1. Introduction
Although extensive research has been performed, the etiology of depressive disorder is not fully understood, and therefore, the currently available antidepressant drugs are not effective in some patients. One of the approaches to the therapy of treatment-resistant depression is supportive treatment with thyroid hormones (THs) [
1]; however, the mechanism of action and the roles of these hormones in the pathogenesis of depression are not known. This is mainly because the effect of thyroid hormones in the central nervous system in adults is not well-studied. It is well established that thyroid hormones regulate many important processes, such as growth, differentiation, migration and neuronal integration, glial cell proliferation, myelination, and neurotransmitter synthesis during development, but the vast majority of the genes regulated by these hormones become insensitive after the period of brain development. It is known that proper TH function during pregnancy is crucial for the development of the central nervous system in the fetus, and under-activity of the thyroid gland can lead to mental dysfunction and impairments in cognitive development [
2]. The present, although still very fragmentary, data [
3,
4] indicate that even in the adult brain, thyroid hormone deficiency impairs certain functions (mood, memory, and learning processes). We can assume that this impairment is probably due to thyroid hormone-mediated interference in metabolic processes and intracellular signaling pathways. In the adult brain, various genetic loci that are responsible for thyroid hormones have been identified; moreover, these hormones act not only on genes that contain thyroid response elements (TREs), but also on other genes and by nongenomic mechanisms [
5]. The participation of TH in the course of depression is evidenced by epidemiological data showing that 1–4% of patients with the affective disorder suffer from hypothyroidism, and approximately 4–40% show symptoms of subclinical hypothyroidism. Furthermore, in people with depression, abnormalities of the thyroxine (T4) to triiodothyronine (T3) ratio, elevated reverse T3 levels, blunted TSH response to TRH, and the presence of anti-thyroid antibodies are observed more often than in the healthy population [
5,
6]. Some studies suggest that in depression, there may be a reduction in the activity, but not necessarily the level of thyroid hormones. This is shown by clinical observations indicating that effective therapy of depression with T4 requires higher doses than those used in the treatment of primary thyroid disorders, and additionally, in depressed patients, supraphysiological doses of T4 cause fewer side effects than in healthy people [
7]. Moreover, the levels of thyroid hormones in the brain do not correlate with their peripheral concentrations, because only approximately 20% of T3, the active form of thyroid hormone in the brain, comes from blood, whereas most is produced in glial cells from T4. Additionally, thyroid hormone content in particular brain regions depends on the expression of their transporters and deiodinases [
8].
The involvement of thyroid hormones in the pathogenesis of depression is also indicated by some symptoms observed in both depression and hypothyroidism. Cognitive function impairment is a characteristic and frequently observed manifestation in both of these diseases. For example, clinical studies reported severe cognitive disabilities, including an inability to concentrate, calculate and understand complex questions, slow mentation, and weakened memory for recent events during the course of hypothyroidism [
9]. Experimental studies have demonstrated that hypothyroidism impairs learning, short-term and long-term memory, induces changes in neurotransmitters and signaling molecules, and disrupts synaptic plasticity [
10,
11]. As we have shown in previous studies, thyroid hormone deficiency also leads to metabolic disturbances in the brain both in control animals and in a depression model [
12].
In light of current knowledge, the present study aimed to analyze the possible link between depression and thyroid hormone deficiency and to explore the mechanisms that underlie cognitive impairment in depression in adulthood, considering dysregulation of thyroid endocrine homeostasis. For this purpose, we performed this study in a model of endogenous depression, the Wistar–Kyoto (WKY) rats, in comparison to control Wistar rats under standard and thyroid hormone deficiency conditions. Propylthiouracil (PTU, an anti-thyroid agent) has been used to induce hypothyroidism in both strains. In the present work, we assessed the behavioral status of the examined animals with the use of tests to measure spatial memory and anxiety-like behavior and evaluated memory formation processes in an electrophysiological study by measuring synaptic long-term potentiation (LTP), short-term synaptic plasticity (paired-pulse responses) and basal excitatory transmission. We also examined the potential molecular mechanisms that could be responsible for the changes in the measured electrophysiological parameters in the studied models of depression and hypothyroidism. To achieve this, we evaluated factors involved in the regulation of cognitive functions that may be affected by both depression and hypothyroidism, such as acetylcholine, synaptotagmin 1, NMDA (N-methyl-d-aspartate) receptor subunits, mitochondrial fusion and fission markers, enzymes regulating glycogen levels, growth factors, caspase-1, and protein kinases essential for the induction and/or maintenance of LTP (Calcium/calmodulin-dependent protein kinase II isoform K (CaMKII), Extracellular signal-regulated kinases 1 and 2 (ERK1 and 2), cAMP Response Element-Binding Protein (CREB), and protein kinase B (AKT1)). We also examined whether the changes observed in depression or hypothyroidism are exacerbated in the coexistence of these two diseases.
3. Discussion
The present study demonstrated anxiety-like behaviors, impairment of spatial memory, disturbances in electrophysiological parameters in the CA1 and DG hippocampal regions, and changes in some biochemical markers of neuronal plasticity in the hippocampus in rat models of depression, hypothyroidism, and the co-occurrence of depression and hypothyroidism.
In our investigation, WKY rats were used as a model of depression, since this rat strain exhibits a natural susceptibility to stress and is an established genetic model of endogenous depression [
13,
14,
15,
16]. As a control group, Wistar rats were used because these strains have similar genetic backgrounds, but differ in their susceptibility to stress [
14,
17]. Hypothyroidism was induced in the Wistar and WKY rats via administration of PTU in the drinking water for three weeks; as we have previously shown, this dosage lowers fT3 and fT4 and increases plasma TSH levels [
12]. Since brain thyroid hormone levels do not correlate with their concentration in the blood, we previously determined the thyroid hormone content in the hippocampus and found that the level of T3 was decreased in Wistar rats receiving PTU and was even more substantially decreased in WKY rats [
12].
The anxiety-like behavior examined in our study with the use of the elevated plus maze test is often observed in addition to depression-like behavior in various animal models of depression, including the WKY rats [
18]. Abnormalities in learning and memory processes in WKY rats have been shown previously in the Morris water maze [
19] and novel object recognition test [
12]. These data are in agreement with our findings that spatial memory impairment, as assayed in the novel object location (NOL) test, also occurred in this rat strain. The behavioral changes indicating a weakening of memory processes in the WKY rats compared to those of the Wistar rats were supported by the electrophysiological recordings showing a reduction of LTP (a form of synaptic plasticity widely accepted as a cellular correlate of learning and memory) in the WKY rats. In contrast to the differences observed between the rat strains in both the NOL test and the LTP measurements, the induction of hypothyroidism did not show such a clear impact. LTP reduction was observed only in the dentate gyrus of the hippocampus in the Wistar rats receiving PTU, and only in rats of this strain was a downward trend in the discrimination index observed in the NOL test. Many data concern the adverse effects of thyroid hormone deficiency during the developmental stage on cognitive functions, but the impact of hypothyroidism on adult animals is poorly reported. Some papers have established that hypothyroidism also leads to LTP impairment in adult male Wistar rats. Similar to the results of our study, a decrease in LTP in the dentate gyrus of the hippocampus was previously observed in Wistar rats treated with PTU and in this rat strain after thyroidectomy [
20,
21,
22]. However, contrary to our results, a decrease in LTP in the CA1 area was observed in Wistar rats after thyroidectomy [
10,
23]. Most likely, these differences result from the use of various methods to lower thyroid hormone levels (PTU administration vs. thyroidectomy) that differ in the intensity of reduction of the measured hormones. In the WKY rats, PTU did not affect LTP in the DG, which was initially lower in this strain; however, it was difficult to explain the observation that in the CA1 region of the hippocampus, PTU administration resulted in LTP intensification. As we did not measure LTD, it cannot be ruled out that despite the increase in LTP, the LTP/LTD ratio was reduced. Nevertheless, these results indicate that thyroid hormones have different effects on the LTP process in WKY and Wistar rats and that there may be other mechanisms of action of these hormones in the studied regions of the hippocampus.
As in the case of LTP, other effects of PTU on basal excitatory transmission were also observed in the WKY rats compared to the Wistar rats. Basal excitatory transmission, measured as the input-output relationship, was significantly increased in both hippocampal regions in slices obtained from the Wistar rats treated with PTU. The same effect of hypothyroidism was also shown in young male Sprague Dawley rats [
24], while in the present study in WKY rats, which were used as a model of depression, PTU had no effect on the magnitude of fEPSPs. The increase in amplitude associated with the deficit of thyroid hormones in Wistar rats may result from presynaptic changes–for example, increased release of glutamate or postsynaptic changes–in the density or reactivity of postsynaptic receptors. The observation that inhibition of thyroid hormone synthesis had no effect on the amplitude of fEPSPs in WKY rats suggested that in this rat strain, thyroid hormones are less involved in the regulation of the glutamate release and/or excitability of postsynaptic neurons. In fact, some studies have shown changes in basal and induced glutamate levels, expression of NMDA receptor subunits, and NMDA receptor binding in WKY rats compared to Wistar rats [
18]. In WKY rats, as well as in humans with treatment-resistant depression, central sensitivity to thyroid hormones seems to be reduced, which in turn may lead to the weakened or absent inhibition of glutamate release or the excitability of the postsynaptic receptors by these hormones [
18,
25].
Abnormalities in the mechanisms of presynaptic neurotransmitter release were also shown by changes in paired-pulse responses. PPR is a kind of short-term synaptic plasticity that could be dependent on presynaptic mechanisms of neurotransmitter release. The recorded changes in PPR may have been caused by residual calcium availability induced by previous stimulations and/or changes in inhibition mediated by GABAergic interneurons [
26]. In the CA1 region of the hippocampus, PPR facilitation manifested as an increase in the amplitude of the second response, while in dentate gyrus cells, the amplitude of the second response was lower than that of the first. Paired-pulse data indicated that PTU administration affected presynaptic release mechanisms in the perforant path of DG synapses in the WKY rats and not in the Wistar rats because only the WKY rats showed a decrease in PPR after PTU. In contrast, Shaffer collateral-CA1 synapses were affected in both Wistar and WKY rats, as evidenced by the decreased PPR after PTU treatment. Moreover, the WKY rats displayed a reduced PPR compared to the Wistar rats under baseline conditions, suggesting that there are subtle differences in presynaptic release machinery between these two strains. The changes in PPR, particularly in the CA1 region of the hippocampus, indicated differences in the mechanisms of presynaptic neurotransmitter release between the Wistar and WKY rats and dysregulation of this process under decreased thyroid hormone conditions. The strongest PPR downregulation was shown in the animal model of the co-occurrence of depression and hypothyroidism, i.e., in the WKY rats treated with PTU. A similar reduction in PPR was also observed in the hippocampus of hypothyroid neonatal rats, and this effect resulted from increased neurotransmitter release during the first stimulus [
27]. Our results suggest that like early hypothyroidism, a lack of thyroid hormones in the adult brain may also disrupt short-term synaptic plasticity.
When we examined the potential molecular mechanisms that could be responsible for the changes in electrophysiological parameters that we observed in the studied models of depression and hypothyroidism, we considered the participation of synaptotagmin I, the main Ca2+ sensor, postsynaptic proteins, metabolic disturbances, changes in mitochondrial dynamics, neurotrophic factors, alterations in the intensity of oxidative stress, intracellular signaling pathways and the level of acetylcholine, a neurotransmitter involved in cognitive processes. We demonstrated increased expression of hippocampal synaptotagmin I in WKY rats with and without PTU treatment. Synaptotagmin I, the primary Ca2+ sensor, is associated with action potential-triggered neurotransmitter release. An elevated level of synaptotagmin I in the hippocampus of hypothyroid neonatal rats was linked with enhanced glutamate release and a reduction in PPR [
27]. The reduction in PPR and the upregulation of synaptotagmin I expression in the WKY rats suggests that this mechanism may also be altered in adult rats of this strain. In contrast to presynaptic neurotransmitter release, we did not observe any changes in the examined postsynaptic mechanisms, that is, the NMDA receptor subunits in the tested models.
The function of thyroid hormones in the periphery is mainly related to metabolism, but the present research reveals that these hormones, not only in the pre- and early postnatal periods, but also in the adult brain, affect metabolic processes and synaptic plasticity. In our previous studies, we found that in WKY rats, as well as in Wistar and WKY rats treated with PTU, glycolysis was reduced, and in a model of the coexistence of depression and hypothyroidism (WKY + PTU), the efficiency of mitochondrial respiration was impaired [
12]. The increase in glycogen synthase expression observed in the present study, together with the lack of changes in glycogen phosphorylase in WKY animals with and without PTU treatment, suggests a shift in the balance towards glycogen synthesis and limiting the process of glycogenolysis. Many studies have indicated that glycogenolysis in astrocytes is an important source of lactate, which is delivered to neurons and, as a substrate for mitochondrial metabolism, plays a critical role in learning and memory mechanisms [
28]. Thus, in WKY rats and in rats with a decrease in thyroid hormones, energy deficiencies may occur not only due to lower glycolysis (as in our previous study), but also as an effect of increased glycogen synthesis.
To obtain sufficient energy necessary for the function of neurons, proper mitochondrial dynamics are also important. The higher levels of dnm1l, a marker of mitochondrial fission, observed in animals of both strains receiving PTU suggest that a reduction in thyroid hormones disrupts the dynamics of mitochondria. However, the increased expression of opa1, a marker of fusion, in WKY rats administered PTU is difficult to explain. The observed changes in the studied markers of mitochondrial dynamics could, on the one hand, increase energy shortages (in the case of increased dnm1l expression), but on the other hand, could be adaptive mechanisms limiting energy deficits (in the case of increased opa 1 expression). However, in the case of opa 1, the available data indicate that only a long isoform of this protein promotes mitochondrial fusion, whereas a short isoform intensifies fission instead; thus, the observed increase in opa1 expression did not necessarily lead to increased fusion [
29].
It is also known that oxidative damage in the brain may lead to cognitive impairments, and hypothyroidism-induced oxidative stress in the brain has been reported to contribute to learning and memory deficits. Additionally, a negative association between oxidative stress and BDNF levels has been shown [
30]. However, in our experimental conditions, in both individual models and in the model of the co-occurrence of hypothyroidism and endogenous depression, this pathway does not seem to be directly or indirectly affected because we did not observe any changes in markers of oxidative stress (MDA and 4-HNE) or hippocampal BDNF and NGF expression, which suggests that learning and memory impairment does not occur through oxidative stress induction. Despite no changes in markers of oxidative stress, both in WKY rats, but mainly in the model of coexistence of depression and hypothyroidism, a strong increase of caspase-1 protein level was observed. Caspase-1 activation, mainly by NLRP3 inflammasome, may lead to the release of pro-inflammatory cytokines, and thus, intensify neuroinflammation. Current research also indicates the role of this enzyme in the regulation of neuronal plasticity. It has also been shown that caspase-1, by influencing the function of the AMPA receptor, weakens the LTP process in the hippocampus. However, in the models tested, the caspase-1 expression did not correlate with LTP values, suggesting that the disturbance in LTP was not due to activation of this enzyme. On the other hand, the increased level of this enzyme, especially in the model of coexistence of depression and hypothyroidism, may suggest the induction of the neuroinflammatory process.
In the WKY rats compared to the control Wistar rats, a reduction in LTP was observed in both the CA1 and DG hippocampal regions. LTP is known to be controlled at the molecular level by the activation of a number of neuronal signaling pathways, mainly the Ca-calmodulin-dependent kinase (CaMK), phosphatidylinositol-3 kinase/protein kinase B (PI3K/AKT), protein kinase A, protein kinase C, and mitogen-activated protein kinase (MAPK) pathways. The reduction in LTP observed in the WKY rats may be associated with a lower level of the active form of CaMKII (p-CaMKII) in the hippocampus, since CaMKII inhibition blocks LTP induction and phosphorylation of AMPA receptor subunits [
31]. In addition to CaMKII, a lowered ratio of phospho-Akt/Akt was also observed in the WKY rats, so this kinase could also be responsible for LTP disturbance in this strain of rats. Given the potentiating effect of acetylcholine on LTP, the lower levels of this neurotransmitter in the hippocampus of the WKY rats could also potentially cause the weakening of the LTP in this strain. However, since hypothyroidism did not decrease the levels of p-CaMKII, p-Akt, or acetylcholine in either the Wistar or WKY rats in the present study, none of these factors seem to be responsible for the reduction in LTP in the dentate gyrus of the hippocampus observed in Wistar rats receiving PTU. Notably, an increase in the expression of p-ERK1-MAP kinase was shown in the hippocampus of rats in the group with coexisting depression and hypothyroidism (WKY + PTU). The fact that ERK activation was also observed after LTP stimulation in hippocampal slices from adult rats with hypothyroidism induced in the pre- and postnatal periods, as well as in the hippocampus of newborn rat pups born to hypothyroid dams, suggests that disturbances in synaptic plasticity associated with a deficiency of thyroid hormones result from changes in ERK signaling [
11,
32].
In summary, this study demonstrated that thyroid hormone deficiency in adult animals disturbed electrophysiological parameters of basal excitatory transmission, short-term synaptic plasticity, and long-term potentiation, as well as biochemical markers of neuronal plasticity in the hippocampus; these changes were similar to those observed with pre-or early postnatal hypothyroidism. Moreover, changes in the investigated markers of synaptic plasticity were also observed in WKY rats, a model of endogenous depression, either under baseline conditions or in response to a decrease in thyroid hormone levels. However, the limitation of our study is the measurement of only the gene expression of some factors. Future protein studies will probably provide additional answers. Although in the model of the co-occurrence of depression and hypothyroidism, stronger changes in PPR in the CA1 region of the hippocampus, the appearance of changes in the level of the active form of ERK, and an increase in the active form of caspase-1 were observed, the changes in basal excitatory transmission were not intensified and, in the case of long-term potentiation in the CA1 region were even decreased, probably due to the substantial differences between the Wistar and WKY strains. These data are currently difficult to interpret since the functional role of thyroid hormones in synaptic plasticity in adults, as well as the role of hypothyroidism in the pathogenesis of depression, has only begun to be elucidated.