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Ge M, Balleine BW. The role of the bed nucleus of the stria terminalis in the motivational control of instrumental action. Front Behav Neurosci 2022; 16:968593. [DOI: 10.3389/fnbeh.2022.968593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 10/21/2022] [Indexed: 11/23/2022] Open
Abstract
We review recent studies assessing the role of the bed nucleus of the stria terminalis (BNST) in the motivational control of instrumental conditioning. This evidence suggests that the BNST and central nucleus of the amygdala (CeA) form a circuit that modulates the ventral tegmental area (VTA) input to the nucleus accumbens core (NAc core) to control the influence of Pavlovian cues on instrumental performance. In support of these claims, we found that activity in the oval region of BNST was increased by instrumental conditioning, as indexed by phosphorylated ERK activity (Experiment 1), but that this increase was not due to exposure to the instrumental contingency or to the instrumental outcome per se (Experiment 2). Instead, BNST activity was most significantly incremented in a test conducted when the instrumental outcome was anticipated but not delivered, suggesting a role for BNST in the motivational effects of anticipated outcomes on instrumental performance. To test this claim, we examined the effect of NMDA-induced cell body lesions of the BNST on general Pavlovian-to-instrumental transfer (Experiment 3). These lesions had no effect on instrumental performance or on conditioned responding during Pavlovian conditioning to either an excitory conditioned stimulus (CS) or a neutral CS (CS0) but significantly attenuated the excitatory effect of the Pavlovian CS on instrumental performance. These data are consistent with the claim that the BNST mediates the general excitatory influence of Pavlovian cues on instrumental performance and suggest BNST activity may be central to CeA-BNST modulation of a VTA-NAc core circuit in incentive motivation.
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Luyck K, Bervoets C, Deblieck C, Nuttin B, Luyten L. Deep brain stimulation in the bed nucleus of the stria terminalis: A symptom provocation study in patients with obsessive-compulsive disorder. J Psychiatr Res 2022; 151:252-260. [PMID: 35512619 DOI: 10.1016/j.jpsychires.2022.04.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 04/22/2022] [Accepted: 04/25/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Deep brain stimulation (DBS) is an emerging therapy for treatment-resistant obsessive-compulsive disorder (OCD), and several targets for electrode implantation and contact selection have been proposed, including the bed nucleus of the stria terminalis (BST). Selecting the active electrode contacts (patients typically have four to choose from in each hemisphere), and thus the main locus of stimulation, can be a taxing process. Here, we investigated whether contact selection based purely on their neuroanatomical position in the BST is a worthwhile approach. For the first time, we also compared the effects of uni- versus bilateral BST stimulation. METHODS Nine OCD patients currently receiving DBS participated in a double-blind, randomized symptom provocation study to compare no versus BST stimulation. Primary outcomes were anxiety and mood ratings in response to disorder-relevant trigger images, as well as ratings of obsessions, compulsions, tendency to avoid and overall wellbeing. Furthermore, we asked whether patients preferred the electrode contacts in the BST over their regular stimulation contacts as a new treatment setting after the end of the task. RESULTS We found no statistically significant group differences between the four conditions (no, left, right and bilateral BST stimulation). Exploratory analyses, as well as follow-up data, did indicate that (bilateral) bipolar stimulation in the BST was beneficial for some patients, particularly for those who had achieved unsatisfactory effects through the typical contact selection procedure. CONCLUSIONS Despite its limitations, this study suggests that selection of stimulation contacts in the BST is a viable option for DBS in treatment-resistant OCD patients.
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Affiliation(s)
- Kelly Luyck
- KU Leuven, Experimental Neurosurgery and Neuroanatomy, Herestraat 49 PB 7003, 3000, Leuven, Belgium; Leuven Brain Institute, Herestraat 49 PB 1021, 3000, Leuven, Belgium
| | - Chris Bervoets
- Leuven Brain Institute, Herestraat 49 PB 1021, 3000, Leuven, Belgium; University Hospitals Leuven, Psychiatry, Campus Gasthuisberg, Herestraat 49, 3000, Leuven, Belgium
| | - Choi Deblieck
- University Hospitals Leuven, Psychiatry, Campus Gasthuisberg, Herestraat 49, 3000, Leuven, Belgium
| | - Bart Nuttin
- KU Leuven, Experimental Neurosurgery and Neuroanatomy, Herestraat 49 PB 7003, 3000, Leuven, Belgium; Leuven Brain Institute, Herestraat 49 PB 1021, 3000, Leuven, Belgium; University Hospitals Leuven, Neurosurgery, Campus Gasthuisberg, Herestraat 49, 3000, Leuven, Belgium
| | - Laura Luyten
- KU Leuven, Experimental Neurosurgery and Neuroanatomy, Herestraat 49 PB 7003, 3000, Leuven, Belgium; Leuven Brain Institute, Herestraat 49 PB 1021, 3000, Leuven, Belgium; KU Leuven, Psychology of Learning and Experimental Psychopathology, Tiensestraat 102 PB 3712, 3000, Leuven, Belgium.
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Abstract
It becomes increasingly clear that (non-)invasive neurostimulation is an effective treatment for obsessive-compulsive disorder (OCD). In this chapter we review the available evidence on techniques and targets, clinical results including a meta-analysis, mechanisms of action, and animal research. We focus on deep brain stimulation (DBS), but also cover non-invasive neurostimulation including transcranial magnetic stimulation (TMS). Data shows that most DBS studies target the ventral capsule/ventral striatum (VC/VS), with an overall 76% response rate in treatment-refractory OCD. Also TMS holds clinical promise. Increased insight in the normalizing effects of neurostimulation on cortico-striatal-thalamic-cortical (CSTC) loops - through neuroimaging and animal research - provides novel opportunities to further optimize treatment strategies. Advancing clinical implementation of neurostimulation techniques is essential to ameliorate the lives of the many treatment-refractory OCD patients.
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Chang KW, Jung HH, Chang JW. Magnetic Resonance-Guided Focused Ultrasound Surgery for Obsessive-Compulsive Disorders: Potential for use as a Novel Ablative Surgical Technique. Front Psychiatry 2021; 12:640832. [PMID: 33889100 PMCID: PMC8057302 DOI: 10.3389/fpsyt.2021.640832] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Accepted: 03/11/2021] [Indexed: 12/24/2022] Open
Abstract
Surgical treatment for psychiatric disorders, such as obsessive-compulsive disorder (OCD) and depression, using ablative techniques, such as cingulotomy and capsulotomy, have historically been controversial for a number of scientific, social, and ethical reasons. Recently, with the elucidation of anatomical and neurochemical substrates of brain function in healthy controls and patients with such disorders using various functional neuroimaging techniques, these criticisms are becoming less valid. Furthermore, by using new techniques, such as deep brain stimulation (DBS), and identifying more precise targets, beneficial effects and the lack of serious complications have been demonstrated in patients with psychiatric disorders. However, DBS also has many disadvantages. Currently, magnetic resonance-guided focused ultrasound surgery (MRgFUS) is used as a minimal-invasive surgical method for generating precisely placed focal thermal lesions in the brain. Here, we review surgical techniques and their potential complications, along with anterior limb of the internal capsule (ALIC) capsulotomy by radiofrequency lesioning and gamma knife radiosurgery, for the treatment of OCD and depression. We also discuss the limitations and technical issues related to ALIC capsulotomy with MRgFUS for medically refractory OCD and depression. Through this review we hope MRgFUS could be considered as a new treatment choice for refractory OCD.
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Affiliation(s)
- Kyung Won Chang
- Department of Neurosurgery & Brain Research Institute, Yonsei University College of Medicine, Seoul, South Korea
| | - Hyun Ho Jung
- Department of Neurosurgery & Brain Research Institute, Yonsei University College of Medicine, Seoul, South Korea
| | - Jin Woo Chang
- Department of Neurosurgery & Brain Research Institute, Yonsei University College of Medicine, Seoul, South Korea
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5
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Abstract
The clinical use of deep brain stimulation (DBS) is among the most important advances in the clinical neurosciences in the past two decades. As a surgical tool, DBS can directly measure pathological brain activity and can deliver adjustable stimulation for therapeutic effect in neurological and psychiatric disorders correlated with dysfunctional circuitry. The development of DBS has opened new opportunities to access and interrogate malfunctioning brain circuits and to test the therapeutic potential of regulating the output of these circuits in a broad range of disorders. Despite the success and rapid adoption of DBS, crucial questions remain, including which brain areas should be targeted and in which patients. This Review considers how DBS has facilitated advances in our understanding of how circuit malfunction can lead to brain disorders and outlines the key unmet challenges and future directions in the DBS field. Determining the next steps in DBS science will help to define the future role of this technology in the development of novel therapeutics for the most challenging disorders affecting the human brain.
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6
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Banasikowski TJ, Hawken ER. The Bed Nucleus of the Stria Terminalis, Homeostatic Satiety, and Compulsions: What Can We Learn From Polydipsia? Front Behav Neurosci 2019; 13:170. [PMID: 31417376 PMCID: PMC6686835 DOI: 10.3389/fnbeh.2019.00170] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 07/12/2019] [Indexed: 12/28/2022] Open
Abstract
A compulsive phenotype characterizes several neuropsychiatric illnesses - including but not limited to - schizophrenia and obsessive compulsive disorder. Because of its perceived etiological heterogeneity, it is challenging to disentangle the specific neurophysiology that precipitates compulsive behaving. Using polydipsia (or non-regulatory water drinking), we describe candidate neural substrates of compulsivity. We further postulate that aberrant neuroplasticity within cortically projecting structures [i.e., the bed nucleus of the stria terminalis (BNST)] and circuits that encode homeostatic emotions (thirst, hunger, satiety, etc.) underlie compulsive drinking. By transducing an inaccurate signal that fails to represent true homeostatic state, cortical structures cannot select appropriate and adaptive actions. Additionally, augmented dopamine (DA) reactivity in striatal projections to and from the frontal cortex contribute to aberrant homeostatic signal propagation that ultimately biases cortex-dependent behavioral selection. Responding becomes rigid and corresponds with both erroneous, inflexible encoding in both bottom-up structures and in top-down pathways. How aberrant neuroplasticity in circuits that encode homeostatic emotion result in the genesis and maintenance of compulsive behaviors needs further investigation.
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Affiliation(s)
- Tomek J Banasikowski
- Department of Psychiatry, Queen's University, Kingston, ON, Canada.,Providence Care Hospital, Kingston, ON, Canada
| | - Emily R Hawken
- Department of Psychiatry, Queen's University, Kingston, ON, Canada.,Providence Care Hospital, Kingston, ON, Canada
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7
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Pinhal CM, van den Boom BJG, Santana-Kragelund F, Fellinger L, Bech P, Hamelink R, Feng G, Willuhn I, Feenstra MGP, Denys D. Differential Effects of Deep Brain Stimulation of the Internal Capsule and the Striatum on Excessive Grooming in Sapap3 Mutant Mice. Biol Psychiatry 2018; 84:917-925. [PMID: 29954580 DOI: 10.1016/j.biopsych.2018.05.011] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Revised: 05/02/2018] [Accepted: 05/02/2018] [Indexed: 01/17/2023]
Abstract
BACKGROUND Deep brain stimulation (DBS) is an effective treatment for patients with obsessive-compulsive disorder (OCD) that do not respond to conventional therapies. Although the precise mechanism of action of DBS remains unknown, modulation of activity in corticofugal fibers originating in the prefrontal cortex is thought to underlie its beneficial effects in OCD. METHODS To gain more mechanistic insight into DBS in OCD, we used Sapap3 mutant mice. These mice display excessive self-grooming and increased anxiety, both of which are responsive to therapeutic drugs used in OCD patients. We selected two clinically relevant DBS targets through which activity in prefronto-corticofugal fibers may be modulated: the internal capsule (IC) and the dorsal part of the ventral striatum (dVS). RESULTS IC-DBS robustly decreased excessive grooming, whereas dVS-DBS was on average less effective. Grooming was reduced rapidly after IC-DBS onset and reinstated upon DBS offset. Only IC-DBS was associated with increased locomotion. DBS in both targets induced c-Fos expression around the electrode tip and in different regions of the prefrontal cortex. This prefronto-cortical activation was more extensive after IC-DBS, but not associated with behavioral effects. Furthermore, we found that the decline in grooming cannot be attributed to altered locomotor activity and that anxiety, measured on the elevated plus maze, was not affected by DBS. CONCLUSIONS DBS in both the IC and dVS reduces compulsive grooming in Sapap3 mutant mice. However, IC stimulation was more effective, but also produced motor activation, even though both DBS targets modulated activity in a similar set of prefrontal cortical fibers.
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Affiliation(s)
- Cindy M Pinhal
- Netherlands Institute for Neuroscience, Royal Netherlands Academy of Arts and Sciences, Amsterdam, the Netherlands
| | - Bastijn J G van den Boom
- Netherlands Institute for Neuroscience, Royal Netherlands Academy of Arts and Sciences, Amsterdam, the Netherlands; Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Fabiana Santana-Kragelund
- Netherlands Institute for Neuroscience, Royal Netherlands Academy of Arts and Sciences, Amsterdam, the Netherlands
| | - Lizz Fellinger
- Netherlands Institute for Neuroscience, Royal Netherlands Academy of Arts and Sciences, Amsterdam, the Netherlands
| | - Pol Bech
- Netherlands Institute for Neuroscience, Royal Netherlands Academy of Arts and Sciences, Amsterdam, the Netherlands
| | - Ralph Hamelink
- Netherlands Institute for Neuroscience, Royal Netherlands Academy of Arts and Sciences, Amsterdam, the Netherlands; Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Guoping Feng
- McGovern Institute for Brain Research, Massachusetts Institute of Technology, Cambridge, Massachusetts
| | - Ingo Willuhn
- Netherlands Institute for Neuroscience, Royal Netherlands Academy of Arts and Sciences, Amsterdam, the Netherlands; Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands.
| | - Matthijs G P Feenstra
- Netherlands Institute for Neuroscience, Royal Netherlands Academy of Arts and Sciences, Amsterdam, the Netherlands; Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Damiaan Denys
- Netherlands Institute for Neuroscience, Royal Netherlands Academy of Arts and Sciences, Amsterdam, the Netherlands; Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
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8
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Jung HH, Chang WS, Kim SJ, Kim CH, Chang JW. The Potential Usefulness of Magnetic Resonance Guided Focused Ultrasound for Obsessive Compulsive Disorders. J Korean Neurosurg Soc 2018; 61:427-433. [PMID: 29631388 PMCID: PMC6046565 DOI: 10.3340/jkns.2017.0505.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Accepted: 07/19/2017] [Indexed: 11/27/2022] Open
Abstract
Obsessive compulsive disorder is a debilitating condition characterized by recurrent obsessive thoughts and compulsive reactions. A great portion of the obsessive compulsive disorder (OCD) patients are managed successfully with psychiatric treatment such as selective serotonin-reuptake inhibitor and cognitive behavioral psychotherapy, but more than 10% of patients are remained as non-responder who needs neurosurgical treatments. These patients are potential candidates for the neurosurgical management. There had been various kind of operation, lesioning such as leucotomy or cingulotomy or capsulotomy or limbic leucotomy, and with advent of stereotaxic approach and technical advances, deep brain stimulation was more chosen by neurosurgeon due to its characteristic of reversibility and adjustability. Gamma knife radiosurgery are also applied to make lesion targeting based on magnetic resonance (MR) imaging, but the complication of adverse radiation effect is not predictable. In the neurosurgical field, MR guided focused ultrasound has advantage of less invasiveness, real-time monitored procedure which is now growing to attempt to apply for various brain disorder. In this review, the neurosurgical treatment modalities for the treatment of OCD will be briefly reviewed and the current state of MR guided focused ultrasound for OCD will be suggested.
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Affiliation(s)
- Hyun Ho Jung
- Department of Neurosurgery and Brain Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Won Seok Chang
- Department of Neurosurgery and Brain Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Se Joo Kim
- Department of Psychiatry and Institute of Behavioral Science, Yonsei University College of Medicine, Seoul, Korea
| | - Chan-Hyung Kim
- Department of Psychiatry and Institute of Behavioral Science, Yonsei University College of Medicine, Seoul, Korea
| | - Jin Woo Chang
- Department of Neurosurgery and Brain Research Institute, Yonsei University College of Medicine, Seoul, Korea
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9
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Schippers MC, Bruinsma B, Gaastra M, Mesman TI, Denys D, De Vries TJ, Pattij T. Deep Brain Stimulation of the Nucleus Accumbens Core Affects Trait Impulsivity in a Baseline-Dependent Manner. Front Behav Neurosci 2017; 11:52. [PMID: 28386221 PMCID: PMC5362621 DOI: 10.3389/fnbeh.2017.00052] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Accepted: 03/07/2017] [Indexed: 12/29/2022] Open
Abstract
Deep brain stimulation (DBS) of the nucleus accumbens (NA) is explored as a treatment for refractory psychiatric disorders, such as obsessive-compulsive disorder (OCD), depressive disorder (MDD), and substance use disorder (SUD). A common feature of some of these disorders is pathological impulsivity. Here, the effects of NAcore DBS on impulsive choice and impulsive action, two distinct forms of impulsive behavior, were investigated in translational animal tasks, the delayed reward task (DRT) and five-choice serial reaction time task (5-CSRTT), respectively. In both tasks, the effects of NAcore DBS were negatively correlated with baseline impulsive behavior, with more pronounced effects in the 5-CSRTT. To further examine the effects of DBS on trait impulsive action, rats were screened for high (HI) and low (LI) impulsive responding in the 5-CSRTT. NAcore DBS decreased impulsive, premature responding in HI rats under conventional conditions. However, upon challenged conditions to increase impulsive responding, NAcore DBS did not alter impulsivity. These results strongly suggest a baseline-dependent effect of DBS on impulsivity, which is in line with clinical observations.
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Affiliation(s)
- Maria C Schippers
- Amsterdam Neuroscience, Department of Anatomy and Neurosciences, VU University Medical Center Amsterdam, Netherlands
| | - Bastiaan Bruinsma
- Amsterdam Neuroscience, Department of Anatomy and Neurosciences, VU University Medical Center Amsterdam, Netherlands
| | - Mathijs Gaastra
- Amsterdam Neuroscience, Department of Anatomy and Neurosciences, VU University Medical Center Amsterdam, Netherlands
| | - Tanja I Mesman
- Amsterdam Neuroscience, Department of Anatomy and Neurosciences, VU University Medical Center Amsterdam, Netherlands
| | - Damiaan Denys
- Amsterdam Neuroscience, Department of Psychiatry, Academic Medical Center, University of Amsterdam Amsterdam, Netherlands
| | - Taco J De Vries
- Amsterdam Neuroscience, Department of Anatomy and Neurosciences, VU University Medical Center Amsterdam, Netherlands
| | - Tommy Pattij
- Amsterdam Neuroscience, Department of Anatomy and Neurosciences, VU University Medical Center Amsterdam, Netherlands
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10
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Electrical stimulation of the bed nucleus of the stria terminalis reduces anxiety in a rat model. Transl Psychiatry 2017; 7:e1033. [PMID: 28195571 PMCID: PMC5438032 DOI: 10.1038/tp.2017.2] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Revised: 10/07/2016] [Accepted: 12/08/2016] [Indexed: 12/12/2022] Open
Abstract
We recently showed that deep brain stimulation (DBS) in the bed nucleus of the stria terminalis (BST) reduces obsessions, compulsions and associated anxiety in patients suffering from severe, treatment-refractory obsessive-compulsive disorder. Here, we investigated the anxiolytic effects of electrical BST stimulation in a rat model of conditioned anxiety, unrelated to obsessions or compulsions. Two sets of stimulation parameters were evaluated. Using fixed settings at 100 Hz, 40 μs and 300 μA (Set A), we observed elevated freezing and startle levels, whereas stimulation at 130 Hz, 220 μs and individually tailored amplitudes (Set B) appeared to reduce freezing. In a follow-up experiment, we evaluated the anxiolytic potential of Set B more extensively, by adding a lesion group and an additional day of stimulation. We found that electrical stimulation significantly reduced freezing, but not to the same extent as lesions. Neither lesions nor stimulation of the BST affected motor behavior or unconditioned anxiety in an open-field test. In summary, electrical stimulation of the BST was successful in reducing contextual anxiety in a rat model, without eliciting unwanted motor effects. Our findings underline the therapeutic potential of DBS in the BST for disorders that are hallmarked by pathological anxiety. Further research will be necessary to assess the translatability of these findings to the clinic.
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Rangarajan JR, Vande Velde G, van Gent F, De Vloo P, Dresselaers T, Depypere M, van Kuyck K, Nuttin B, Himmelreich U, Maes F. Image-based in vivo assessment of targeting accuracy of stereotactic brain surgery in experimental rodent models. Sci Rep 2016; 6:38058. [PMID: 27901096 PMCID: PMC5128925 DOI: 10.1038/srep38058] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Accepted: 11/01/2016] [Indexed: 01/27/2023] Open
Abstract
Stereotactic neurosurgery is used in pre-clinical research of neurological and psychiatric disorders in experimental rat and mouse models to engraft a needle or electrode at a pre-defined location in the brain. However, inaccurate targeting may confound the results of such experiments. In contrast to the clinical practice, inaccurate targeting in rodents remains usually unnoticed until assessed by ex vivo end-point histology. We here propose a workflow for in vivo assessment of stereotactic targeting accuracy in small animal studies based on multi-modal post-operative imaging. The surgical trajectory in each individual animal is reconstructed in 3D from the physical implant imaged in post-operative CT and/or its trace as visible in post-operative MRI. By co-registering post-operative images of individual animals to a common stereotaxic template, targeting accuracy is quantified. Two commonly used neuromodulation regions were used as targets. Target localization errors showed not only variability, but also inaccuracy in targeting. Only about 30% of electrodes were within the subnucleus structure that was targeted and a-specific adverse effects were also noted. Shifting from invasive/subjective 2D histology towards objective in vivo 3D imaging-based assessment of targeting accuracy may benefit a more effective use of the experimental data by excluding off-target cases early in the study.
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Affiliation(s)
- Janaki Raman Rangarajan
- Department of Electrical Engineering (ESAT/PSI), KU Leuven & Medical Imaging Research Center, University Hospital Leuven, Leuven, Flanders, Belgium
- Molecular Small Animal Imaging Center (MoSAIC), Faculty of Medicine, KU Leuven, Leuven, Flanders, Belgium
| | - Greetje Vande Velde
- Molecular Small Animal Imaging Center (MoSAIC), Faculty of Medicine, KU Leuven, Leuven, Flanders, Belgium
- Biomedical MRI unit, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, Leuven, Flanders, Belgium
| | - Friso van Gent
- Biomedical MRI unit, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, Leuven, Flanders, Belgium
- Laboratory for Experimental Functional Neurosurgery, Department of Neurosciences, Faculty of Medicine, KU Leuven, Leuven, Flanders, Belgium
| | - Philippe De Vloo
- Laboratory for Experimental Functional Neurosurgery, Department of Neurosciences, Faculty of Medicine, KU Leuven, Leuven, Flanders, Belgium
| | - Tom Dresselaers
- Molecular Small Animal Imaging Center (MoSAIC), Faculty of Medicine, KU Leuven, Leuven, Flanders, Belgium
- Biomedical MRI unit, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, Leuven, Flanders, Belgium
| | - Maarten Depypere
- Department of Electrical Engineering (ESAT/PSI), KU Leuven & Medical Imaging Research Center, University Hospital Leuven, Leuven, Flanders, Belgium
| | - Kris van Kuyck
- Laboratory for Experimental Functional Neurosurgery, Department of Neurosciences, Faculty of Medicine, KU Leuven, Leuven, Flanders, Belgium
| | - Bart Nuttin
- Laboratory for Experimental Functional Neurosurgery, Department of Neurosciences, Faculty of Medicine, KU Leuven, Leuven, Flanders, Belgium
| | - Uwe Himmelreich
- Molecular Small Animal Imaging Center (MoSAIC), Faculty of Medicine, KU Leuven, Leuven, Flanders, Belgium
- Biomedical MRI unit, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, Leuven, Flanders, Belgium
| | - Frederik Maes
- Department of Electrical Engineering (ESAT/PSI), KU Leuven & Medical Imaging Research Center, University Hospital Leuven, Leuven, Flanders, Belgium
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12
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Field Potential Oscillations in the Bed Nucleus of the Stria Terminalis Correlate with Compulsion in a Rat Model of Obsessive-Compulsive Disorder. J Neurosci 2016; 36:10050-9. [PMID: 27683902 DOI: 10.1523/jneurosci.1872-15.2016] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2015] [Accepted: 08/06/2016] [Indexed: 01/01/2023] Open
Abstract
UNLABELLED The bed nucleus of the stria terminalis (BNST) is implicated in anxiety and reward processing, both of which are associated with obsessive-compulsive disorder (OCD). Specific neuronal groups in the BNST related to anxiety and reward have been identified, but quantitative data about the information carried by local field potential (LFP) signals in this area during obsession/compulsion are lacking. Here we investigate the BNST LFP in the schedule-induced polydipsia, an animal model of OCD. We implanted electrodes bilaterally in the BNST and random control brain regions in 32 male Wistar rats, and recorded corresponding LFP during compulsive and noncompulsive behavior. We first applied high-frequency (100 Hz) electrical stimulation through the implanted electrodes and analyzed its effects on compulsive behavior. We then performed time-frequency analysis of LFPs and statistically compared the normalized power of δ (1-4 Hz), θ (4-8 Hz), α (8-12 Hz), β (12-30 Hz), and lower γ (30-45 Hz) bands between different groups. Our data showed that the normalized δ, β, and γ powers in the right BNST were specifically correlated with compulsive behaviors. δ and γ oscillations increased and decreased during the initiation phase of compulsion, respectively, whereas β increased after compulsion stopped. Moreover, the effect of BNST electrical stimulation, in terms of suppression of compulsion, was significantly correlated with the percentage change of these bands during compulsion. Our research reveals potential biomarkers and underlying neurophysiological mechanisms of compulsion and warrants further assessment of the use of LFP for closed-loop neuromodulation in OCD. SIGNIFICANCE STATEMENT Although specific neuronal groups in the bed nucleus of the stria terminalis (BNST) related to anxiety and reward circuitries have been identified, psychopathological information carried by local field potentials in the BNST has not yet been described. We discovered that normalized powers of the right BNST δ, β, and γ oscillations were highly correlated with compulsion. Specifically, δ and γ oscillations increased and decreased during the initiation phase of compulsion, respectively, whereas β increased after compulsion stopped. Such correlations were not found in other parts of the brain during compulsion, or in the BNST during noncompulsive behavior. Current findings reveal real-time neurophysiological biomarkers of compulsion and warrant further assessment of the use of local field potentials for closed-loop neuromodulation for OCD.
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13
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Luyten L, Hendrickx S, Raymaekers S, Gabriëls L, Nuttin B. Electrical stimulation in the bed nucleus of the stria terminalis alleviates severe obsessive-compulsive disorder. Mol Psychiatry 2016; 21:1272-80. [PMID: 26303665 DOI: 10.1038/mp.2015.124] [Citation(s) in RCA: 148] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2015] [Revised: 05/11/2015] [Accepted: 06/25/2015] [Indexed: 12/22/2022]
Abstract
In 1998, we proposed deep brain stimulation as a last-resort treatment option for patients suffering from severe, treatment-resistant obsessive-compulsive disorder (OCD). Here, 24 OCD patients were included in a long-term follow-up study to evaluate the effects of electrical stimulation in the anterior limbs of the internal capsule (ALIC) and bed nucleus of the stria terminalis (BST). We find that electrical stimulation in the ALIC/BST area is safe and significantly decreases obsessions, compulsions, and associated anxiety and depressive symptoms, and improves global functioning in a blinded crossover trial (n=17), after 4 years (n=18), and at last follow-up (up to 171 months, n=24). Moreover, our data indicate that BST may be a better stimulation target compared with ALIC to alleviate OCD symptoms. We conclude that electrical stimulation in BST is a promising therapeutic option for otherwise treatment-resistant OCD patients.
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Affiliation(s)
- L Luyten
- KU Leuven Research Group Experimental Neurosurgery and Neuroanatomy, Leuven, Belgium.,KU Leuven Research Group Psychology of Learning and Experimental Psychopathology, Leuven, Belgium
| | - S Hendrickx
- KU Leuven Research Group Experimental Neurosurgery and Neuroanatomy, Leuven, Belgium
| | - S Raymaekers
- KU Leuven Research Group Psychiatry, Leuven, Belgium
| | - L Gabriëls
- UPC-KU Leuven University Center for OCD, Leuven, Belgium
| | - B Nuttin
- KU Leuven Research Group Experimental Neurosurgery and Neuroanatomy, Leuven, Belgium.,UZ Leuven Department of Neurosurgery, Leuven, Belgium
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Wei N, Wang Y, Wang X, He Z, Zhang M, Zhang X, Pan Y, Zhang J, Qin Z, Zhang K. The different effects of high-frequency stimulation of the nucleus accumbens shell and core on food consumption are possibly associated with different neural responses in the lateral hypothalamic area. Neuroscience 2015; 301:312-22. [PMID: 26071960 DOI: 10.1016/j.neuroscience.2015.06.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2015] [Revised: 05/31/2015] [Accepted: 06/03/2015] [Indexed: 11/16/2022]
Abstract
Obesity may result from dysfunction of the reward system, especially in the nucleus accumbens (Acb). Based on this hypothesis, many researchers have tested the effect of high-frequency stimulation (HFS) of the Acb shell (Acb-Sh) and/or core (Acb-Co) on ingestive behaviors, but few studies have explored the possible mechanisms involved in the differences between the Acb-Sh and Acb-Co. The present study tested effects of HFS of the Acb-Sh and Acb-Co on high-fat food (HFF) consumption in rats after 24h of food deprivation. Microdialysis and electrophysiological experiments were carried out in awake rats to explore potential mechanisms. The results showed that the Acb-Sh decreased HFF consumption after food deprivation both during and post-HFS. However, HFS of the Acb-Co did not induce similar changes in food consumption. HFS of the Acb-Sh (Sh-HFS) induced an increase in GABA level in the lateral hypothalamic area (LHA) during both phases, whereas HFS of the Acb-Co (Co-HFS) did not exhibit similar effects. The electrophysiological experiment showed that nearly all the LHA neurons were inhibited by Sh-HFS, and the mean firing rate decreased significantly both during and post-HFS. In contrast, the mean firing rate of the LHA neurons did not exhibit clear changes during Co-HFS, although some individual neurons appeared to exhibit responses to Co-HFS. Considering all the data, we postulated that Sh-HFS, rather than Co-HFS, might inhibit palatable food consumption after food deprivation by decreasing the reward value of that food, which suggested that it might also disturb the process of developing obesity. The mechanisms involved in the different effects of Sh-HFS and Co-HFS on food consumption may be associated with different neural responses in the LHA. The Acb-Sh has abundant GABAergic projections to the LHA, whereas the Acb-Co has few or no GABAergic innervations to the LHA. Thus, neural activity in the LHA exhibits different responses to Sh-HFS and Co-HFS.
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Affiliation(s)
- N Wei
- Department of Neurosurgery, The Second Hospital of Lanzhou University, Chengguan District, Lanzhou, Gansu 730030, China; Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Tiantan Xili 6, Dongcheng, Beijing 100050, China
| | - Y Wang
- Beijing Jingmei Group General Hospital, Heishan Street 18, Mentougou, Beijing 102300, China
| | - X Wang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Tiantan Xili 6, Dongcheng, Beijing 100050, China; Beijing Neurosurgical Institute, Capital Medical University, Tiantan Xili 6, Dongcheng, Beijing 100050, China
| | - Z He
- Department of Neurosurgery, The Second Hospital of Lanzhou University, Chengguan District, Lanzhou, Gansu 730030, China
| | - M Zhang
- Experimental Research Center, China Academy of Traditional Chinese Medicine, Beijing 100700, China
| | - X Zhang
- Department of Neurosurgery, The Second Hospital of Lanzhou University, Chengguan District, Lanzhou, Gansu 730030, China
| | - Y Pan
- Department of Neurosurgery, The Second Hospital of Lanzhou University, Chengguan District, Lanzhou, Gansu 730030, China
| | - J Zhang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Tiantan Xili 6, Dongcheng, Beijing 100050, China; Beijing Neurosurgical Institute, Capital Medical University, Tiantan Xili 6, Dongcheng, Beijing 100050, China
| | - Z Qin
- Department of Neurosurgery, The Second Hospital of Lanzhou University, Chengguan District, Lanzhou, Gansu 730030, China
| | - K Zhang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Tiantan Xili 6, Dongcheng, Beijing 100050, China; Beijing Neurosurgical Institute, Capital Medical University, Tiantan Xili 6, Dongcheng, Beijing 100050, China.
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Alonso P, López-Solà C, Real E, Segalàs C, Menchón JM. Animal models of obsessive-compulsive disorder: utility and limitations. Neuropsychiatr Dis Treat 2015; 11:1939-55. [PMID: 26346234 PMCID: PMC4531004 DOI: 10.2147/ndt.s62785] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Obsessive-compulsive disorder (OCD) is a disabling and common neuropsychiatric condition of poorly known etiology. Many attempts have been made in the last few years to develop animal models of OCD with the aim of clarifying the genetic, neurochemical, and neuroanatomical basis of the disorder, as well as of developing novel pharmacological and neurosurgical treatments that may help to improve the prognosis of the illness. The latter goal is particularly important given that around 40% of patients with OCD do not respond to currently available therapies. This article summarizes strengths and limitations of the leading animal models of OCD including genetic, pharmacologically induced, behavioral manipulation-based, and neurodevelopmental models according to their face, construct, and predictive validity. On the basis of this evaluation, we discuss that currently labeled "animal models of OCD" should be regarded not as models of OCD but, rather, as animal models of different psychopathological processes, such as compulsivity, stereotypy, or perseverance, that are present not only in OCD but also in other psychiatric or neurological disorders. Animal models might constitute a challenging approach to study the neural and genetic mechanism of these phenomena from a trans-diagnostic perspective. Animal models are also of particular interest as tools for developing new therapeutic options for OCD, with the greatest convergence focusing on the glutamatergic system, the role of ovarian and related hormones, and the exploration of new potential targets for deep brain stimulation. Finally, future research on neurocognitive deficits associated with OCD through the use of analogous animal tasks could also provide a genuine opportunity to disentangle the complex etiology of the disorder.
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Affiliation(s)
- Pino Alonso
- OCD Clinical and Research Unit, Department of Psychiatry, Hospital de Bellvitge, Barcelona, Spain ; Bellvitge Biomedical Research Institute-IDIBELL, Barcelona, Spain ; Centro de Investigación en Red de Salud Mental, Carlos III Health Institute, Barcelona, Spain ; Department of Clinical Sciences, Bellvitge Campus, University of Barcelona, Barcelona, Spain
| | - Clara López-Solà
- OCD Clinical and Research Unit, Department of Psychiatry, Hospital de Bellvitge, Barcelona, Spain ; Bellvitge Biomedical Research Institute-IDIBELL, Barcelona, Spain ; Centro de Investigación en Red de Salud Mental, Carlos III Health Institute, Barcelona, Spain
| | - Eva Real
- OCD Clinical and Research Unit, Department of Psychiatry, Hospital de Bellvitge, Barcelona, Spain ; Bellvitge Biomedical Research Institute-IDIBELL, Barcelona, Spain ; Centro de Investigación en Red de Salud Mental, Carlos III Health Institute, Barcelona, Spain
| | - Cinto Segalàs
- OCD Clinical and Research Unit, Department of Psychiatry, Hospital de Bellvitge, Barcelona, Spain ; Bellvitge Biomedical Research Institute-IDIBELL, Barcelona, Spain ; Centro de Investigación en Red de Salud Mental, Carlos III Health Institute, Barcelona, Spain
| | - José Manuel Menchón
- OCD Clinical and Research Unit, Department of Psychiatry, Hospital de Bellvitge, Barcelona, Spain ; Bellvitge Biomedical Research Institute-IDIBELL, Barcelona, Spain ; Centro de Investigación en Red de Salud Mental, Carlos III Health Institute, Barcelona, Spain ; Department of Clinical Sciences, Bellvitge Campus, University of Barcelona, Barcelona, Spain
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A microstructural analysis of schedule-induced polydipsia reveals incentive-induced hyperactivity in an animal model of ADHD. Behav Brain Res 2014; 278:417-23. [PMID: 25447297 DOI: 10.1016/j.bbr.2014.10.022] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2014] [Revised: 10/13/2014] [Accepted: 10/17/2014] [Indexed: 11/23/2022]
Abstract
Recent research has suggested that frequent short bursts of activity characterize hyperactivity associated with attention deficit hyperactivity disorder (ADHD). This study determined whether such pattern is also visible in schedule-induced polydipsia (SIP) in the spontaneously hypertensive rat (SHR), an animal model of ADHD. Male SHR, Wistar Kyoto (WKY) and Wistar rats were exposed to 40 sessions of SIP using a multiple fixed-time (FT) schedule of food delivery with FT 30-s and FT 90-s components. Stable performance was analyzed to determine the extent to which SIP-associated drinking is organized in bouts. The Bi-Exponential Refractory Model (BERM) of free-operant performance was applied to schedule-induced licks. A model comparison analysis supported BERM as a description of SIP episodes: licks were not produced at a constant rate but organized into bouts within drinking episodes. FT 30-s induced similar overall licking rates, latencies to first licks and episode durations across strains; FT 90-s induced longer episode durations in SHRs and reduced licking rate in WKY and Wistar rats to nearly baseline levels. Across schedules, SHRs made more and shorter bouts when compared to the other strains. These results suggest an incentive-induced hyperactivity in SHR that has been observed in operant behaviour and in children with ADHD.
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Ibias J, Pellón R. Different relations between schedule-induced polydipsia and impulsive behaviour in the Spontaneously Hypertensive Rat and in high impulsive Wistar rats: questioning the role of impulsivity in adjunctive behaviour. Behav Brain Res 2014; 271:184-94. [PMID: 24931797 DOI: 10.1016/j.bbr.2014.06.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2013] [Revised: 06/03/2014] [Accepted: 06/06/2014] [Indexed: 12/17/2022]
Abstract
Rats belonging to three different strains (15 Wistar, 8 Spontaneously Hypertensive - SHR- and 8 Wistar Kyoto - WKY-) were used to evaluate the possible relationship between different levels of impulsivity and development of schedule-induced polydipsia (SIP). We first measured the rats' levels of impulsivity by means of delay-discounting and indifference-point procedures. Secondly, development of SIP was studied under a series of fixed time 15, 30, 60 and 120s food schedules, which were counterbalanced by means of a Latin-square design. Finally, we re-assessed the rats' levels of impulsivity by replicating the delay-discounting test. The findings showed that, starting from equivalent levels of impulsivity, development of SIP differed among the groups of rats. In comparison with the rest of the animals, the SHRs were observed to attain elevated drinking rates under SIP. On the other hand, the Wistar rats which had initial high impulsivity levels similar to those of the SHRs, displayed the lowest rates of induced drinking. Moreover, low levels of impulsivity in Wistar rats prior to SIP acquisition were reflected into high drinking rates. Relation of SIP and impulsivity is questioned by present results, which gives ground to the understanding of the behavioural mechanisms involved in adjunctive behaviour and its usefulness as an animal model of excessive behaviour.
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Affiliation(s)
- Javier Ibias
- Animal Behaviour Laboratories, Facultad de Psicología, Universidad Nacional de Educación a Distancia (UNED), C/Juan del Rosal 10, Ciudad Universitaria, 28040 Madrid, Spain
| | - Ricardo Pellón
- Animal Behaviour Laboratories, Facultad de Psicología, Universidad Nacional de Educación a Distancia (UNED), C/Juan del Rosal 10, Ciudad Universitaria, 28040 Madrid, Spain.
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Nucleus accumbens high-frequency stimulation selectively impacts nigrostriatal dopaminergic neurons. Int J Neuropsychopharmacol 2014; 17:421-7. [PMID: 24131575 PMCID: PMC4454358 DOI: 10.1017/s1461145713001211] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
High-frequency stimulation of the nucleus accumbens, also known as deep brain stimulation (DBS), is currently used to alleviate obsessive compulsive symptoms when pharmacotherapy is ineffective. However, the mechanism by which DBS achieves its therapeutic actions is not understood. Imaging studies and the actions of dopaminergic drugs in untreated patients suggest that the dopamine (DA) system likely plays a role in the pathophysiology of obsessive compulsive disorder. Therefore, we examined whether DBS would impact the DA system as a potential component of its therapeutic actions. The activity of DA neurons in the substantia nigra pars compacta (SNc) and ventral tegmental area (VTA) were recorded in anesthetized rats under high-frequency stimulation. DA neuron activity was measured in terms of number of neurons firing, average firing rate and firing pattern. DBS of the nucleus accumbens core did not significantly affect VTA activity or discharge pattern. On the other hand, DBS caused a potent decrease in the number of SNc DA neurons firing spontaneously. Such an effect could contribute to the disruption of pathological habit formation in the SNc-dorsal striatal projection system that may have therapeutic implications for the treatment of obsessive compulsive disorder.
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Abstract
Obsessive-compulsive disorder (OCD) and related conditions (trichotillomania, pathological skin-picking, pathological nail-biting) are common and disabling. Current treatment approaches fail to help a significant proportion of patients. Multiple tiers of evidence link these conditions with underlying dysregulation of particular cortico-subcortical circuitry and monoamine systems, which represent targets for treatment. Animal models designed to capture aspects of these conditions are critical for several reasons. First, they help in furthering our understanding of neuroanatomical and neurochemical underpinnings of the obsessive-compulsive (OC) spectrum. Second, they help to account for the brain mechanisms by which existing treatments (pharmacotherapy, psychotherapy, deep brain stimulation) exert their beneficial effects on patients. Third, they inform the search for novel treatments. This article provides a critique of key animal models for selected OC spectrum disorders, beginning with initial work relating to anxiety, but moving on to recent developments in domains of genetic, pharmacological, cognitive, and ethological models. We find that there is a burgeoning literature in these areas with important ramifications, which are considered, along with salient future lines of research.
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Deep Brain Stimulation in the Treatment of Obsessive-Compulsive Disorder. World Neurosurg 2013; 80:e245-53. [DOI: 10.1016/j.wneu.2012.10.006] [Citation(s) in RCA: 90] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2012] [Accepted: 10/02/2012] [Indexed: 11/21/2022]
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Morphometric brain characterization of refractory obsessive-compulsive disorder: diffeomorphic anatomic registration using exponentiated Lie algebra. Prog Neuropsychopharmacol Biol Psychiatry 2013; 46:126-31. [PMID: 23876787 DOI: 10.1016/j.pnpbp.2013.07.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2013] [Revised: 07/10/2013] [Accepted: 07/11/2013] [Indexed: 11/21/2022]
Abstract
BACKGROUND Few studies have used neuroimaging to characterize treatment-refractory obsessive-compulsive disorder (OCD). This study sought to explore gray matter structure in patients with treatment-refractory OCD and compare it with that of healthy controls. METHODS A total of 18 subjects with treatment-refractory OCD and 26 healthy volunteers were analyzed by MRI using a 3.0-T scanner and voxel-based morphometry (VBM). Diffeomorphic anatomical registration using exponentiated Lie algebra (DARTEL) was used to identify structural changes in gray matter associated with treatment-refractory OCD. A partial correlation model was used to analyze whether morphometric changes were associated with Yale-Brown Obsessive-Compulsive Scale scores and illness duration. RESULTS Gray matter volume did not differ significantly between the two groups. Treatment-refractory OCD patients showed significantly lower gray matter density than healthy subjects in the left posterior cingulate cortex (PCC) and mediodorsal thalamus (MD) and significantly higher gray matter density in the left dorsal striatum (putamen). These changes did not correlate with symptom severity or illness duration. CONCLUSIONS Our findings provide new evidence of deficits in gray matter density in treatment-refractory OCD patients. These patients may show characteristic density abnormalities in the left PCC, MD and dorsal striatum (putamen), which should be verified in longitudinal studies.
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Krawczyk M, Mason X, DeBacker J, Sharma R, Normandeau CP, Hawken ER, Di Prospero C, Chiang C, Martinez A, Jones AA, Doudnikoff É, Caille S, Bézard E, Georges F, Dumont ÉC. D1 dopamine receptor-mediated LTP at GABA synapses encodes motivation to self-administer cocaine in rats. J Neurosci 2013; 33:11960-71. [PMID: 23864683 PMCID: PMC4011800 DOI: 10.1523/jneurosci.1784-13.2013] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2013] [Revised: 05/28/2013] [Accepted: 06/13/2013] [Indexed: 11/21/2022] Open
Abstract
Enhanced motivation to take drugs is a central characteristic of addiction, yet the neural underpinning of this maladaptive behavior is still largely unknown. Here, we report a D1-like dopamine receptor (DRD1)-mediated long-term potentiation of GABAA-IPSCs (D1-LTPGABA) in the oval bed nucleus of the stria terminalis that was positively correlated with motivation to self-administer cocaine in rats. Likewise, in vivo intra-oval bed nucleus of the stria terminalis DRD1 pharmacological blockade reduced lever pressing for cocaine more effectively in rats showing enhanced motivation toward cocaine. D1-LTPGABA resulted from enhanced function and expression of G-protein-independent DRD1 coupled to c-Src tyrosine kinases and required local release of neurotensin. There was no D1-LTPGABA in rats that self-administered sucrose, in those with limited cocaine self-administration experience, or in those that received cocaine passively (yoked). Therefore, our study reveals a novel neurophysiological mechanism contributing to individual motivation to self-administer cocaine, a critical psychobiological element of compulsive drug use and addiction.
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Affiliation(s)
- Michal Krawczyk
- Department of Biomedical and Molecular Sciences and Center for Neuroscience Studies, Queen's University, Kingston, Ontario K7 L 3N6, Canada
| | - Xenos Mason
- Department of Biomedical and Molecular Sciences and Center for Neuroscience Studies, Queen's University, Kingston, Ontario K7 L 3N6, Canada
| | - Julian DeBacker
- Department of Biomedical and Molecular Sciences and Center for Neuroscience Studies, Queen's University, Kingston, Ontario K7 L 3N6, Canada
| | - Robyn Sharma
- Department of Biomedical and Molecular Sciences and Center for Neuroscience Studies, Queen's University, Kingston, Ontario K7 L 3N6, Canada
| | - Catherine P. Normandeau
- Department of Biomedical and Molecular Sciences and Center for Neuroscience Studies, Queen's University, Kingston, Ontario K7 L 3N6, Canada
| | - Emily R. Hawken
- Department of Biomedical and Molecular Sciences and Center for Neuroscience Studies, Queen's University, Kingston, Ontario K7 L 3N6, Canada
| | - Cynthia Di Prospero
- Department of Biomedical and Molecular Sciences and Center for Neuroscience Studies, Queen's University, Kingston, Ontario K7 L 3N6, Canada
| | - Cindy Chiang
- Department of Biomedical and Molecular Sciences and Center for Neuroscience Studies, Queen's University, Kingston, Ontario K7 L 3N6, Canada
| | - Audrey Martinez
- Université de Bordeaux, Institut des Maladies Neurodégénératives, UMR 5293
- Université de Bordeaux, Interdisciplinary Institute for Neuroscience, UMR 5297, and
| | - Andrea A. Jones
- Department of Biomedical and Molecular Sciences and Center for Neuroscience Studies, Queen's University, Kingston, Ontario K7 L 3N6, Canada
| | - Évelyne Doudnikoff
- Université de Bordeaux, Institut des Maladies Neurodégénératives, UMR 5293
- Université de Bordeaux, Interdisciplinary Institute for Neuroscience, UMR 5297, and
| | - Stephanie Caille
- Université de Bordeaux, Aquitaine Institute for Cognitive and Integrative Neuroscience, F-33076 Bordeaux, France, and
- Centre National de la Recherche Scientifique, UMR 5287, Aquitaine Institute for Cognitive and Integrative Neuroscience, F-33076 Bordeaux, France
| | - Erwan Bézard
- Université de Bordeaux, Institut des Maladies Neurodégénératives, UMR 5293
- Université de Bordeaux, Interdisciplinary Institute for Neuroscience, UMR 5297, and
| | - François Georges
- Université de Bordeaux, Interdisciplinary Institute for Neuroscience, UMR 5297, and
- Centre National de la Recherche Scientifique, Interdisciplinary Institute for Neuroscience, UMR 5297, F-33000 Bordeaux, France
| | - Éric C. Dumont
- Department of Biomedical and Molecular Sciences and Center for Neuroscience Studies, Queen's University, Kingston, Ontario K7 L 3N6, Canada
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Enhanced reward-facilitating effects of d-amphetamine in rats in the quinpirole model of obsessive-compulsive disorder. Int J Neuropsychopharmacol 2013; 16:1083-91. [PMID: 23043789 DOI: 10.1017/s1461145712000983] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
The underlying neurobiology of addictive or repetitive behaviours, such as obsessive-compulsive disorder (OCD), involves dopaminergic dysregulation. While addictive behaviour depends strongly on mesolimbocortical dopaminergic responses, repetitive behaviours have been associated with dopaminergic dysregulation in the basal ganglia-thalamo-cortical circuitry. The present study investigates differences in brain stimulation reward in rats with quinpirole-induced compulsive checking behaviour, in order to examine if deficits in reward processing are also relevant for OCD. Rats were tested in the intracranial self-stimulation (ICSS) paradigm, which targets reward-related responses. After phenotype induction, animals were implanted with a monopolar stimulation electrode in the left medial forebrain bundle and trained to press a lever to self-administer electric stimulation of varying frequency. The curve-shift method was used to assess the reward-facilitating effects of d-amphetamine and the reward-attenuating effects of haloperidol (a D(2) antagonist). Thresholds for ICSS were estimated before and after drug/saline injection. The reward-facilitating effects of d-amphetamine were enhanced in quinpirole-treated rats in comparison to controls. This finding suggests that chronic quinpirole-treatment induces changes within the reward circuitry relevant for compulsive behaviour in the rat.
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Klanker M, Post G, Joosten R, Feenstra M, Denys D. Deep brain stimulation in the lateral orbitofrontal cortex impairs spatial reversal learning. Behav Brain Res 2013; 245:7-12. [DOI: 10.1016/j.bbr.2013.01.043] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2012] [Revised: 01/08/2013] [Accepted: 01/15/2013] [Indexed: 01/27/2023]
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Welkenhuysen M, Gligorijevic I, Ameye L, Prodanov D, Van Huffel S, Nuttin B. Neuronal activity in the bed nucleus of the stria terminalis in a rat model for obsessive-compulsive disorder. Behav Brain Res 2012. [PMID: 23195114 DOI: 10.1016/j.bbr.2012.11.019] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
In search of a new potential target for deep brain stimulation in patients with obsessive-compulsive disorder (OCD), we evaluated the single-cell activity of neurons in the bed nucleus of the stria terminalis (BST) in urethane-anesthetized rats in an animal model for OCD, the schedule-induced polydipsia (SIP) model, and compared this to the BST activity in control rats and to a third group of rats which were introduced in the model but did not develop the SIP, and thus were considered resistant. We compared the firing rate and firing pattern of BST neurons between these groups, between hemispheres and made a correlation of the firing rate and firing pattern to the position in the BST. The variability of BST neurons in SIP rats was lower and the randomness higher than BST neurons in control rats or resistant rats. The firing rate of BST neurons in SIP rats was significantly higher and the burst index lower than BST neurons in resistant rats but not in control rats. Also, neurons from the right hemisphere in the SIP group had a higher burst index than neurons from the left hemisphere. However, this is opposite in the resistant and control group. Third, we found a higher bursting index with increasing (more ventral) depth of recording. These findings suggest that schedule-induced polydipsia, which models compulsive behavior in humans, induces a change in firing behavior of BST neurons.
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Affiliation(s)
- Marleen Welkenhuysen
- Laboratory of Experimental Functional Neurosurgery, Department of Neurosciences, K.U. Leuven, Provisorium II, Minderbroedersstraat 19 Box 1033, 3000 Leuven, Belgium.
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Klein J, Hadar R, Götz T, Männer A, Eberhardt C, Baldassarri J, Schmidt TT, Kupsch A, Heinz A, Morgenstern R, Schneider M, Weiner I, Winter C. Mapping brain regions in which deep brain stimulation affects schizophrenia-like behavior in two rat models of schizophrenia. Brain Stimul 2012; 6:490-9. [PMID: 23085443 DOI: 10.1016/j.brs.2012.09.004] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2012] [Revised: 08/16/2012] [Accepted: 09/14/2012] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND AND OBJECTIVES The development of more efficient treatment remains a major unmet need in the realm of schizophrenia disease. Using the maternal immune stimulation and the pubertal cannabinoid administration rat model of schizophrenia, the present study aimed at testing the hypothesis that deep brain stimulation (DBS) serves as a novel therapeutic technique for this disorder. METHODS Adult offspring of dams, treated with the immune activating agent poly I:C (4 mg/kg, n = 50) or saline (n = 50), underwent bilateral stereotactic electrode implantation into one of the following brain regions: subthalamic nucleus (STN, n = 12/10), entopeduncularis nucleus (EP, n = 10/11), globus pallidus (GP, n = 10/10), medial prefrontal cortex (mPFC, n = 8/8), or dorsomedial thalamus (DM, n = 10/11). Adult rats treated with the CB1 receptor agonist WIN 55,212-2 (WIN, n = 16) or saline (n = 12) during puberty were bilaterally implanted with electrodes into either the mPFC (n = 8/6) or the DM (n = 8/6). After a post-operative recovery period of one week, all rats were tested on a well-established cross-species phenomenon that is disrupted in schizophrenia, the pre-pulse inhibition (PPI) of the acoustic startle reflex (ASR) under different DBS conditions. RESULTS Poly I:C induced deficits in PPI of the ASR were normalized upon DBS. DBS effects depended on both stimulation target and stimulation parameters. Most prominent effects were found under DBS at high frequencies in the mPFC and DM. These effects were replicated in the pubertal WIN administration rat model of schizophrenia. CONCLUSIONS Brain regions, in which DBS normalized PPI deficits, might be of therapeutic relevance to the treatment of schizophrenia. Results imply that DBS could be considered a plausible therapeutic technique in the realm of schizophrenia disease.
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Affiliation(s)
- Julia Klein
- Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Germany
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Hamani C, Temel Y. Deep Brain Stimulation for Psychiatric Disease: Contributions and Validity of Animal Models. Sci Transl Med 2012; 4:142rv8. [DOI: 10.1126/scitranslmed.3003722] [Citation(s) in RCA: 111] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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Deep-brain stimulation for anorexia nervosa. World Neurosurg 2012; 80:S29.e1-10. [PMID: 22743198 DOI: 10.1016/j.wneu.2012.06.039] [Citation(s) in RCA: 96] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2012] [Revised: 05/25/2012] [Accepted: 06/21/2012] [Indexed: 01/11/2023]
Abstract
OBJECTIVE Anorexia nervosa (AN) is a complex and severe, sometimes life-threatening, psychiatric disorder with high relapse rates under standard treatment. After decades of brain-lesioning procedures offered as a last resort, deep-brain stimulation (DBS) has come under investigation in the last few years as a treatment option for severe and refractory AN. METHODS AND RESULTS In this jointly written article, Sun et al. (the Shanghai group) report an average of 65% increase in body weight in four severe and refractory patients with AN after they underwent the DBS procedure (average follow-up: 38 months). All patients weighed greater than 85% of expected body weight and thus no longer met the diagnostic criteria of AN at last follow-up. Nuttin et al. (the Leuven group) describe other clinical studies that provide evidence for the use of DBS for AN and further discuss patient selection criteria, target selection, and adverse event of this evolving therapy. CONCLUSION Preliminary results from the Shanghai group and other clinical centers showed that the use of DBS to treat AN may be a valuable option for weight restoration in otherwise-refractory and life-threatening cases. The nature of this procedure, however, remains investigational and should not be viewed as a standard clinical treatment option. Further scientific investigation is essential to warrant the long-term efficacy and safety of DBS for AN.
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Bourne SK, Eckhardt CA, Sheth SA, Eskandar EN. Mechanisms of deep brain stimulation for obsessive compulsive disorder: effects upon cells and circuits. Front Integr Neurosci 2012; 6:29. [PMID: 22712007 PMCID: PMC3375018 DOI: 10.3389/fnint.2012.00029] [Citation(s) in RCA: 94] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2012] [Accepted: 05/24/2012] [Indexed: 12/28/2022] Open
Abstract
Deep brain stimulation (DBS) has emerged as a safe, effective, and reversible treatment for a number of movement disorders. This has prompted investigation of its use for other applications including psychiatric disorders. In recent years, DBS has been introduced for the treatment of obsessive compulsive disorder (OCD), which is characterized by recurrent unwanted thoughts or ideas (obsessions) and repetitive behaviors or mental acts performed in order to relieve these obsessions (compulsions). Abnormal activity in cortico-striato-thalamo-cortical (CSTC) circuits including the orbitofrontal cortex (OFC), anterior cingulate cortex (ACC), ventral striatum, and mediodorsal (MD) thalamus has been implicated in OCD. To this end a number of DBS targets including the anterior limb of the internal capsule (ALIC), ventral capsule/ventral striatum (VC/VS), ventral caudate nucleus, subthalamic nucleus (STN), and nucleus accumbens (NAc) have been investigated for the treatment of OCD. Despite its efficacy and widespread use in movement disorders, the mechanism of DBS is not fully understood, especially as it relates to psychiatric disorders. While initially thought to create a functional lesion akin to ablative procedures, it is increasingly clear that DBS may induce clinical benefit through activation of axonal fibers spanning the CSTC circuits, alteration of oscillatory activity within this network, and/or release of critical neurotransmitters. In this article we review how the use of DBS for OCD informs our understanding of both the mechanisms of DBS and the circuitry of OCD. We review the literature on DBS for OCD and discuss potential mechanisms of action at the neuronal level as well as the broader circuit level.
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Affiliation(s)
- Sarah K Bourne
- Department of Neurosurgery, Massachusetts General Hospital, Boston MA, USA
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Albelda N, Joel D. Current animal models of obsessive compulsive disorder: an update. Neuroscience 2012; 211:83-106. [PMID: 21925243 DOI: 10.1016/j.neuroscience.2011.08.070] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2011] [Revised: 08/29/2011] [Accepted: 08/31/2011] [Indexed: 12/30/2022]
Affiliation(s)
- N Albelda
- Department of Psychology, Tel Aviv University, Ramat-Aviv, Tel Aviv 69978, Israel
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Luyten L, Casteels C, Vansteenwegen D, van Kuyck K, Koole M, Van Laere K, Nuttin B. Micro-positron emission tomography imaging of rat brain metabolism during expression of contextual conditioning. J Neurosci 2012; 32:254-63. [PMID: 22219287 PMCID: PMC6621336 DOI: 10.1523/jneurosci.3701-11.2012] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2011] [Revised: 10/13/2011] [Accepted: 10/27/2011] [Indexed: 11/21/2022] Open
Abstract
Using (18)F-fluorodeoxyglucose microPET imaging, we investigated the neurocircuitry of contextual anxiety versus control in awake, conditioned rats (n = 7-10 per group). In addition, we imaged a group expressing cued fear. Simultaneous measurements of startle amplitude and freezing time were used to assess conditioning. To the best of our knowledge, no neuroimaging studies in conditioned rats have been conducted thus far, although visualizing and quantifying the metabolism of the intact brain in behaving animals is clearly of interest. In addition, more insight into the neurocircuitry involved in contextual anxiety may stimulate the development of new treatments for anxiety disorders. Our main finding was hypermetabolism in a cluster comprising the bed nucleus of the stria terminalis (BST) in rats expressing contextual anxiety compared with controls. Analysis of a subset of rats showing the best behavioral results (n = 5 per subgroup) confirmed this finding. We also observed hypermetabolism in the same cluster in rats expressing contextual anxiety compared with rats expressing cued fear. Our results provide novel evidence for a role of the BST in the expression of contextual anxiety.
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Affiliation(s)
- Laura Luyten
- Division of Experimental Neurosurgery and Neuroanatomy, Katholieke Universiteit Leuven, 3000 Leuven, Belgium.
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Schedule-induced polydipsia as a model of compulsive behavior: neuropharmacological and neuroendocrine bases. Psychopharmacology (Berl) 2012; 219:647-59. [PMID: 22113447 DOI: 10.1007/s00213-011-2570-3] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2011] [Accepted: 11/01/2011] [Indexed: 12/24/2022]
Abstract
BACKGROUND Schedule-induced polydipsia (SIP), characterized by the development of excessive drinking under intermittent food-reinforcement schedules, has been proposed as a successful model for obsessive-compulsive disorder (OCD), schizophrenia, and alcohol abuse. OBJECTIVES The purpose of this study was to review the main findings and current thinking regarding the use of SIP for compulsivity assessment and evaluate its contribution to improving our knowledge of the neurobehavioral mechanisms underlying the excessive behavior manifested in SIP relevant to compulsive behavior disorders. METHODS The literature reviews SIP procedure and surveys main findings about its neurobehavioral basis and pharmacology relevant to its possible status as a model for compulsive disorders. Specifically, we reviewed effects of antipsychotics and serotoninergic drugs used in the treatment of OCD and schizophrenia. We also considered individual differences in SIP and its relevance as a possible compulsivity endophenotype. CONCLUSIONS SIP represents an animal model of non-regulatory and excessive drinking that may be valid for studying the psychopharmacology of the compulsive phenotype and modeling different psychopathologies from compulsivity spectrum disorders.
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Abstract
Psychiatric disorders are worldwide a common cause of severe and long-term disability and socioeconomic burden. The management of patients with psychiatric disorders consists of drug therapy and/or psychotherapy. However, in some patients, these treatment modalities do not produce sufficient therapeutic effects or induce intolerable side effects. For these patients, neuromodulation has been suggested as a potential treatment modality. Neuromodulation includes deep brain stimulation, vagal nerve stimulation, and transcranial magnetic and electrical stimulation. The rationale for neuromodulation is derived from the research identifying neurobiologically localized substrates for refractory psychiatric symptoms. Here, we review the clinical data on neuromodulation in the major psychiatric disorders. Relevant data from animal models will also be discussed to explain the neurobiological basis of the therapy.
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van Dijk A, Mason O, Klompmakers AA, Feenstra MGP, Denys D. Unilateral deep brain stimulation in the nucleus accumbens core does not affect local monoamine release. J Neurosci Methods 2011; 202:113-8. [PMID: 21565219 DOI: 10.1016/j.jneumeth.2011.04.034] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2010] [Revised: 03/29/2011] [Accepted: 04/25/2011] [Indexed: 11/19/2022]
Abstract
Recent publications have shown promising results of deep brain stimulation (DBS) in the nucleus accumbens for patients with obsessive compulsive disorder and major depressive disorder. Despite its increasing application in the clinical setting, the neurobiological mechanism of action of DBS is still uncertain. One of the possible effects of DBS might be phasic or tonic changes in monoamine release either locally in the target area or in a distant, connected region. In the present study we investigate whether unilateral DBS of the Nucleus Accumbens Core (NAc core) has a local effect on in vivo monoamine release. Freely moving animals were unilaterally stimulated with 300 μA or 400 μA (120 Hz, pulse width 80 μs) in the NAc core for 5 h. 1h before and during stimulation we measured dopamine, serotonin, their metabolites and noradrenaline using in vivo microdialysis. We found no significant effect of stimulation on extracellular concentrations of monoaminergic neurotransmitters or their metabolites in the NAc core during stimulation. Our results suggest that the rapid effects of DBS in the NAc are not a result of changes in local monoamine release in the NAc core. For future directions it is interesting to note that several microdialysis and electrophysiology studies have shown effects of DBS in areas distant from the stimulation target.
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Affiliation(s)
- Addy van Dijk
- Department of Psychiatry, Academic Medical Center, University of Amsterdam, Postbus 22660, 1100 DD Amsterdam, The Netherlands.
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Activity modulation of the globus pallidus and the nucleus entopeduncularis affects compulsive checking in rats. Behav Brain Res 2011; 219:149-58. [DOI: 10.1016/j.bbr.2010.12.036] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2010] [Revised: 12/20/2010] [Accepted: 12/27/2010] [Indexed: 11/20/2022]
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Winter C, Harnack D, Kupsch A. [Deep brain stimulation for neurological and psychiatric diseases: animal experiments on effect and mechanisms]. DER NERVENARZT 2010; 81:711-8. [PMID: 20502860 DOI: 10.1007/s00115-010-2936-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Deep brain stimulation at high frequencies has emerged as a powerful therapeutic strategy in the treatment of basal ganglia-related movement disorders. Attempts have also been made to establish this for the treatment of therapy-resistant psychiatric disorders. To date the mechanisms underlying the clinical efficacy of high frequency stimulation remain largely unknown. Their detailed description, however, is essential for promoting the extended application of high frequency stimulation as a therapeutic alternative and may simultaneously allow conclusions to be drawn on the pathophysiological mechanisms underlying the diseases benefiting from deep brain stimulation. This review demonstrates how animal models contribute to i) further understand the mechanisms underlying deep brain stimulation at high frequencies and ii) promote the establishment of high frequency stimulation for the treatment of therapy-resistant psychiatric disorders.
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Affiliation(s)
- C Winter
- Klinik für Psychiatrie und Psychotherapie, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, Fetscherstrasse 74, Dresden, Germany.
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Invasive circuitry-based neurotherapeutics: stereotactic ablation and deep brain stimulation for OCD. Neuropsychopharmacology 2010; 35:317-36. [PMID: 19759530 PMCID: PMC3055421 DOI: 10.1038/npp.2009.128] [Citation(s) in RCA: 268] [Impact Index Per Article: 19.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Psychiatric neurosurgery, specifically stereotactic ablation, has continued since the 1940s, mainly at a few centers in Europe and the US. Since the late 1990s, the resurgence of interest in this field has been remarkable; reports of both lesion procedures and the newer technique of deep brain stimulation (DBS) have increased rapidly. In early 2009, the US FDA granted limited humanitarian approval for DBS for otherwise intractable obsessive-compulsive disorder (OCD), the first such approval for a psychiatric illness. Several factors explain the emergence of DBS and continued small-scale use of refined lesion procedures. DBS and stereotactic ablation have been successful and widely used for movement disorders. There remains an unmet clinical need: current drug and behavioral treatments offer limited benefit to some seriously ill people. Understandings of the neurocircuitry underlying psychopathology and the response to treatment, while still works in progress, are much enhanced. Here, we review modern lesion procedures and DBS for OCD in the context of neurocircuitry. A key issue is that clinical benefit can be obtained after surgeries targeting different brain structures. This fits well with anatomical models, in which circuits connecting orbitofrontal cortex (OFC), medial prefrontal cortex (mPFC), basal ganglia, and thalamus are central to OCD pathophysiology and treatment response. As in movement disorders, dedicated interdisciplinary teams, here led by psychiatrists, are required to implement these procedures and maintain care for patients so treated. Available data, although limited, support the promise of stereotactic ablation or DBS in carefully selected patients. Benefit in such cases appears not to be confined to obsessions and compulsions, but includes changes in affective state. Caution is imperative, and key issues in long-term management of psychiatric neurosurgery patients deserve focused attention. DBS and contemporary ablation also present different patterns of potential benefits and burdens. Translational research to elucidate how targeting specific nodes in putative OCD circuitry might lead to therapeutic gains is accelerating in tandem with clinical use.
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Andrade P, Fernández-Guasti A, Carrillo-Ruiz JD, Ulloa RE, Ramírez Y, Reyes R, Jiménez F. Effects of bilateral lesions in thalamic reticular nucleus and orbitofrontal cortex in a T-maze perseverative model produced by 8-OH-DPAT in rats. Behav Brain Res 2009; 203:108-12. [DOI: 10.1016/j.bbr.2009.04.026] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2009] [Revised: 04/10/2009] [Accepted: 04/20/2009] [Indexed: 11/26/2022]
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Gubellini P, Salin P, Kerkerian-Le Goff L, Baunez C. Deep brain stimulation in neurological diseases and experimental models: From molecule to complex behavior. Prog Neurobiol 2009; 89:79-123. [DOI: 10.1016/j.pneurobio.2009.06.003] [Citation(s) in RCA: 119] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2008] [Revised: 04/28/2009] [Accepted: 06/18/2009] [Indexed: 11/30/2022]
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Andrade P, Carrillo-Ruiz JD, Ramírez Y, Jiménez F. Effects of Thalamic Reticular Nucleus Electrical Stimulation in Rats in a T-maze Perseverative Behavior Model Induced by 8-OH-DPAT. Neuromodulation 2009; 13:2-9. [DOI: 10.1111/j.1525-1403.2009.00242.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Mundt A, Klein J, Joel D, Heinz A, Djodari-Irani A, Harnack D, Kupsch A, Orawa H, Juckel G, Morgenstern R, Winter C. High-frequency stimulation of the nucleus accumbens core and shell reduces quinpirole-induced compulsive checking in rats. Eur J Neurosci 2009; 29:2401-12. [PMID: 19490027 DOI: 10.1111/j.1460-9568.2009.06777.x] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Electrical deep brain stimulation (DBS) is currently studied in the treatment of therapy-refractory obsessive compulsive disorders (OCDs). The variety of targeted brain areas and the inconsistency in demonstrating anti-compulsive effects, however, highlight the need for better mapping of brain regions in which stimulation may produce beneficial effects in OCD. Such a goal may be advanced by the assessment of DBS in appropriate animal models of OCD. Currently available data on DBS of the nucleus accumbens (NAc) on OCD-like behavior in rat models of OCD are contradictory and partly in contrast to clinical data and theoretical hypotheses about how the NAc might be pathophysiologically involved in the manifestation of OCD. Consequently, the present study investigates the effects of DBS of the NAc core and shell in a quinpirole rat model of OCD. The study demonstrates that electrical modulation of NAc core and shell activity via DBS reduces quinpirole-induced compulsive checking behavior in rats. We therefore conclude that both, the NAc core and shell constitute potential target structures in the treatment of OCD.
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Affiliation(s)
- Adrian Mundt
- Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité University Medicine, Berlin, Germany
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Sesia T, Temel Y, Lim LW, Blokland A, Steinbusch HWM, Visser-Vandewalle V. Deep brain stimulation of the nucleus accumbens core and shell: opposite effects on impulsive action. Exp Neurol 2008; 214:135-9. [PMID: 18762185 DOI: 10.1016/j.expneurol.2008.07.015] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2008] [Revised: 07/20/2008] [Accepted: 07/22/2008] [Indexed: 10/21/2022]
Abstract
The nucleus accumbens is gaining interest as a target for deep brain stimulation in refractory neuropsychiatric disorders with impulsivity as core symptom. The nucleus accumbens is composed of two subterritories, core and shell, which have different anatomical connections. Here, we tested the hypothesis that stimulation of the nucleus accumbens core and shell would have different effects on impulsivity. Rats received bilateral stimulation at the level of the nucleus accumbens core or shell during a reaction time task. Stimulation of the nucleus accumbens core significantly decreased impulsivity, while stimulation of the shell increased it. Our results support the hypothesis that the nucleus accumbens is a potential target to treat neuropsychiatric disorders related to impulsivity by deep brain stimulation. However, different behavioral effects resulting from stimulation of the subterritories should be taken into account.
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Affiliation(s)
- Thibaut Sesia
- Department of Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.
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