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Metformin alleviates type 2 diabetes-related depressive-like behaviors via AKAP150 signaling in NAc D1 medium spiny neurons

Deng Q, Gao SQ, Xue SG, Zhang SQ, Yang JW, Cui QQ, Zhang CL, Zhou HY

Pharmacological research, 2026

Abstract

Type 2 diabetes mellitus (T2DM) exhibits high comorbidity with depression, and progressive synaptic maladaptation of D1- and D2-expressing medium spine neurons (D1/D2-MSNs) in the nucleus accumbens (NAc) is critical involved in this pathological process. The first-line hypoglycemic drug metformin has been suggested to alleviates depressive symptoms. A-kinase anchoring protein 150 (AKAP150) modulates postsynaptic AMPA receptor (AMPAR) phosphorylation and synaptic function. However, the cell-type-specific role of AKAP150 in T2DM-related depression and its relevance to metformin's antidepressant mechanism remain unclear. Here, we established T2DM mouse models with depressive-like behaviors using D1-Cre and D2-Cre transgenic mice, combined with RNA sequencing, immunofluorescence, and electrophysiology and viral genetic manipulation to dissect NAc AKAP150 signaling. We detected specific downregulation of AKAP150 exclusively in D1-MSNs (rather than D2-MSNs) of T2DM mice and its expression level negatively correlated with the severity depressive-like phenotypes. Cell-specific overexpression of wild-type AKAP150 in D1-MSNs restored AMPAR-mediated synaptic transmission, corrected aberrant dendritic spine remodeling, and rescued T2DM-related depressive-like behaviors. In contrast, overexpression of a PKA-binding-deficient AKAP150 mutant failed to reverse these effects. Notably, metformin treatment selectively restored AKAP150 expression in D1-MSNs, rescued synaptic deficits and…

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