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Neurodevelopmental disorders and the role of PSD-95: Understanding pathways and pharmacological interventions

Gerardo Medina1* ,  Alex E. MacKenzie1,2,3
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1 Children’s Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
2 Department of Cellular and Molecular Medicine, Faculty of Medicine, University of Ottawa; Ottawa, Ontario, Canada
3 Eric Poulin Center for Neuromuscular Disease, Faculty of Medicine, University of Ottawa, Ontario, Canada
Advanced Neurology 2024, 3(1), 2095 https://doi.org/10.36922/an.2095
Submitted: 24 October 2023 | Accepted: 27 December 2023 | Published: 4 March 2024
© 2024 by the Author (s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
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Abstract

Neurodevelopmental disorders (NDDs) are often linked to disruption in brain development and present challenges for affected individuals in achieving their cognitive, emotional, and motor developmental milestones. NDDs encompass a spectrum of conditions, including autism spectrum disorder (ASD), schizophrenia (SCZ), attention-deficit hyperactivity disorder (ADHD), and epilepsy. The unequivocal diagnosis of an NDD is often challenging due to overlapping signs and symptoms across different conditions. Synaptic plasticity, the activity-driven modification of synaptic strength and efficacy, plays a crucial role in brain network formation and organization and is frequently altered in NDDs. Here, we explore the multifaceted roles of postsynaptic density-95 kDa (PSD-95) in NDDs. Psd-95 is a scaffolding protein belonging to the membrane-associated guanylate kinases (MAGUKs) family, located at the core of synapses, and is central to synaptic plasticity. Dysregulation of PSD-95 is linked to various neuropsychiatric disorders. In SCZ, decreased PSD-95 expression affects synaptic plasticity, thereby impacting learning and memory. Genes associated with ASD interact with PSD-95, and its removal in mice leads to ASD-like behavioral abnormalities. Furthermore, PSD-95 is implicated in ADHD, where its modulation influences neurotransmission. Medications used in NDD treatment, such as antipsychotic drugs and selective serotonin reuptake inhibitors (SSRIs), can alter PSD-95 levels, potentially influencing synapse formation. Alpha-2 adrenergic agonists might enhance synaptic integrity by impacting PSD-95. Alternative pharmacotherapies such as memantine, allopurinol, and ketamine, all influencing PSD-95 to a certain extent, hold promise in managing NDDs. Understanding the role of PSD-95 in these disorders can deepen our biological comprehension and pave the way for targeted therapies. Specifically, exploring how PSD-95 affects synaptic plasticity and dendritic spine development could uncover opportunities for repurposing drugs to treat NDDs associated with mutations in the DLG4 gene encoding PSD-95.

Keywords
PSD-95
DLG4
Neurodevelopmental disorder
Pharmacotherapy
N-methyl-d-aspartate receptor
Autism
Funding
None.
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Conflict of interest
The authors declare that they have no conflict of interest.
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Advanced Neurology, Electronic ISSN: 2810-9619 Published by AccScience Publishing
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