Electrophysiology of seizure disorders may hold key to the pathophysiology of psychiatric disorders. AJCEM 2019; 7 (5): 103-110.
[15] Greenberg BD, Ziemann U, Cora-Locatelli G et al. Altered cortical excitability in obsessive-compulsive disorder. Neurology 2000; 54: 142–147.
[16] Ting JT Feng G. Neurobiology of obsessive-compulsive disorder: insights into neural circuitry dysfunction through mouse genetics. Curr Opin Neurobiol 2011; 21 (6): 842-848.
[17] Lindgren KA, Larson CL, Schaefer SM, et al. Thalamic metabolic rate predicts EEG alpha power in healthy control subjects but not in depressed patients. Biological Psychiatry 1999; 45: 943-952.
[18] Lassemo E, Sandanger I, Nygard JF, Sorgaard KW. The epidemiology of post-traumatic stress disorder in Norway: trauma characteristics and pre-existing psychiatric disorders. Soc Psychiatry Psychiatr Epidemiol 2017; 52 (1): 11-19.
[19] Finocchi C, Ferrari M. Female reproductive steroids and neuronal excitability. Neurol Sci. 2011; 32 (Suppl 1): S31-5.
[20] Bowcut JC, Weiser M. Inflammation and schizophrenia. Psychiatric Annals 2018; 48 (5): 237-243.
[21] Boorman E, Romano GF, Russell A, Mondelli V, Pariante CM. Are mood and anxiety disorders inflammatory diseases? Psychiatric Annals 2015; 45 (5): 240-248.
[22] Orlovska S, Vestergaard CH, Bech BH, et al. Association of streptococcal throat infection with mental disorders: testing key aspects of the PANDAS hypothesis in a nationwide study. JAMA Psychiatry 2017; 74 (7): 740-746.
[23] Kenney MJ, Ganta CK. Autonomic Nervous System and Immune System Interactions. Compr Physiol 2014; 4 (3): 1177-1200.
[24] Schäfers M, Sorkin L. Effect of cytokines on neuronal excitability. Neuroscience Letters 2008; 437 (3): 188-193.
[25] Vezzani A, Viviani B. Neuromodulatory properties of inflammatory cytokines and their impact on neuronal excitability. Neuropharmacology 2015; 96 (Part A): 70-82.
[26] Galic MA, Riazi K, Pittman QJ. Cytokines and brain excitability. Frontiers in Neuroendocrinology 2012; 33 (1): 116-125.
[27] Meyers Jr MG, Olson DP. Central nervous system control of metabolism. Nature 2012; 491: 357-363.
[28] Han C, Rice MW, Cai D. Neuroinflammatory and autonomic mechanisms in diabetes and hypertension. Am J Physiol Endocrinol Metab 2016; 311 (1): E32-E41.
[29] Kassi E, Pervanidou P, Kaltsas G, Chrousos G. Metabolic syndrome: definitions and controversies. BMC Medicine 2011; 9 (48).
[30] Murphy R, Carroll RW, Krebs JD. Pathogenesis of the metabolic syndrome: Insights from monogenic disorders. Mediators of Inflammation 2013; 2013.
[31] Alvares GA, Quintana DS, Hickie IB, Guastella AJ. Autonomic nervous system dysfunction in psychiatric disorders and the impact of psychotropic medications: a systematic review and meta-analysis. J Psychiatry Neurosci 2016; 41 (2): 89-104.
[32] Hershey T, Black KJ, Hartlein JM, et al. Cognitive-pharmacologic functional magnetic resonance Imaging in Tourette syndrome: a pilot study. Biol Psychiatry 2014; 55: 916–925.
[33] Scahill L. Prevalence of Diagnosed Tourette Syndrome in Persons Aged 6--17 Years --- United States, 2007. Yale Univ Child Study Center and School of Nursing. Bitsko, RH and Visser, SN. Div of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities. Blumberg, SJ. Div of Health Interview Statistics, National Center for Health Statistics, CDC.
[34] Cassidy CM, Balsam PE, Weinstein JJ, et al. A perceptual inference mechanism for hallucinations linked to striatal dopamine. Current Biology 2018; 28 (4): 503-514. e4.
[35] Gittelman JX, Perke DJ, Portfors CV. Dopamine modulates auditory responses in the inferior colliculus in a heterogeneous manner. J Assoc Res Otolaryngol 2013; 14 (5): 719-729.
[36] Hargreave E. (2006) The neuroplasticity phenomenon of kindling. http://hargreaves.swong.webfactional.com/ kindle.htm. (Accessed 5/19/18).
[37] Begh M, Beghi E, Cornaggia CM. Epilepsy in psychiatric disorders. In: Mula M. (eds) Neuropsychiatric Symptoms of Epilepsy. Neuropsychiatric symptoms of neurological disease. pp. 289-302. Springer, Cham Publishing Company, 2016. ISBN: 978-3-319-22158-8.
[38] Josephson CB, Lowerison M, Vallerand I, et al. Association of depression and treated depression with epilepsy and seizure outcomes: a multicohort analysis. JAMA Neurol 2017; 74 (5): 533-539.
[39] Lopez AY, Wang X, Xu M, et al. Ankyrin-G isoform imbalance and interneuronopathy link epilepsy and bipolar disorder. Molecular Psychiatry 2017; 22: 1464–1472.
[40] Fleming KC, Volcheck MM. Central sensitization syndrome and the initial evaluation of a patient with fibromyalgia: a review. Rambam Maimonides Med J 2015; 6 (2): e0020.
[41] Yunus MB. Central sensitivity syndromes: a new paradigm and group nosology for fibromyalgia and overlapping conditions, and the related issue of disease versus illness. Semin Arthritis Rheum 2008 Jun; 37 (6): 339-352.
[42] Yunus MB. Fibromyalgia and overlapping disorders: the unifying concept of central sensitivity syndromes. Semin Arthritis Rheum 2007; 36 (6): 339-356.
[43] Fink P, Rosendal M, Dam ML, Schröder A. Ny faelles diagnose for de funktionelle sygdomme [New unifying diagnosis of functional diseases]. Ugeskr Laeger 2010; 14; 172 (24): 1835-1838.
[44] Aurora SK, Wilkinson F. The brain is hyperexcitable in migraine. Cephalalgia 2007; 27 (12) 1442-1453.
[45] Griner T. What's really wrong with you? A revolutionary look at how muscles affect your health. Avery Publishing. New York, NY, 1995.
[46] Binder M. The golden Book of muscle health and restoration. Lightningsource Publishing, 2016.
[47] Harden CL. Pseudoseizures and dissociative disorders: a common mechanism involving traumatic experiences. Seizure 1997; 6 (2): 151-155.
[48] El-Naggar H, Moloney P, Widdess-Walsh P, Kilbride R, Delanty N. Simultaneous occurrence of nonepileptic and epileptic seizures during a single period of in-patient video-electroencephalographic monitoring. Epilepsia Open 2017; 2 (4): 467-471.
[49] Substance Abuse and Mental Health Services Administration, Office of Applied Studies, Rockville, MD. The NSDUH Report: Substance use and dependence following initiation of alcohol or illicit drug use. 2008.
[50] Saisan J, Smith M, Robinson L, Segal J. Substance abuse and mental health issues: dealing with drug or alcohol addiction and co-occurring mental health problems. https://www.helpguide.org/articles/addictions/substance- abuse-and-mental-health.htm. (Accessed 9/25/18).
[51] Cherry D, Albert M, McCaig LF. Mental health-related physician office visits by adults aged 18 and over: United States, 2012-2014. NCHS Data Brief 2018; 311.
[52] Blinder BJ, Cumella EJ, Sanathara VA. Psychiatric comorbidities of female inpatients with eating disorders. Psychosom Med 2006; 68 (3): 454-462.
[53] Klump KL, Burt SA, McGue M, Lacono WG. Changes in Genetic and Environmental Influences on Disordered Eating Across Adolescence A Longitudinal Twin Study. Arch Gen Psychiatry 2007; 64 (12): 1409-1415.
[54] Keyes KM, Eaton NR, Hasin DS. Childhood maltreatment and the structure of common psychiatric disorders. British Journal of Psychiatry 2012; 200 (2): 107-115.
[55] Weye N, Santomauro DF, Agerbo E, et al. Register-based metrics of years lived with disability associated with mental and substance use disorders: a register-based cohort study in Denmark. Lancet Psychiatry 2021; 8 (4): 310-319.
[56] Friedman M, Rosenman R. Association of specific overt behaviour pattern with blood and cardiovascular findings. Journal of the American Medical Association 1959; 169 (12): 1286–1296.
[57] Friedman HS, Booth-Kewley S. Personality, Type A behavior, and coronary heart disease: the role of emotional expression. Journal of Personality and Social Psychology 1987; 53 (4): 783-792.
[58] Levy KN, Johnson BN, Clouthier TL, Scala JW, Temes CM. An attachment theoretical framework for personality disorders. Canadian Psychology 2015; 56 (2): 197–207.
[59] Latvala A, Kuja-Halkola R, Rick C, et al. Association of resting heart rate and blood pressure in late adolescence with subsequent mental disorders: a longitudinal population study of more than 1 million men in Sweden. JAMA Psychiatry 2016; 73 (12): 1268-1275.
[60] Ginsberg Y, Hirvikoski T, Lindefors N. Attention deficit hyperactivity disorder (ADHD) among longer-term prison inmates is a prevalent, persistent and disabling disorder. BMC Psychiatry 2010; 10: 112.
[61] Bronson J, Berzofsky M. U.S. Department of Justice Special Report: Indicators of mental health problems reported by prisoners and jail inmates, 2011-2012.
[62] Ill-equipped: US prisons and offenders with mental illness. Human Rights Watch. October 2003.
[63] Jen Karberg JC, James DJ. Bureau of Statistics Special Report. Substance Dependence, Abuse, and Treatment of Jail Inmates, 2002.
[64] Binder MR. Introducing the term “Neuroregulator” in Psychiatry. AJCEM 2019; 7 (3): 66-70.
[65] Nieratschker V, Brückmann C, Plewnia C. CACNA1C risk variant affects facial emotion recognition in healthy individuals. Sci Rep 2015; 5: 17349.
[66] Ferreira, MAR, O’Donovan MC, Sklar P. (2008) Collaborative genome-wide association analysis supports a role for ANK3 and CACNA1C in bipolar disorder. Nat Genet 2008; 40 (9): 1056-1058.
[67] Yuan A, Yi Z, Wang Q, et al. ANK3 as a risk gene for schizophrenia: new data in Han Chinese and meta analysis. Am J Med Genet B Neuropsychiatr Genet 2012; 159B (8): 997-1005.
[68] Green EK, Grozeva D, Jones I, et al., Wellcome Trust Case Control Consortium, Holmans, PA, Owen, MJ, O'Donovan, MC, Craddock N. The bipolar disorder risk allele at CACNA1C also confers risk of recurrent major depression and of schizophrenia. Mol Psychiatry 2010; 15 (10): 1016-1022.
[69] Liu Y, Blackwood DH, Caesar S, et al. Meta-analysis of genome-wide association data of bipolar disorder and major depressive disorder. Mol Psychiatry 2011; 16 (1).
[70] Iqbal Z, Vandeweyer G, van der Voet M, et al. Homozygous and heterozygous disruptions of ANK3: at the crossroads of neurodevelopmental and psychiatric disorders. Human Molecular Genetics 2013; 22: 1960-1970.
[71] Subramanian J, Dye L, and Morozov, A. Rap1 signaling prevents L-type calcium channel-dependent neurotransmitter release. Journal of Neuroscience 2013; 33 (17): 7245.
[72] Santos M, D'Amico D, Spadoni O, et al. Hippocampal hyperexcitability underlies enhanced fear memories in TgNTRK3, a panic disorder mouse model. Journal of Neuroscience 2013; 33 (38): 15259-15271.
[73] Contractor A, Klyachko VA, Portera-Cailliau C. Altered neuronal and circuit excitability in Fragile X syndrome. Neuron 2015; 87 (4): 699-715.
[74] O’Brien NL, Way MJ, Kandaswamy R, et al. The functional GRM3 Kozak sequence variant rs148754219 affects the risk of schizophrenia and alcohol dependence as well as bipolar disorder. Psychiatric Genetics 2014; 24: 277–278.
[75] Schizophrenia Working Group of the Psychiatric Genomics Consortium: Ripke S, Neale BM, O’Donovan MC. Biological insights from 108 schizophrenia-associated genetic loci. Nature 2014; 511 (7510): 421-427.
[76] Freedman R, Coon H, Myles-Worsley M, et al. Linkage of a neurophysiological deficit in schizophrenia to a chromosome 15 locus. PNAS 1997; 94 (2): 587–592.
[77] Pizzarelli R, Cherubini E. Alterations of GABAergic signaling in autism spectrum disorders. Neural Plast 2011; 1011: 157193.
Cite This Article
  • APA Style

    Michael Raymond Binder. (2021). Neuronal Hyperexcitability: Significance, Cause, and Diversity of Clinical Expression. American Journal of Clinical and Experimental Medicine, 9(5), 157-167. https://doi.org/10.11648/j.ajcem.20210905.16

    Copy | Download

    ACS Style

    Michael Raymond Binder. Neuronal Hyperexcitability: Significance, Cause, and Diversity of Clinical Expression. Am. J. Clin. Exp. Med. 2021, 9(5), 157-167. doi: 10.11648/j.ajcem.20210905.16

    Copy | Download

    AMA Style

    Michael Raymond Binder. Neuronal Hyperexcitability: Significance, Cause, and Diversity of Clinical Expression. Am J Clin Exp Med. 2021;9(5):157-167. doi: 10.11648/j.ajcem.20210905.16

    Copy | Download

  • @article{10.11648/j.ajcem.20210905.16,
      author = {Michael Raymond Binder},
      title = {Neuronal Hyperexcitability: Significance, Cause, and Diversity of Clinical Expression},
      journal = {American Journal of Clinical and Experimental Medicine},
      volume = {9},
      number = {5},
      pages = {157-167},
      doi = {10.11648/j.ajcem.20210905.16},
      url = {https://doi.org/10.11648/j.ajcem.20210905.16},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajcem.20210905.16},
      abstract = {Although the pathophysiology of psychiatric disorders remains unclear, an emerging hypothesis contends that most of the common psychiatric disorders are rooted in an inherent hyperexcitability of the neurological system. Particularly under the influence of stress, too many neurons fire for too long, resulting in pathologically severe and persistent symptoms such as anxiety, depression, irritability, insomnia, inattention, and obsessional thinking. However, these symptoms are just a small sampling of the many ways that neuronal hyperexcitability can be expressed. According to the Multi-Circuit Neuronal (MCNH) Hypothesis of Psychiatric Disorders, the trait can also be expressed as overly aggressive behavior, disruptive behavior, risky behavior, promiscuous behavior, avoidant behavior, self-injurious behavior, deviant behavior, addictive behavior, and criminal behavior. In essence, any behavioral extreme is likely to be rooted in an inherent hyperexcitability of the neurological system. The importance of recognizing this is that the abnormality, though highly treatable, is commonly overlooked and either mismanaged or poorly managed. Also, there is emerging evidence that the neuronal hyperexcitability trait, which appears to be heritable as a single nucleotide polymorphism, may be detectable by simply measuring one’s resting vital signs. If proven to be correct, these findings could incentivize carriers to develop prophylactic strategies early in life. The importance of this is immense, not only because it could reduce the risk of developing psychiatric and substance use disorders but also because it could have a protective effect against developing any of a wide range of general medical conditions, such as diabetes, high blood pressure, heart disease, cancer, and dementia. This article explores the many faces of neuronal hyperexcitability in an effort to increase awareness of this highly prevalent but elusive neurophysiological abnormality.},
     year = {2021}
    }
    

    Copy | Download

  • TY  - JOUR
    T1  - Neuronal Hyperexcitability: Significance, Cause, and Diversity of Clinical Expression
    AU  - Michael Raymond Binder
    Y1  - 2021/10/15
    PY  - 2021
    N1  - https://doi.org/10.11648/j.ajcem.20210905.16
    DO  - 10.11648/j.ajcem.20210905.16
    T2  - American Journal of Clinical and Experimental Medicine
    JF  - American Journal of Clinical and Experimental Medicine
    JO  - American Journal of Clinical and Experimental Medicine
    SP  - 157
    EP  - 167
    PB  - Science Publishing Group
    SN  - 2330-8133
    UR  - https://doi.org/10.11648/j.ajcem.20210905.16
    AB  - Although the pathophysiology of psychiatric disorders remains unclear, an emerging hypothesis contends that most of the common psychiatric disorders are rooted in an inherent hyperexcitability of the neurological system. Particularly under the influence of stress, too many neurons fire for too long, resulting in pathologically severe and persistent symptoms such as anxiety, depression, irritability, insomnia, inattention, and obsessional thinking. However, these symptoms are just a small sampling of the many ways that neuronal hyperexcitability can be expressed. According to the Multi-Circuit Neuronal (MCNH) Hypothesis of Psychiatric Disorders, the trait can also be expressed as overly aggressive behavior, disruptive behavior, risky behavior, promiscuous behavior, avoidant behavior, self-injurious behavior, deviant behavior, addictive behavior, and criminal behavior. In essence, any behavioral extreme is likely to be rooted in an inherent hyperexcitability of the neurological system. The importance of recognizing this is that the abnormality, though highly treatable, is commonly overlooked and either mismanaged or poorly managed. Also, there is emerging evidence that the neuronal hyperexcitability trait, which appears to be heritable as a single nucleotide polymorphism, may be detectable by simply measuring one’s resting vital signs. If proven to be correct, these findings could incentivize carriers to develop prophylactic strategies early in life. The importance of this is immense, not only because it could reduce the risk of developing psychiatric and substance use disorders but also because it could have a protective effect against developing any of a wide range of general medical conditions, such as diabetes, high blood pressure, heart disease, cancer, and dementia. This article explores the many faces of neuronal hyperexcitability in an effort to increase awareness of this highly prevalent but elusive neurophysiological abnormality.
    VL  - 9
    IS  - 5
    ER  - 

    Copy | Download

Author Information
  • Department of Psychiatry, North Shore University Health System, Highland Park, USA

  • Sections