A reliable, facial nociception device for unrestrained, awake animals: effects of morphine and trigeminal complex lesions

Cortical pain induced by optogenetic cortical spreading depression: from whole brain activity mapping

BACKGROUND

Cortical spreading depression (CSD) is an electrophysiological event underlying migraine aura. Traditional CSD models are invasive and often cause injuries. The aim of the study was to establish a minimally invasive optogenetic CSD model and identify the active networks after CSD using whole-brain activity mapping.

METHODS

CSD was induced in mice by light illumination, and their periorbital thresholds and behaviours in the open field, elevated plus-maze and light-aversion were recorded. Using c-fos, we mapped the brain activity after CSD. The whole brain was imaged, reconstructed and analyzed using the Volumetric Imaging with Synchronized on-the-fly-scan and Readout technique. To ensure the accuracy of the results, the immunofluorescence staining method was used to verify the imaging results.

RESULTS

The optogenetic CSD model showed significantly decreased periorbital thresholds, increased facial grooming and freezing behaviours and prominent light-aversion behaviours. Brain activity mapping revealed that the somatosensory, primary sensory, olfactory, basal ganglia and default mode networks were activated. However, the thalamus and trigeminal nucleus caudalis were not activated.

CONCLUSIONS

Optogenetic CSD model could mimic the behaviours of headache and photophobia. Moreover, the optogenetic CSD could activate multiple sensory cortical regions without the thalamus or trigeminal nucleus caudalis to induce cortical pain.

Synergistic interaction between tapentadol and flupirtine in the rat orafacial formalin test

Combination therapy with two or more analgesics is widely used for conditions associated with moderate to severe pain. Combinations of diverse analgesics with different modes of action can improve the risk-benefit ratio of analgesic treatments. The aim of this study is to evaluate the antinociceptive effect of tapentadol (TAP) and flupirtine (FLP), when administered separately or in combination, as well as their synergistic interaction in the orofacial formalin test in rats. After i.p. injection of TAP at different doses (2, 5, 10 and 15mg/kg), the biphasic nociceptive behavior was reduced in a dose-dependent manner in both phase I and II. Conversely, i.p. injection of FLP at different doses (0.6, 1.6, 3.3, 6.6, 16.6 and 22.2mg/kg) induced a dose-dependent antinociceptive effect in phase II only. TAP was found to be more effective than FLP. The interaction between TAP and FLP was synergistic in phase II with an interaction index (γ) of 0.50±0.24. The data reported in this study indicate that FLP enhances the antinociceptive effect of TAP and this drug combination might be potentially useful in the treatment of chronic pain.

A novel operant-based behavioral assay of mechanical allodynia in the orofacial region of rats

BACKGROUND

Detecting behaviors related to orofacial pain in rodent models often relies on subjective investigator grades or methods that place the animal in a stressful environment. In this study, an operant-based behavioral assay is presented for the assessment of orofacial tactile sensitivity in the rat.

NEW METHODS

In the testing chamber, rats are provided access to a sweetened condensed milk bottle; however, a 360° array of stainless steel wire loops impedes access. To receive the reward, an animal must engage the wires across the orofacial region. Contact with the bottle triggers a motor, requiring the animal to accept increasing pressure on the face during the test. To evaluate this approach, tolerated bottle distance was measured for 10 hairless Sprague Dawley rats at baseline and 30 min after application of capsaicin cream (0.1%) to the face. The experiment was repeated to evaluate the ability of morphine to reverse this effect.

RESULTS

The application of capsaicin cream reduced tolerated bottle distance measures relative to baseline (p<0.05). As long as morphine did not cause reduced participation due to sedation, subcutaneous morphine dosing reduced the effects of capsaicin (p<0.001). Comparison with existing method: For behavioral tests, experimenters often make subjective decisions of an animal's response. Operant methods can reduce these effects by measuring an animal's selection in a reward-conflict decision. Herein, a method to measure orofacial sensitivity is presented using an operant system.

CONCLUSIONS

This operant device allows for consistent measurement of heightened tactile sensitivity in the orofacial regions of the rat.

Behavioral testing in rodent models of orofacial neuropathic and inflammatory pain

Orofacial pain conditions are often very debilitating to the patient and difficult to treat. While clinical interest is high, the proportion of studies performed in the orofacial region in laboratory animals is relatively low, compared with other body regions. This is partly due to difficulties in testing freely moving animals and therefore lack of reliable testing methods. Here we present a comprehensive review of the currently used rodent models of inflammatory and neuropathic pain adapted to the orofacial areas, taking into account the difficulties and drawbacks of the existing approaches. We examine the available testing methods and procedures used for assessing the behavioral responses in the face in both mice and rats and provide a summary of some pharmacological agents used in these paradigms to date. The use of these agents in animal models is also compared with outcomes observed in the clinic.

Nitric oxide/cGMP pathway mediates orofacial antinociception induced by electroacupuncture at the St36 acupoint

The aim of the present study was to test the hypothesis that electroacupuncture (EA) at acupoint St36 induces antinociception by activation of the L-arg/NO/cGMP pathway. Nociception was produced by thermal stimuli applied to the face of Wistar rats and latency was measured by face withdrawal. Electric stimulation of acupoint St36 for 20 min induced antinociception in this model, which was maintained for 150 min. For comparison, a so-called dry needle group (DN) was used, which received needling at the same point without stimulation. The antinociception obtained by stimulation of acupoint St36 was only achieved when high frequency (100 Hz) was used, whereas low frequencies (5 and 30 Hz) were not capable of achieving this effect. Subcutaneous administration of both inhibitors of NO synthase (N-nitro-L-arginine) and guanylyl cyclase (ODQ) and intraperitoneal administration of specific antagonists of neuronal NO synthase (L-NNA) and inductible NO synthase (aminoguanidine) antagonized the antinociception induced by St36 stimulation. The results of this paper suggest that stimulation of acupoint St36 at high frequency induces antinociception, which seems to be related to L-arg/NO/cGMP pathway activation.

The orofacial formalin test

The subcutaneous injection of formalin into the rat upper lip generates behavioral responses that last several minutes. The time course of the response is similar to what is observed following formalin injection into the paw, i.e. biphasic, with an early and short-lasting first phase followed, after a quiescent period by a second, prolonged (tonic) phase. The applied chemical stimulus (formalin) can be qualified as noxious since it produces tissue injury, activates Adelta and C nociceptors as well as trigeminal and spinal nociceptive neurons and is felt as painful in man. In addition, increasing the concentration of formalin causes a parallel aggravation of histological signs of tissue inflammation and injury. The measured behavioral response (face rubbing) is a relevant end-point: prolonged face rubbing is evoked by formalin but not saline injection and a positive relationship between the amplitude of the response and the formalin concentration is observed, at least up to 2.5%. At higher formalin concentrations, the use of other or additional end-points should be considered. Finally, the behavioral response in the orofacial formalin test is sensitive to various opioid and non-opioid analgesics. The orofacial formalin test can then be considered as a reliable way of producing and quantifying nociception in the trigeminal region of the rat.

The orofacial capsaicin test in rats: effects of different capsaicin concentrations and morphine

The aim of this study was to develop a rat model of capsaicin-induced pain in the orofacial region. We examined the effects of subcutaneous injection of different doses of capsaicin (0.25, 0.4, 0.8, 1.5, 2.5, 25, 50, 100, 500 microg) on the face-grooming response. Injection of capsaicin into the vibrissa pad produced an immediate grooming of the injected area with ipsilateral fore- or hindpaw. A positive relationship between the amplitude of the grooming response and the capsaicin dose was observed until 1.5 microg, but with the highest concentrations (ranging from 25 to 500 microg) the amplitude of the response decreased. Morphine administered either systemically (in the neck, 0.5-4.0 mg/kg) or locally (0.25-1.0 mg/kg) reduced in a dose-dependent fashion the face grooming provoked by subcutaneous capsaicin (1.5 microg). The systemic and local morphine effects could be reversed by systemic (0.1 mg/kg) and local (0.05 mg/kg) administration of naloxone, respectively. The local administration of morphine (ED(50): 0.65 mg/kg) was more potent than systemic injection (ED50: 2.54 mg/kg) in reducing the grooming behavior. In conclusion, the orofacial capsaicin test appears to be a valid and reliable method for studying trigeminal pain mechanisms and testing analgesic drugs. The results of the present study also support the clinical use of peripheral opioid administration for the treatment of orofacial painful conditions.

Orofacial deep and cutaneous tissue inflammation and trigeminal neuronal activation. Implications for persistent temporomandibular pain

A rat model has been developed to characterize the responses of brainstem trigeminal neurons to orofacial deep and cutaneous tissue inflammation and hyperalgesia. Complete Freund's adjuvant (CFA) was injected unilaterally into the rat temporomandibular joint (TMJ) or perioral (PO) skin to produce inflammation in deep or cutaneous tissues, respectively. The TMJ and PO inflammation resulted in orofacial behavioral hyperalgesia and allodynia that peaked within 4-24 h and persisted for at least 2 weeks. Compared to cutaneous CFA injection, the injection of CFA into the TMJ produced a significantly stronger inflammation associated with a selective upregulation of preprodynorphin mRNA in the trigeminal spinal complex, an enhanced medullary dorsal horn hyperexcitability, and a greater trigeminal Fos protein expression, a marker of neuronal activation. The Fos-LI induced by TMJ inflammation persisted longer, was more intense, particularly in the superficial laminae, and more widespread rostrocaudally. Thus, the inflammatory irritant produces a stronger effect in deep than in cutaneous orofacial tissue. As there is heavy innervation of the TMJ by unmyelinated nerve endings, a strong nociceptive primary afferent barrage is expected following inflammation. An increase in TMJ C-fiber input after inflammation and strong central neuronal activation may initiate central hyperexcitability and contribute to persistent pain associated with temporomandibular disorders. Since deep inputs may be more effective in inducing central neuronal excitation than cutaneous inputs, greater sensory disturbances may occur in pain conditions involving deep tissues than in those involving cutaneous tissues.

An improved method for assessing mechanical allodynia in the rat

A method has been developed for assessing mechanical nociceptive threshold and allodynia in the rat. The animal was habituated to stand on its hind paws while leaning against an experimenter's hand. The rat was unrestrained, but remained in the position throughout the test session. The Semmes-Weinstein monofilaments were used to probe body areas such as the lateral edge of the hind paw and the orofacial skin. The median withdrawal response threshold was found to be 62.9 g for both hind paws (95 % confidence interval, CL, 61.4-66.7 g, n = 69). The median response thresholds of the orofacial skin were 62.9 g (95% CL: 55.7-68.7 g, n = 45), and 25.6 g (95% CL: 22.6-36.3 g, n = 45), for the skin above the temporomandibular joint (PT) and the perioral (PO) skin, respectively. The injection of an inflammatory agent, complete Freund's adjuvant, into the hind paw, peritemporomandibular joint tissue (PTMJ), or PO skin resulted in significant mechanical allodynia. The median response thresholds were reduced to 0.09 g (p < 0.01, n = 6), 5.60 g (p < 0.001, n = 9), and 3.24 g (p < 0.001, n = 9), after hind paw, PTMJ, and PO inflammation, respectively. The allodynia persisted for at least 2 weeks in all cases. This testing paradigm eliminates confounding factors related to weight bearing, and offers a simple, objective, and reliable approach to assess mechanical sensitivity in rats. The method will be useful for studying the central mechanisms of mechanical allodynia. Importantly, this method can also be used in the orofacial region, and will facilitate studies on the mechanisms of persistent orofacial pain in animals.

Applied psychophysiology and biofeedback of event-related potentials (brain waves): historical perspective, review, future directions

This paper reviews the efforts of workers in the 1960s-1980s to demonstrate voluntary control of exogenously evoked (event-related) potentials in visual, somatic sensory, and auditory systems in rats, cats, and humans. The first part of the paper reviews the conceptual foundation and development of the work--it actually arose from traditional sensory coding and neural correlates of behavior studies. The second part summarizes recent applications of the method in the area of pain control. In reviewing these matters, the major effort is directed at revealing how the ideas unfolded in very human, day-to-day, anecdotal terms. There is not much of an attempt to formally review the literature, which is cited for consultation elsewhere. In the same spirit, many possible future experiments are suggested by way of elucidating the key remaining questions in the area.

Application of the formalin test to the study of orofacial pain in the rat

A modification of the formalin test for assessing pain and analgesia in the orofacial region of the rat is described. A formalin solution (5%) was subcutaneously injected into the upper lip, then the length of time the animal spent rubbing the injected zone was recorded. Two distinct periods of intensive rubbing activity were identified: an early phase between 0 and 3 min after the injection and a late phase between 18 and 42 min after the injection. Acetylsalicylic acid, paracetamol and morphine all had an antinociceptive effect during the two phases although incomplete during the early phase. Our results indicate that this orofacial formalin test is a valid technique for the study of orofacial pain.

Cutting rostral trigeminal nuclear complex projections preferentially affects perioral nociception in the rat

Sagittal knife cuts were made medial to rostral trigeminal brainstem nuclei in 11 rats. These cuts resulted in significant group deficits in facial thermal nociception at only two of the 5 ipsilateral sites tested. The affected sites were close to the vibrissa and oral cavity, suggesting that rostral trigeminal projections signal anterior rather than more caudal facial nociception. Three rats were also tested for EEG arousal responsiveness to innocuous air puffs before and after the cuts at the same facial sites. Only one of the rats demonstrated a significant deficit at one of the 5 sites tested, suggesting that the rostral projections interrupted in this study are not necessary for innocuous facial sensation.

Lesions of the mid-spinal trigeminal complex are effective in producing perioral thermal hypoalgesia

The hypoalgesic effects of lesions in the rat spinal trigeminal complex at the levels of subnucleus interpolaris and caudal subnucleus oralis were investigated. Lesions of the trigeminal tract, nucleus, or adjacent reticular formation resulted in significant elevations in escape latencies to noxious thermal stimulation of the ipsilateral perioral area. The nuclear lesions were significantly more effective in producing latency elevations than were the reticular formation lesions. Behavioral and anatomical evidence is presented suggesting that the mid-spinal trigeminal complex, including the ascending trigeminal intranuclear pathways, participate in perioral thermal nociception.

Opiate microinjections into midbrain do not affect the aversiveness of caudal trigeminal stimulation but produce somatotopically organized peripheral hypoalgesia

High-dose microinjections of morphine sulfate (15 micrograms) and (D-Ala2)-Met-enkephalin (30 micrograms) were made into the ventral periaqueductal gray of rats. Consistent with previous reports using lower doses, both opiates produced hypoalgesia for noxious thermal stimuli applied to the upper and lower body. More hypoalgesia was observed on the face than on the hind legs or tail. Current thresholds of aversive reaction to stimulation in the trigeminal subnucleus caudalis were unaffected by microinjection of either opiate. Systemic injections of 6 mg/kg morphine sulfate profoundly inhibited defense responses to peripheral noxious stimuli and significantly elevated aversive reaction thresholds for stimulation in the trigeminal subnucleus caudalis. Aversive reactions to stimulation in the dorsal periaqueductal gray remained unaffected by either microinjected or systemically administered opiates.

Medial hypothalamic stimulation produces analgesia to facial heating in unrestrained rats

Gradual heating of the face in unrestrained conscious rats produced a behavioural response at a mean threshold temperature of 41.9 degrees C (S.E.M. +/- 0.02, 174 tests). This temperature did not change with tests repeated at 5-min intervals over one hour. During stimulation of the preoptic area of the hypothalamus the response temperature was consistently raised by about 3 degrees C but returned to the control level within 5 min.

Operant conditioning of somatosensory evoked potential (SEP) amplitude in rats. I. Specific changes in SEP amplitude and a naloxone-reversible somatotopically specific change in facial nociception

The aim of this experiment was to investigate possible endogenous opioid modulation of innocuous somatosensory activity. Somatosensory activity was measured by recording cortical somatosensory evoked potential (SEP) and reflex movement amplitude evoked by innocuous electrical stimulation of the spinal trigeminal tract in awake rats. Putative endogenous opioid activity was blocked using the opiate antagonist naloxone (1 mg/kg). The amplitude of midlatency SEP components (14-50 ms latency) increased following administration of naloxone and repeated stimulus presentations. The amplitude of these components decreased following administration of the opiate agonist morphine (3 mg/kg). An early cortical component (10 ms latency) habituated following the administration of saline but did not habituate following naloxone. Naloxone also enhanced habituation of the late SEP components (60-120 ms latency) and reflex movement evoked at higher stimulus intensities. Morphine decreased the amplitude of the early cortical component but had no consistent effect on the amplitude of the late SEP components.

Effects of trigeminal tractotomy on facial thermal nociception in the rat

Wire knife-cuts lesioning the descending trigeminal tract and trigeminal sensory nuclear complex at the level of subnucleus interpolaris significantly elevated response latencies to noxious thermal stimuli applied to one perioral locus of facial skin. Group analyses of four other ipsilateral sites did not reveal significant effects. Medial cuts, extensively damaging the sensory nuclear complex as well as the tract, were more likely to produce significant elevations than were lateral cuts. These results suggest that tractotomy does not result in complete facial analgesia in the rat, and that the effectiveness of tractotomy may in part be due to interruption of intranuclear trigeminal projections.

Distribution of substance P-responsive and nociceptive neurones in relation to substance P-immunoreactivity within the caudal trigeminal nucleus of the rat

Substance P is a peptide which is found in small diameter primary afferent fibres and may have a function in nociceptive afferent transmission. In order to study the role of substance P in sensory processes in depth, we have compared the distributions of nociceptive neurones and substance P-responsive neurones with the distribution of substance P in the caudal trigeminal nucleus of the rat. It was found that substance P-like immunoreactivity was located primarily in the superficial layers of nucleus caudalis (equivalent to laminae I and II of the dorsal horn) and in more ventromedially located areas (equivalent to laminae V and VI). The distribution was found to be in good agreement with the distribution of nociceptive neurones. Iontophoretically applied substance P had predominantly excitatory actions on both nociceptive and non-nociceptive nucleus caudalis neurones, although the peptide did appear to be slightly more likely to excite nociceptive neurones. Similarly, the peptide appeared slightly more likely to be excitatory in areas of nucleus caudalis showing substance P staining, but excitations were also predominantly seen in areas containing little or no apparent substance P staining. These results are consistent with the proposed role for substance P as a nociceptive afferent neurotransmitter. However, it is also possible that the peptide performs other functions in the processing of sensory information.

A new, reliable lower-body nociception device for unrestrained animals yields data comparable to a new portable version of the face-rub test

A novel lower body heating device is described for use in lower body analgesiometry with freely-moving, small animals. It consists of a resistor in contact with a hindlimb. The defensive biting response to heat shows reliable dose-response effects with morphine which compare well with our similar upper body device (Rosenfeld et al. 1978). Issues dealing with upper versus lower body nociception effects may be tested with the new device set described.

Operant conditioning of trigeminally-evoked cortical potentials: correlated effects on facial nociception

The effects of operant conditioning somatosensory evoked potential (SEP) amplitude on nociceptive sensitivity were studied in albino rats. SEPs were evoked by stimulation to the descending trigeminal tract. Rewarding medial forebrain bundle stimulation (at intensities predetermined to sustain bar pressing) was made contingent upon the animal making the amplitude of the SEP 0.5 standard deviation (S.D.) large (uptraining) or 0.5 S.D. smaller (downtraining) than the predetermined mean value. Nociceptive sensitivity was measured immediately following the conditioning session by heating the rat's face and noting the latency of a defensive face rubbing response directed at that area of the face. Increasing the amplitude of the SEP (uptraining) was associated with a decrease in noxious sensitivity. Decreasing the amplitude of the SEP (downtraining) was associated with an increase in noxious sensitivity.

Effects of serotonin and morphine on spontaneous and evoked firing of nociceptive neurons in the trigeminal spinal nucleus of rats

Spontaneously firing neurons that were responsive to noxious face pinch or noxious heat were studied in the trigeminal spinal nucleus of the rat brain. These neurons responded with either an increase or decrease in firing rate. In these neurons serotonin (5-hydroxytryptamine; 5-HT) apparently acts through two mechanisms to attenuate the response to a noxious stimulus. One mechanism is mimicked by morphine; these two drugs block the response to the noxious stimuli without having a consistent effect on spontaneous firing. The effects of the two drugs were somewhat selective depending on the noxious stimulus used and the effect of the noxious stimulus; morphine and 5-HT were more effective in blocking the increase in firing rate evoked by the face pinch but 5-HT and morphine were more effective in blocking the decrease in firing rate evoked by the noxious heat stimulus. Interestingly, the direction of the response to a particular noxious stimulus frequently predicted whether or not both morphine and 5-HT would act on the same or different neurons. A second mechanism by which 5-HT, but not morphine, acted was to change the spontaneous firing in a direction opposite that evoked by the noxious stimulus. This type of effect apparently modulated the response to a noxious stimulus by changing the spontaneous firing rate such that a noxious stimulus had to be more intense before it could significantly alter the neuronal firing in the opposite direction. Morphine occasionally produced a change in firing pattern in neurons; this effect remains to be documented more extensively.

Differential effects of intracerebrally microinjected enkephalin analogs on centrally versus peripherally induced pain, and evidence for a facial versus lower body analgesic effect

[D-Ala2]-Met-Enkephalin and [D-Ala2]-Met-Enkephalinamide were microinjected (10-30 microgram) into the midbrain ventrolateral central gray of rats. The opiate analogs produced profound analgesia in left and right facial areas, and on the hot plate test. The tail-flick test showed significant analgesia, but in a significantly smaller amount than that obtained with noxious face heating. All effects were blocked by naloxone pre-treatment. The drugs had no effect on thresholds for defense responses to high (200 Hz) and low (20 Hz) frequency aversive stimulation in midbrain areas associated with pain perception.