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Laurencin C, Lancelot S, Brosse S, Mérida I, Redouté J, Greusard E, Lamberet L, Liotier V, Le Bars D, Costes N, Thobois S, Boulinguez P, Ballanger B. Noradrenergic alterations in Parkinson's disease: a combined 11C-yohimbine PET/neuromelanin MRI study. Brain 2024; 147:1377-1388. [PMID: 37787503 PMCID: PMC10994534 DOI: 10.1093/brain/awad338] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 09/05/2023] [Accepted: 09/19/2023] [Indexed: 10/04/2023] Open
Abstract
Degeneration of the noradrenergic system is now considered a pathological hallmark of Parkinson's disease, but little is known about its consequences in terms of parkinsonian manifestations. Here, we evaluated two aspects of the noradrenergic system using multimodal in vivo imaging in patients with Parkinson's disease and healthy controls: the pigmented cell bodies of the locus coeruleus with neuromelanin sensitive MRI; and the density of α2-adrenergic receptors (ARs) with PET using 11C-yohimbine. Thirty patients with Parkinson's disease and 30 age- and sex-matched healthy control subjects were included. The characteristics of the patients' symptoms were assessed using the Movement Disorder Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS). Patients showed reduced neuromelanin signal intensity in the locus coeruleus compared with controls and diminished 11C-yohimbine binding in widespread cortical regions, including the motor cortex, as well as in the insula, thalamus and putamen. Clinically, locus coeruleus neuronal loss was correlated with motor (bradykinesia, motor fluctuations, tremor) and non-motor (fatigue, apathy, constipation) symptoms. A reduction of α2-AR availability in the thalamus was associated with tremor, while a reduction in the putamen, the insula and the superior temporal gyrus was associated with anxiety. These results highlight a multifaceted alteration of the noradrenergic system in Parkinson's disease since locus coeruleus and α2-AR degeneration were found to be partly uncoupled. These findings raise important issues about noradrenergic dysfunction that may encourage the search for new drugs targeting this system, including α2-ARs, for the treatment of Parkinson's disease.
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Affiliation(s)
- Chloé Laurencin
- Lyon Neuroscience Research Center (CRNL), INSERM U1028, CNRS UMR5292, University Lyon 1, F-69000 Lyon, France
- Department of Neurology C, Expert Parkinson Centre, Hospices Civils de Lyon, Pierre Wertheimer Neurological Hospital, NS-Park/F-CRIN, 69500 Bron, France
| | - Sophie Lancelot
- Lyon Neuroscience Research Center (CRNL), INSERM U1028, CNRS UMR5292, University Lyon 1, F-69000 Lyon, France
- CERMEP-Imagerie du Vivant, PET-MRI Department, 69500 Bron, France
| | - Sarah Brosse
- Lyon Neuroscience Research Center (CRNL), INSERM U1028, CNRS UMR5292, University Lyon 1, F-69000 Lyon, France
| | - Inés Mérida
- CERMEP-Imagerie du Vivant, PET-MRI Department, 69500 Bron, France
| | - Jérôme Redouté
- CERMEP-Imagerie du Vivant, PET-MRI Department, 69500 Bron, France
| | - Elise Greusard
- CERMEP-Imagerie du Vivant, PET-MRI Department, 69500 Bron, France
| | - Ludovic Lamberet
- CERMEP-Imagerie du Vivant, PET-MRI Department, 69500 Bron, France
| | | | - Didier Le Bars
- CERMEP-Imagerie du Vivant, PET-MRI Department, 69500 Bron, France
| | - Nicolas Costes
- CERMEP-Imagerie du Vivant, PET-MRI Department, 69500 Bron, France
| | - Stéphane Thobois
- Department of Neurology C, Expert Parkinson Centre, Hospices Civils de Lyon, Pierre Wertheimer Neurological Hospital, NS-Park/F-CRIN, 69500 Bron, France
- Institut des Sciences Cognitives Marc Jeannerod, UMR 5229, CNRS, 69500 Bron, France
| | - Philippe Boulinguez
- Lyon Neuroscience Research Center (CRNL), INSERM U1028, CNRS UMR5292, University Lyon 1, F-69000 Lyon, France
| | - Bénédicte Ballanger
- Lyon Neuroscience Research Center (CRNL), INSERM U1028, CNRS UMR5292, University Lyon 1, F-69000 Lyon, France
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Kemp AF, Kinnerup M, Johnsen B, Jakobsen S, Nahimi A, Gjedde A. EEG Frequency Correlates with α 2-Receptor Density in Parkinson's Disease. Biomolecules 2024; 14:209. [PMID: 38397446 PMCID: PMC10886955 DOI: 10.3390/biom14020209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Revised: 01/31/2024] [Accepted: 02/06/2024] [Indexed: 02/25/2024] Open
Abstract
INTRODUCTION Increased theta and delta power and decreased alpha and beta power, measured with quantitative electroencephalography (EEG), have been demonstrated to have utility for predicting the development of dementia in patients with Parkinson's disease (PD). Noradrenaline modulates cortical activity and optimizes cognitive processes. We claim that the loss of noradrenaline may explain cognitive impairment and the pathological slowing of EEG waves. Here, we test the relationship between the number of noradrenergic α2 adrenoceptors and changes in the spectral EEG ratio in patients with PD. METHODS We included nineteen patients with PD and thirteen healthy control (HC) subjects in the study. We used positron emission tomography (PET) with [11C]yohimbine to quantify α2 adrenoceptor density. We used EEG power in the delta (δ, 1.5-3.9 Hz), theta (θ, 4-7.9 Hz), alpha (α, 8-12.9 Hz) and beta (β, 13-30 Hz) bands in regression analyses to test the relationships between α2 adrenoceptor density and EEG band power. RESULTS PD patients had higher power in the theta and delta bands compared to the HC volunteers. Patients' theta band power was inversely correlated with α2 adrenoceptor density in the frontal cortex. In the HC subjects, age was correlated with, and occipital background rhythm frequency (BRF) was inversely correlated with, α2 adrenoceptor density in the frontal cortex, while occipital BRF was inversely correlated with α2 adrenoceptor density in the thalamus. CONCLUSIONS The findings support the claim that the loss or dysfunction of noradrenergic neurotransmission may relate to the parallel processes of cognitive decline and EEG slowing.
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Affiliation(s)
- Adam F. Kemp
- Department of Nuclear Medicine, Odense University Hospital, 5000 Odense, Denmark;
| | - Martin Kinnerup
- Department of Clinical Medicine, Aarhus University, 8000 Aarhus, Denmark; (M.K.); (B.J.); (S.J.)
| | - Birger Johnsen
- Department of Clinical Medicine, Aarhus University, 8000 Aarhus, Denmark; (M.K.); (B.J.); (S.J.)
- Department of Clinical Neurophysiology, Aarhus University Hospital, 8200 Aarhus, Denmark
| | - Steen Jakobsen
- Department of Clinical Medicine, Aarhus University, 8000 Aarhus, Denmark; (M.K.); (B.J.); (S.J.)
| | - Adjmal Nahimi
- Clinical Memory Research Unit, Department of Clinical Sciences, 211 46 Malmö, Sweden;
- Department of Neurology, Skåne University Hospital, 221 85 Lund, Sweden
| | - Albert Gjedde
- Department of Clinical Medicine, Aarhus University, 8000 Aarhus, Denmark; (M.K.); (B.J.); (S.J.)
- Department of Neuroscience, University of Copenhagen, 1172 Copenhagen, Denmark
- Department of Neurology and Neurosurgery, McGill University, Montreal, QC H3A 0G4, Canada
- Translational Neuropsychiatry Unit, Department of Clinical Medicine, Aarhus University, 8000 Aarhus, Denmark
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Ballegaard S, Faber J, Selmer C, Gyntelberg F, Kreiner S, Karpatschof B, Klausen TW, Hjalmarson Å, Gjedde A. In Ischemic Heart Disease, Reduced Sensitivity to Pressure at the Sternum Accompanies Lower Mortality after Five Years: Evidence from a Randomized Controlled Trial. J Clin Med 2023; 12:7585. [PMID: 38137654 PMCID: PMC10744062 DOI: 10.3390/jcm12247585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Revised: 11/16/2023] [Accepted: 12/04/2023] [Indexed: 12/24/2023] Open
Abstract
Background: Autonomic nervous system dysfunction (ANSD) is associated with negative prognosis of ischemic heart disease (IHD). Elevated periosteal pressure sensitivity (PPS) at the sternum relates to ANSD and sympathetic hyperactivity. Two previous observational case-control studies of the effect of reduction of PPS suggested lower all-cause mortality from IHD and stroke. We now used a specific daily, adjunct, non-pharmacological program of reduction of elevated PPS to test the hypothetical association between the intervention and reduced all-cause mortality in patients with stable IHD in a randomized controlled trial (RCT). Methods: We completed active (n = 106) and passive interventions (n = 107) and compared the five-year mortalities. We also compared the five-year individual all-cause mortality of each participant to approximately 35.000 members of the general population of Denmark. Pooling the mortality data from the active group of the RCT with the two preliminary studies, we registered the mortality following active intervention of 1.168 person-years, compared to 40 million person-years of the pooled general population. Results: We recorded fewer deaths of the active RCT intervention group than of the corresponding control group from the general population (p = 0.01), as well as of the passive RCT intervention group (p = 0.035). The meta-analysis of the three studies together demonstrated reduced 4.2-year all-cause mortality of 60% (p = 0.007). Conclusions: The test of the hypothetical effect of an intervention aimed at the attenuation of ANSD accompanied by a lowered PPS revealed reduced all-cause mortality in patients with stable IHD.
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Affiliation(s)
- Søren Ballegaard
- Endocrine Unit, Department of Medicine, Herlev-Gentofte University Hospitals, 2730 Herlev, Denmark; (J.F.)
| | - Jens Faber
- Endocrine Unit, Department of Medicine, Herlev-Gentofte University Hospitals, 2730 Herlev, Denmark; (J.F.)
- Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark
| | - Christian Selmer
- Endocrine Unit, Department of Medicine, Herlev-Gentofte University Hospitals, 2730 Herlev, Denmark; (J.F.)
- Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark
- Department of Endocrinology, Bispebjerg-Frederiksberg University Hospitals, 2400 Copenhagen, Denmark
| | - Finn Gyntelberg
- The National Research Center for the Working Environment, 2100 Copenhagen, Denmark
| | - Svend Kreiner
- Institute of Biostatistics, University of Copenhagen, 1017 Copenhagen, Denmark
| | - Benny Karpatschof
- Institute of Psychology, University of Copenhagen, 1017 Copenhagen, Denmark
| | - Tobias Wirenfeldt Klausen
- Endocrine Unit, Department of Medicine, Herlev-Gentofte University Hospitals, 2730 Herlev, Denmark; (J.F.)
| | - Åke Hjalmarson
- Department of Cardiology, Sahlgrenska University Hospital, University of Gothenburg, 41345 Gothenburg, Sweden
| | - Albert Gjedde
- Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark
- Department of Neuroscience, University of Copenhagen, 2200 Copenhagen, Denmark
- Translational Neuropsychiatry Unit, Department of Clinical Medicine, Aarhus University, 8000 Aarhus, Denmark
- Department of Neurology and Neurosurgery, McGill University, Montreal, QC H3A 2B4, Canada
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Faber J, Ballegaard S, Ørsted N, Eldrup E, Karpatschof B, Gyntelberg F, Hecquet SK, Gjedde A. In Type 2 Diabetes Mellitus, normalization of hemoglobin A1c accompanies reduced sensitivity to pressure at the sternum. Front Neurosci 2023; 17:1067098. [PMID: 37389368 PMCID: PMC10303981 DOI: 10.3389/fnins.2023.1067098] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 04/18/2023] [Indexed: 07/01/2023] Open
Abstract
Background The autonomic nervous system (ANS) maintains glucose homeostasis. While higher than normal glucose levels stimulate the ANS toward reduction, previous findings suggest an association between sensitivity to, or pain from, pressure at the chest bone (pressure or pain sensitivity, PPS) and activity of the ANS. A recent randomized controlled trial (RCT) of type 2 diabetes (T2DM) suggested that addition of an experimental, non-pharmacological intervention more effectively than conventional treatment lowered the levels of both PPS and HbA1c. Materials and analyses We tested the null hypothesis that conventional treatment (n = 60) would reveal no association between baseline HbA1c and normalization of HbA1c in 6 months, related to change of PPS. We compared the changes of HbA1c in PPS reverters who experienced a minimum reduction of 15 units of PPS and in PPS non-reverters who experienced no reduction. Depending on the result, we tested the association in a second group of participants with addition of the experimental program (n = 52). Results In the conventional group, PPS reverters experienced normalization of HbA1c that corrected the basal increase, thus disproving the null hypothesis. With the addition of the experimental program, PPS reverters experienced similar reduction. The reduction of HbA1c among reverters averaged 0.62 mmol/mol per mmol/mol increase of baseline HbA1c (P < 0.0001 compared to non-reverters). For baseline HbA1c ≥ 64 mmol/mol, reverters averaged 22% reduction of HbA1c (P < 0.01). Conclusion In consecutive analyses of two different populations of individuals with T2DM, we demonstrated that the higher the baseline HbA1c, the greater the reduction of HbA1c but only in individuals with a concomitant reduction of sensitivity to PPS, suggesting a homeostatic effect of the autonomic nervous system on glucose metabolism. As such, ANS function, measured as PPS, is an objective measure of HbA1c homeostasis. This observation may be of great clinical importance.
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Affiliation(s)
- Jens Faber
- Department of Endocrinology, Herlev-Gentofte University Hospital, Herlev, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Søren Ballegaard
- Department of Endocrinology, Herlev-Gentofte University Hospital, Herlev, Denmark
| | - Nanna Ørsted
- Department of Endocrinology, Herlev-Gentofte University Hospital, Herlev, Denmark
| | - Ebbe Eldrup
- Department of Endocrinology, Herlev-Gentofte University Hospital, Herlev, Denmark
| | - Benny Karpatschof
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Finn Gyntelberg
- The National Research Center for the Working Environment, Copenhagen, Denmark
| | | | - Albert Gjedde
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Neuroscience, University of Copenhagen, Copenhagen, Denmark
- Translational Neuropsychiatry Unit, Aarhus University, Aarhus, Denmark
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Landau AM, Jakobsen S, Thomsen MB, Alstrup AKO, Orlowski D, Jacobsen J, Wegener G, Mørk A, Sørensen JCH, Doudet DJ. Combined In Vivo Microdialysis and PET Studies to Validate [ 11C]Yohimbine Binding as a Marker of Noradrenaline Release. Biomolecules 2023; 13:674. [PMID: 37189421 PMCID: PMC10136072 DOI: 10.3390/biom13040674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Revised: 04/05/2023] [Accepted: 04/07/2023] [Indexed: 05/17/2023] Open
Abstract
The noradrenaline system attracts attention for its role in mood disorders and neurodegenerative diseases but the lack of well-validated methods impairs our understanding when assessing its function and release in vivo. This study combines simultaneous positron emission tomography (PET) and microdialysis to explore if [11C]yohimbine, a selective antagonist radioligand of the α2 adrenoceptors, may be used to assess in vivo changes in synaptic noradrenaline during acute pharmacological challenges. Anesthetised Göttingen minipigs were positioned in a head holder in a PET/CT device. Microdialysis probes were placed in the thalamus, striatum and cortex and dialysis samples were collected every 10 min. Three 90 min [11C]yohimbine scans were acquired: at baseline and at two timepoints after the administration of amphetamine (1-10 mg/kg), a non-specific releaser of dopamine and noradrenaline, or nisoxetine (1 mg/kg), a specific noradrenaline transporter inhibitor. [11C]yohimbine volumes of distribution (VT) were obtained using the Logan kinetic model. Both challenges induced a significant decrease in yohimbine VT, with time courses reflecting their different mechanisms of action. Dialysis samples revealed a significant increase in noradrenaline extracellular concentrations after challenge and an inverse correlation with changes in yohimbine VT. These data suggest that [11C]yohimbine can be used to evaluate acute variations in synaptic noradrenaline concentrations after pharmacological challenges.
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Affiliation(s)
- Anne Marlene Landau
- Translational Neuropsychiatry Unit, Department of Clinical Medicine, Aarhus University, A701, Palle Juul Jensens Boulevard 99, 8200 Aarhus, Denmark
- Department of Nuclear Medicine & PET-Center, Aarhus University Hospital, 8200 Aarhus, Denmark
| | - Steen Jakobsen
- Department of Nuclear Medicine & PET-Center, Aarhus University Hospital, 8200 Aarhus, Denmark
| | - Majken Borup Thomsen
- Translational Neuropsychiatry Unit, Department of Clinical Medicine, Aarhus University, A701, Palle Juul Jensens Boulevard 99, 8200 Aarhus, Denmark
- Department of Nuclear Medicine & PET-Center, Aarhus University Hospital, 8200 Aarhus, Denmark
| | | | - Dariusz Orlowski
- Center for Experimental Neuroscience (CENSE), Department of Neurosurgery, Aarhus University Hospital, 8200 Aarhus, Denmark
| | - Jan Jacobsen
- Department of Nuclear Medicine & PET-Center, Aarhus University Hospital, 8200 Aarhus, Denmark
| | - Gregers Wegener
- Translational Neuropsychiatry Unit, Department of Clinical Medicine, Aarhus University, A701, Palle Juul Jensens Boulevard 99, 8200 Aarhus, Denmark
| | - Arne Mørk
- Synaptic Transmission, H. Lundbeck A/S, Ottiliavej 9, Valby, 2500 Copenhagen, Denmark
| | | | - Doris J. Doudet
- Department of Medicine/Neurology, University of British Columbia, 2221 Wesbrook Mall, Vancouver, BC V6T 2B5, Canada;
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Xu H, Jin T, Zhang R, Xie H, Zhuang C, Zhang Y, Kong D, Xiao G, Yu X. Cerebral cortex and hippocampus neural interaction during vagus nerve stimulation under in vivo large-scale imaging. Front Neurosci 2023; 17:1131063. [PMID: 36937685 PMCID: PMC10017477 DOI: 10.3389/fnins.2023.1131063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Accepted: 02/13/2023] [Indexed: 03/06/2023] Open
Abstract
Objective The purpose of this study was to study mechanisms of VNS modulation from a single neuron perspective utilizing a practical observation platform with single neuron resolution and widefield, real-time imaging coupled with an animal model simultaneously exposing the cerebral cortex and the hippocampus. Methods We utilized the observation platform characterized of widefield of view, real-time imaging, and high spatiotemporal resolution to obtain the neuronal activities in the cerebral cortex and the hippocampus during VNS in awake states and under anesthesia. Results Some neurons in the hippocampus were tightly related to VNS modulation, and varied types of neurons showed distinct responses to VNS modulation. Conclusion We utilized such an observation platform coupled with a novel animal model to obtain more information on neuron activities in the cerebral cortex and the hippocampus, providing an effective method to further study the mechanisms of therapeutic effects modulated by VNS.
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Affiliation(s)
- Hanyun Xu
- Chinese PLA Medical School, Beijing, China
- Department of Neurosurgery, The First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Tingting Jin
- Pulmonary and Critical Care Department, Wuhu Hospital of East China Normal University, Wuhu, Anhui, China
| | - Rujin Zhang
- Department of Anesthesiology, The First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Hao Xie
- Department of Automation, Tsinghua University, Beijing, China
| | - Chaowei Zhuang
- Department of Automation, Tsinghua University, Beijing, China
| | - Yanyang Zhang
- Department of Neurosurgery, The First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Dongsheng Kong
- Department of Neurosurgery, The First Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Guihua Xiao
- Department of Automation, Tsinghua University, Beijing, China
- BNRist, Tsinghua University, Beijing, China
- *Correspondence: Guihua Xiao,
| | - Xinguang Yu
- Department of Neurosurgery, The First Medical Center of Chinese PLA General Hospital, Beijing, China
- Xinguang Yu,
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Real CC, Binda KH, Thomsen MB, Lillethorup TP, Brooks DJ, Landau AM. Selecting the Best Animal Model of Parkinson's Disease for Your Research Purpose: Insight from in vivo PET Imaging Studies. Curr Neuropharmacol 2023; 21:1241-1272. [PMID: 36797611 PMCID: PMC10286593 DOI: 10.2174/1570159x21666230216101659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 09/08/2022] [Accepted: 09/08/2022] [Indexed: 02/18/2023] Open
Abstract
Parkinson's disease (PD) is a debilitating neurodegenerative multisystem disorder leading to motor and non-motor symptoms in millions of individuals. Despite intense research, there is still no cure, and early disease biomarkers are lacking. Animal models of PD have been inspired by basic elements of its pathogenesis, such as dopamine dysfunction, alpha-synuclein accumulation, neuroinflammation and disruption of protein degradation, and these have been crucial for a deeper understanding of the mechanisms of pathology, the identification of biomarkers, and evaluation of novel therapies. Imaging biomarkers are non-invasive tools to assess disease progression and response to therapies; their discovery and validation have been an active field of translational research. Here, we highlight different considerations of animal models of PD that can be applied to future research, in terms of their suitability to answer different research questions. We provide the reader with important considerations of the best choice of model to use based on the disease features of each model, including issues related to different species. In addition, positron emission tomography studies conducted in PD animal models in the last 5 years are presented. With a variety of different species, interventions and genetic information, the choice of the most appropriate model to answer research questions can be daunting, especially since no single model recapitulates all aspects of this complex disorder. Appropriate animal models in conjunction with in vivo molecular imaging tools, if selected properly, can be a powerful combination for the assessment of novel therapies and developing tools for early diagnosis.
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Affiliation(s)
- Caroline Cristiano Real
- Department of Nuclear Medicine and PET Center, Aarhus University Hospital, Aarhus, Denmark
- Translational Neuropsychiatry Unit, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Karina Henrique Binda
- Department of Nuclear Medicine and PET Center, Aarhus University Hospital, Aarhus, Denmark
- Translational Neuropsychiatry Unit, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Majken Borup Thomsen
- Department of Nuclear Medicine and PET Center, Aarhus University Hospital, Aarhus, Denmark
- Translational Neuropsychiatry Unit, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Thea Pinholt Lillethorup
- Department of Nuclear Medicine and PET Center, Aarhus University Hospital, Aarhus, Denmark
- Translational Neuropsychiatry Unit, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - David James Brooks
- Department of Nuclear Medicine and PET Center, Aarhus University Hospital, Aarhus, Denmark
- Institute of Translational and Clinical Research, University of Newcastle, Upon Tyne, UK
| | - Anne Marlene Landau
- Department of Nuclear Medicine and PET Center, Aarhus University Hospital, Aarhus, Denmark
- Translational Neuropsychiatry Unit, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
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Gadeyne S, Mertens A, Carrette E, Van den Bossche F, Boon P, Raedt R, Vonck K. Transcutaneous auricular vagus nerve stimulation cannot modulate the P3b event-related potential in healthy volunteers. Clin Neurophysiol 2021; 135:22-29. [PMID: 35007840 DOI: 10.1016/j.clinph.2021.11.079] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 11/09/2021] [Accepted: 11/23/2021] [Indexed: 01/01/2023]
Abstract
OBJECTIVE The release of cortical norepinephrine is one of the possible mechanisms of action of vagus nerve stimulation (VNS), a neuromodulatory treatment currently under investigation for cognitive impairment. Transcutaneous auricular VNS (taVNS) may be able to activate vagal nerve branches ending in the brainstem's locus coeruleus (LC) non-invasively. The aim was to investigate if acute taVNS can modulate the P3b, a cognitive event-related potential (ERP) reflecting noradrenergic brain activation under control of the LC. METHODS Thirty-nine healthy volunteers performed an auditory oddball task during no stimulation, sham stimulation and taVNS in a randomized order. P3b amplitude, latency and behavioral outcome parameters were compared between conditions using linear mixed models. RESULTS P3b amplitude and latency during taVNS did not differ significantly from sham or control. Reaction time shortened and P3b latency prolonged with repetition of the oddball task. CONCLUSIONS We were unable to modulate cognitive ERPs by means of acute taVNS in a large group of healthy volunteers. SIGNIFICANCE Targeting vagal nerve fibres via a transcutaneous approach did not alter the P3b in healthy participants. The stimulation parameters used and transient delivery of taVNS might be insufficient to adequately modulate the LC. Also, a disbalanced locus coeruleus - norepinephrine system in patients may be more prone for improvement.
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Affiliation(s)
- Stefanie Gadeyne
- 4Brain, Department of Neurology, Ghent University Hospital, Ghent, Belgium.
| | - Ann Mertens
- 4Brain, Department of Neurology, Ghent University Hospital, Ghent, Belgium
| | - Evelien Carrette
- 4Brain, Department of Neurology, Ghent University Hospital, Ghent, Belgium
| | | | - Paul Boon
- 4Brain, Department of Neurology, Ghent University Hospital, Ghent, Belgium
| | - Robrecht Raedt
- 4Brain, Department of Neurology, Ghent University Hospital, Ghent, Belgium
| | - Kristl Vonck
- 4Brain, Department of Neurology, Ghent University Hospital, Ghent, Belgium
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Laurencin C, Lancelot S, Gobert F, Redouté J, Mérida I, Iecker T, Liger F, Irace Z, Greusard E, Lamberet L, Bars DL, Costes N, Ballanger B. Modeling [ 11C]yohimbine PET human brain kinetics with test-retest reliability, competition sensitivity studies and search for a suitable reference region. Neuroimage 2021; 240:118328. [PMID: 34224852 DOI: 10.1016/j.neuroimage.2021.118328] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 05/20/2021] [Accepted: 06/30/2021] [Indexed: 10/20/2022] Open
Abstract
Previous work introduced the [11C]yohimbine as a suitable ligand of central α2-adrenoreceptors (α2-ARs) for PET imaging. However, reproducibility of [11C]yohimbine PET measurements in healthy humans estimated with a simplified modeling method with reference region, as well as sensitivity of [11C]yohimbine to noradrenergic competition were not evaluated. The objectives of the present study were therefore to fill this gap. METHODS Thirteen healthy humans underwent two [11C]yohimbine 90-minute dynamic scans performed on a PET-MRI scanner. Seven had arterial blood sampling with metabolite assessment and plasmatic yohimbine free fraction evaluation at the first scan to have arterial input function and test appropriate kinetic modeling. The second scan was a simple retest for 6 subjects to evaluate the test-retest reproducibility. For the remaining 7 subjects the second scan was a challenge study with the administration of a single oral dose of 150 µg of clonidine 90 min before the PET scan. Parametric images of α2-ARs distribution volume ratios (DVR) were generated with two non-invasive models: Logan graphical analysis with Reference (LREF) and Simplified Reference Tissue Method (SRTM). Three reference regions (cerebellum white matter (CERWM), frontal white matter (FLWM), and corpus callosum (CC)) were tested. RESULTS We showed high test-retest reproducibility of DVR estimation with LREF and SRTM regardless of reference region (CC, CERWM, FLWM). The best fit was obtained with SRTMCC (r2=0.94). Test-retest showed that the SRTMCC is highly reproducible (mean ICC>0.7), with a slight bias (-1.8%), whereas SRTMCERWM had lower bias (-0.1%), and excellent ICC (mean>0.8). Using SRTMCC, regional changes have been observed after clonidine administration with a significant increase reported in the amygdala and striatum as well as in several posterior cortical areas as revealed with the voxel-based analysis. CONCLUSION The results add experimental support for the suitability of [11C]yohimbine PET in the quantitative assessment of α2-ARs occupancy in vivo in the human brain. Trial registration EudraCT 2018-000380-82.
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Affiliation(s)
- Chloé Laurencin
- Lyon Neuroscience Research Center (CRNL), INSERM U1028, CNRS UMR5292, University Lyon 1, Lyon F-69000, France; Pierre Wertheimer Neurological Hospital, Hospices Civils de Lyon (HCL), Lyon, France
| | - Sophie Lancelot
- Lyon Neuroscience Research Center (CRNL), INSERM U1028, CNRS UMR5292, University Lyon 1, Lyon F-69000, France; Pierre Wertheimer Neurological Hospital, Hospices Civils de Lyon (HCL), Lyon, France; CERMEP, Lyon, France
| | - Florent Gobert
- Pierre Wertheimer Neurological Hospital, Hospices Civils de Lyon (HCL), Lyon, France
| | | | | | | | | | - Zacharie Irace
- CERMEP, Lyon, France; Siemens-Healthcare, SAS, Saint-Denis, France
| | - Elise Greusard
- Pierre Wertheimer Neurological Hospital, Hospices Civils de Lyon (HCL), Lyon, France; CERMEP, Lyon, France
| | - Ludovic Lamberet
- Pierre Wertheimer Neurological Hospital, Hospices Civils de Lyon (HCL), Lyon, France; CERMEP, Lyon, France
| | - Didier Le Bars
- Pierre Wertheimer Neurological Hospital, Hospices Civils de Lyon (HCL), Lyon, France; CERMEP, Lyon, France
| | - Nicolas Costes
- Lyon Neuroscience Research Center (CRNL), INSERM U1028, CNRS UMR5292, University Lyon 1, Lyon F-69000, France; CERMEP, Lyon, France
| | - Bénédicte Ballanger
- Lyon Neuroscience Research Center (CRNL), INSERM U1028, CNRS UMR5292, University Lyon 1, Lyon F-69000, France.
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10
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Wang Y, Zhan G, Cai Z, Jiao B, Zhao Y, Li S, Luo A. Vagus nerve stimulation in brain diseases: Therapeutic applications and biological mechanisms. Neurosci Biobehav Rev 2021; 127:37-53. [PMID: 33894241 DOI: 10.1016/j.neubiorev.2021.04.018] [Citation(s) in RCA: 71] [Impact Index Per Article: 23.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Revised: 04/12/2021] [Accepted: 04/18/2021] [Indexed: 12/21/2022]
Abstract
Brain diseases, including neurodegenerative, cerebrovascular and neuropsychiatric diseases, have posed a deleterious threat to human health and brought a great burden to society and the healthcare system. With the development of medical technology, vagus nerve stimulation (VNS) has been approved by the Food and Drug Administration (FDA) as an alternative treatment for refractory epilepsy, refractory depression, cluster headaches, and migraines. Furthermore, current evidence showed promising results towards the treatment of more brain diseases, such as Parkinson's disease (PD), autistic spectrum disorder (ASD), traumatic brain injury (TBI), and stroke. Nonetheless, the biological mechanisms underlying the beneficial effects of VNS in brain diseases remain only partially elucidated. This review aims to delve into the relevant preclinical and clinical studies and update the progress of VNS applications and its potential mechanisms underlying the biological effects in brain diseases.
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Affiliation(s)
- Yue Wang
- Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
| | - Gaofeng Zhan
- Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
| | - Ziwen Cai
- Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
| | - Bo Jiao
- Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
| | - Yilin Zhao
- Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
| | - Shiyong Li
- Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
| | - Ailin Luo
- Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
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11
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Cumming P, Gründer G, Brinson Z, Wong DF. Applications, Advances, and Limitations of Molecular Imaging of Brain Receptors. Mol Imaging 2021. [DOI: 10.1016/b978-0-12-816386-3.00063-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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12
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Neuser MP, Teckentrup V, Kühnel A, Hallschmid M, Walter M, Kroemer NB. Vagus nerve stimulation boosts the drive to work for rewards. Nat Commun 2020; 11:3555. [PMID: 32678082 PMCID: PMC7366927 DOI: 10.1038/s41467-020-17344-9] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Accepted: 06/16/2020] [Indexed: 11/23/2022] Open
Abstract
Interoceptive feedback transmitted via the vagus nerve plays a vital role in motivation by tuning actions according to physiological needs. Whereas vagus nerve stimulation (VNS) reinforces actions in animals, motivational effects elicited by VNS in humans are still largely elusive. Here, we applied non-invasive transcutaneous auricular VNS (taVNS) on the left or right ear while participants exerted effort to earn rewards using a randomized cross-over design (vs. sham). In line with preclinical studies, acute taVNS enhances invigoration of effort, and stimulation on the left side primarily facilitates invigoration for food rewards. In contrast, we do not find conclusive evidence that acute taVNS affects effort maintenance or wanting ratings. Collectively, our results suggest that taVNS enhances reward-seeking by boosting invigoration, not effort maintenance and that the stimulation side affects generalization beyond food reward. Thus, taVNS may enhance the pursuit of prospective rewards which may pave avenues to treat motivational deficiencies. The vagus nerve transmits signals between the gut and the brain thereby tuning motivated behavior to physiological needs. Here, the authors show that acute non-invasive stimulation of the vagus nerve via the ear enhances the invigoration of effort for rewards.
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Affiliation(s)
- Monja P Neuser
- Department of Psychiatry and Psychotherapy, University of Tübingen, Calwerstraße 14, 72076, Tübingen, Germany
| | - Vanessa Teckentrup
- Department of Psychiatry and Psychotherapy, University of Tübingen, Calwerstraße 14, 72076, Tübingen, Germany
| | - Anne Kühnel
- Department of Psychiatry and Psychotherapy, University of Tübingen, Calwerstraße 14, 72076, Tübingen, Germany.,Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry and International Max Planck Research School for Translational Psychiatry (IMPRS-TP), Kraeplinstraße 2-10, 80804, Munich, Germany
| | - Manfred Hallschmid
- Department of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Otfried-Müller-Straße 25, 72076, Tübingen, Germany.,German Center for Diabetes Research (DZD), Otfried-Müller-Straße 10, 72076, Tübingen, Germany.,Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the Eberhard Karls University Tübingen, Otfried-Müller-Str. 10, 72076, Tübingen, Germany
| | - Martin Walter
- Department of Psychiatry and Psychotherapy, University of Tübingen, Calwerstraße 14, 72076, Tübingen, Germany.,Department of Psychiatry and Psychotherapy, Otto von Guericke University Magdeburg, Leipziger Straße 44, 39120, Magdeburg, Germany.,Department of Psychiatry and Psychotherapy, University Hospital Jena, Philosophenweg 3, 07743, Jena, Germany.,Department of Behavioral Neurology, Leibniz Institute for Neurobiology, Brenneckestr 6, 39118, Magdeburg, Germany
| | - Nils B Kroemer
- Department of Psychiatry and Psychotherapy, University of Tübingen, Calwerstraße 14, 72076, Tübingen, Germany.
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13
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Activation of NMDA receptor ion channels by deep brain stimulation in the pig visualised with [18F]GE-179 PET. Brain Stimul 2020; 13:1071-1078. [DOI: 10.1016/j.brs.2020.03.019] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2019] [Revised: 03/17/2020] [Accepted: 03/30/2020] [Indexed: 11/20/2022] Open
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14
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Thomsen MB, Schacht AC, Alstrup AKO, Jacobsen J, Lillethorup TP, Bærentzen SL, Noer O, Orlowski D, Elfving B, Müller HK, Brooks DJ, Landau AM. Preclinical PET Studies of [ 11C]UCB-J Binding in Minipig Brain. Mol Imaging Biol 2020; 22:1290-1300. [PMID: 32514885 DOI: 10.1007/s11307-020-01506-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
PURPOSE Loss of neuronal synapse function is associated with a number of brain disorders. The [11C]UCB-J positron emission tomography (PET) tracer allows for in vivo examination of synaptic density, as it binds to synaptic vesicle glycoprotein 2A (SV2A) expressed in presynaptic terminals. Here, we characterise [11C]UCB-J imaging in Göttingen minipigs. PROCEDURES Using PET imaging, we examined tracer specificity and compared kinetic models. We explored the use of a standard blood curve and centrum semiovale white matter as a reference region. We compared in vivo [11C]UCB-J PET imaging to in vitro autoradiography, Western blotting and real-time quantitative polymerase chain reaction. RESULTS The uptake kinetics of [11C]UCB-J could be described using a 1-tissue compartment model and blocking of SV2A availability with levetiracetam showed dose-dependent specific binding. Population-based blood curves resulted in reliable [11C]UCB-J binding estimates, while it was not possible to use centrum semiovale white matter as a non-specific reference region. Brain [11C]UCB-J PET signals correlated well with [3H]UCB-J autoradiography and SV2A protein levels. CONCLUSIONS [11C]UCB-J PET is a valid in vivo marker of synaptic density in the minipig brain, with binding values close to those reported for humans. Minipig models of disease could be valuable for investigating the efficacy of putative neuroprotective agents for preserving synaptic function in future non-invasive, longitudinal studies.
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Affiliation(s)
- Majken Borup Thomsen
- Department of Nuclear Medicine and PET, Department of Clinical Medicine, Aarhus University, Palle Juul-Jensens Boulevard 165, J, 8200, Aarhus N, Denmark
| | - Anna Christina Schacht
- Department of Nuclear Medicine and PET, Department of Clinical Medicine, Aarhus University, Palle Juul-Jensens Boulevard 165, J, 8200, Aarhus N, Denmark
| | - Aage Kristian Olsen Alstrup
- Department of Nuclear Medicine and PET, Department of Clinical Medicine, Aarhus University, Palle Juul-Jensens Boulevard 165, J, 8200, Aarhus N, Denmark
| | - Jan Jacobsen
- Department of Nuclear Medicine and PET, Department of Clinical Medicine, Aarhus University, Palle Juul-Jensens Boulevard 165, J, 8200, Aarhus N, Denmark
| | - Thea Pinholt Lillethorup
- Department of Nuclear Medicine and PET, Department of Clinical Medicine, Aarhus University, Palle Juul-Jensens Boulevard 165, J, 8200, Aarhus N, Denmark
| | - Simone Larsen Bærentzen
- Department of Nuclear Medicine and PET, Department of Clinical Medicine, Aarhus University, Palle Juul-Jensens Boulevard 165, J, 8200, Aarhus N, Denmark.,Translational Neuropsychiatry Unit, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Ove Noer
- Department of Nuclear Medicine and PET, Department of Clinical Medicine, Aarhus University, Palle Juul-Jensens Boulevard 165, J, 8200, Aarhus N, Denmark
| | - Dariusz Orlowski
- Center for Experimental Neuroscience (CENSE), Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Betina Elfving
- Translational Neuropsychiatry Unit, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Heidi Kaastrup Müller
- Translational Neuropsychiatry Unit, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - David J Brooks
- Department of Nuclear Medicine and PET, Department of Clinical Medicine, Aarhus University, Palle Juul-Jensens Boulevard 165, J, 8200, Aarhus N, Denmark.,Institute of Translational and Clinical Research, Faculty of Medical Science, Newcastle upon Tyne University, Newcastle upon Tyne, UK
| | - Anne M Landau
- Department of Nuclear Medicine and PET, Department of Clinical Medicine, Aarhus University, Palle Juul-Jensens Boulevard 165, J, 8200, Aarhus N, Denmark. .,Translational Neuropsychiatry Unit, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
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15
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Landau AM, Noer O, Alstrup AKO, Audrain H, Wegener G, Gjedde A, Doudet DJ, Winterdahl M. Type of Anaesthetic Influences [ 11C]MDL100,907 Binding to 5HT 2A Receptors in Porcine Brain. Mol Imaging Biol 2020; 22:797-804. [PMID: 31993926 DOI: 10.1007/s11307-020-01476-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
PURPOSE Anaesthesia routinely is used in animal neuroimaging in order to reduce head motion artefacts and minimize the influence of stress. However, anaesthetics can modify radioligand binding profiles at receptor targets studied by positron emission tomography (PET). Here, we determined the effects of two routine anaesthetics on the binding of a tracer of the serotonin 5HT2A receptors. PROCEDURES Isoflurane- and propofol-anesthetised Göttingen minipigs were imaged with [11C]MDL100,907 PET and analysed using regions of interest and statistical non-parametric mapping. RESULTS The binding potentials of the tracer in striatum under isoflurane anaesthesia significantly exceeded those obtained under propofol anaesthesia, an effect we attribute to the higher blood flow in brain induced by the former. CONCLUSIONS Interactions between radioligands and anaesthesia must be carefully evaluated in the design of in vivo neuroimaging and interpretation of data.
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Affiliation(s)
- Anne M Landau
- Department of Nuclear Medicine and PET, Aarhus University, Aarhus, Denmark. .,Translational Neuropsychiatry Unit, Aarhus University, Aarhus, Denmark.
| | - Ove Noer
- Department of Nuclear Medicine and PET, Aarhus University, Aarhus, Denmark
| | | | - Hélène Audrain
- Department of Nuclear Medicine and PET, Aarhus University, Aarhus, Denmark
| | - Gregers Wegener
- Translational Neuropsychiatry Unit, Aarhus University, Aarhus, Denmark
| | - Albert Gjedde
- Department of Nuclear Medicine and PET, Aarhus University, Aarhus, Denmark.,Department of Nuclear Medicine, University of Southern Denmark, Odense University Hospital, Odense, Denmark.,Department of Neurology and Neurosurgery, McGill University, Montreal, Canada
| | - Doris J Doudet
- Department of Medicine/Neurology, University of British Columbia, Vancouver, Canada
| | - Michael Winterdahl
- Department of Nuclear Medicine and PET, Aarhus University, Aarhus, Denmark
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16
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Mirza KB, Golden CT, Nikolic K, Toumazou C. Closed-Loop Implantable Therapeutic Neuromodulation Systems Based on Neurochemical Monitoring. Front Neurosci 2019; 13:808. [PMID: 31481864 PMCID: PMC6710388 DOI: 10.3389/fnins.2019.00808] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Accepted: 07/19/2019] [Indexed: 12/29/2022] Open
Abstract
Closed-loop or intelligent neuromodulation allows adjustable, personalized neuromodulation which usually incorporates the recording of a biomarker, followed by implementation of an algorithm which decides the timing (when?) and strength (how much?) of stimulation. Closed-loop neuromodulation has been shown to have greater benefits compared to open-loop neuromodulation, particularly for therapeutic applications such as pharmacoresistant epilepsy, movement disorders and potentially for psychological disorders such as depression or drug addiction. However, an important aspect of the technique is selection of an appropriate, preferably neural biomarker. Neurochemical sensing can provide high resolution biomarker monitoring for various neurological disorders as well as offer deeper insight into neurological mechanisms. The chemicals of interest being measured, could be ions such as potassium (K+), sodium (Na+), calcium (Ca2+), chloride (Cl−), hydrogen (H+) or neurotransmitters such as dopamine, serotonin and glutamate. This review focusses on the different building blocks necessary for a neurochemical, closed-loop neuromodulation system including biomarkers, sensors and data processing algorithms. Furthermore, it also highlights the merits and drawbacks of using this biomarker modality.
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Affiliation(s)
- Khalid B Mirza
- Department of Electrical and Electronic Engineering, Centre for Bio-Inspired Technology, Institute of Biomedical Engineering, Imperial College London, London, United Kingdom
| | - Caroline T Golden
- Department of Electrical and Electronic Engineering, Centre for Bio-Inspired Technology, Institute of Biomedical Engineering, Imperial College London, London, United Kingdom
| | - Konstantin Nikolic
- Department of Electrical and Electronic Engineering, Centre for Bio-Inspired Technology, Institute of Biomedical Engineering, Imperial College London, London, United Kingdom
| | - Christofer Toumazou
- Department of Electrical and Electronic Engineering, Centre for Bio-Inspired Technology, Institute of Biomedical Engineering, Imperial College London, London, United Kingdom
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17
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Keute M, Demirezen M, Graf A, Mueller NG, Zaehle T. No modulation of pupil size and event-related pupil response by transcutaneous auricular vagus nerve stimulation (taVNS). Sci Rep 2019; 9:11452. [PMID: 31391505 PMCID: PMC6685960 DOI: 10.1038/s41598-019-47961-4] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Accepted: 07/24/2019] [Indexed: 01/20/2023] Open
Abstract
Transcutaneous auricular vagus nerve stimulation (taVNS) bears therapeutic potential for a wide range of medical conditions. However, previous studies have found substantial interindividual variability in responsiveness to taVNS, and no reliable predictive biomarker for stimulation success has been developed so far. In this study, we investigate pupil size and event-related pupil response as candidate biomarkers. Both measures have a direct physiological link to the activity of the locus coeruleus (LC), a brainstem structure and the main source of norepinephrine in the brain. LC activation is considered one of the key mechanisms of action of taVNS, therefore, we expected a clear increase of the pupillary measures under taVNS compared to sham (placebo) stimulation, such that it could serve as a prospective predictor for individual clinical and physiological taVNS effects in future studies. We studied resting pupil size and pupillary responses to target stimuli in an auditory oddball task in 33 healthy young volunteers. We observed stronger pupil responses to target than to standard stimuli. However, and contrary to our hypothesis, neither pupil size nor the event-related pupil response nor behavioral performance were modulated by taVNS. We discuss potential explanations for this negative finding and its implications for future clinical investigation and development of taVNS.
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Affiliation(s)
- Marius Keute
- Department of Neurology, Otto von Guericke University, Magdeburg, Germany
| | - Mustafa Demirezen
- Department of Neurology, Otto von Guericke University, Magdeburg, Germany
| | - Alina Graf
- Neuroprotection Group, German Center for Neurodegenerative Diseases, Magdeburg, Germany
| | - Notger G Mueller
- Department of Neurology, Otto von Guericke University, Magdeburg, Germany.,Neuroprotection Group, German Center for Neurodegenerative Diseases, Magdeburg, Germany.,Center for Behavioral Brain Sciences, Magdeburg, Germany
| | - Tino Zaehle
- Department of Neurology, Otto von Guericke University, Magdeburg, Germany. .,Center for Behavioral Brain Sciences, Magdeburg, Germany.
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18
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Horrillo I, Ortega JE, Diez-Alarcia R, Urigüen L, Meana JJ. Chronic fluoxetine reverses the effects of chronic corticosterone treatment on α 2-adrenoceptors in the rat frontal cortex but not locus coeruleus. Neuropharmacology 2019; 158:107731. [PMID: 31376424 DOI: 10.1016/j.neuropharm.2019.107731] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 07/29/2019] [Accepted: 07/30/2019] [Indexed: 01/27/2023]
Abstract
Disruption of the hypothalamic-pituitary-adrenal axis is an established finding in patients with anxiety and/or depression. Chronic corticosterone administration in animals has been proposed as a model for the study of these stress-related disorders and the antidepressant action. Alterations of the central noradrenergic system and specifically of inhibitory α2-adrenoceptors seem to be part of the pathophysiology of depression and contribute to the antidepressant activity. The present study evaluates in male rats the effect of chronic corticosterone treatment during 35 days (16-20 mg kg-1 day-1) on the sensitivity of α2-adrenoceptors expressed in the somatodendritic and terminal noradrenergic areas locus coeruleus (LC) and prefrontal cortex (PFC), respectively. Further, the effect of chronic fluoxetine treatment (5 mg kg-1, i.p., since the 15th day) on the sensitivity of α2-adrenoceptors was examined under control conditions and in corticosterone-treated rats. The α2-adrenoceptor functionality was analysed in vitro by agonist-mediated [35S]GTPγS binding stimulation and in vivo through the modulation of noradrenaline (NA) release evaluated by dual-probe microdialysis. The concentration-effect curves of the [35S]GTPγS binding stimulation by the agonist UK14304 (5-bromo-N-(4,5-dihydro-1H-imidazol-2-yl)-6-quinoxalinamine) demonstrated a desensitization of cortical α2-adrenoceptors induced by corticosterone (-logEC50 = 6.7 ± 0.2 vs 8.2 ± 0.3 in controls) that was reverted by fluoxetine treatment (-logEC50 = 7.5 ± 0.3). Local administration of the α2-adrenoceptor antagonist RS79948 ((8aR,12aS,13aS)-5,8,8a,9,10,11,12,12a,13,13a-decahydro-3-methoxy-12-(ethylsulfonyl)-6H-isoquino[2,1-g][1,6]naphthyridine) (0.1-100 μmol L-1) into the LC induced a concentration-dependent NA increase in the PFC of the control group (Emax = 191 ± 30%) but non-significant effect was observed in corticosterone-treated rats (Emax = 133 ± 46%), reflecting a desensitization of α2-adrenoceptors that control the firing of noradrenergic neurons. Fluoxetine treatment did not alter the corticosterone-induced desensitization in this area (Emax = 136 ± 19%). No effect of fluoxetine on α2-adrenoceptor functionality was observed in control animals (Emax = 223 ± 30%). In PFC, the local administration of RS79948 increased NA in controls (Emax = 226 ± 27%) without effect in the corticosterone group (Emax = 115 ± 26%), suggesting a corticosterone-induced desensitization of terminal α2-adrenoceptors. Fluoxetine administration prevented the desensitization induced by corticosterone in the PFC (Emax = 233 ± 33%) whereas desensitized α2-adrenoceptors in control animals (Emax = -24 ± 10%). These data indicate that chronic corticosterone increases noradrenergic activity by acting at different α2-adrenoceptor subpopulations. Treatment with the antidepressant fluoxetine seems to counteract these changes by acting mainly on presynaptic α2-adrenoceptors expressed in terminal areas.
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Affiliation(s)
- Igor Horrillo
- Department of Pharmacology, University of the Basque Country UPV/EHU, Spain; Centro de Investigación Biomédica en Red de Salud Mental CIBERSAM, Spain; Biocruces Bizkaia Health Research Institute, Spain
| | - Jorge E Ortega
- Department of Pharmacology, University of the Basque Country UPV/EHU, Spain; Centro de Investigación Biomédica en Red de Salud Mental CIBERSAM, Spain; Biocruces Bizkaia Health Research Institute, Spain
| | - Rebeca Diez-Alarcia
- Department of Pharmacology, University of the Basque Country UPV/EHU, Spain; Centro de Investigación Biomédica en Red de Salud Mental CIBERSAM, Spain; Biocruces Bizkaia Health Research Institute, Spain
| | - Leyre Urigüen
- Department of Pharmacology, University of the Basque Country UPV/EHU, Spain; Centro de Investigación Biomédica en Red de Salud Mental CIBERSAM, Spain; Biocruces Bizkaia Health Research Institute, Spain
| | - J Javier Meana
- Department of Pharmacology, University of the Basque Country UPV/EHU, Spain; Centro de Investigación Biomédica en Red de Salud Mental CIBERSAM, Spain; Biocruces Bizkaia Health Research Institute, Spain.
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19
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San-Juan D, Dávila-Rodríguez DO, Jiménez CR, González MS, Carranza SM, Hernández Mendoza JR, Anschel DJ. Neuromodulation techniques for status epilepticus: A review. Brain Stimul 2019; 12:835-844. [PMID: 31053521 DOI: 10.1016/j.brs.2019.04.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Revised: 04/05/2019] [Accepted: 04/14/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Electroconvulsive therapy (ECT), Vagal Nerve Stimulation (VNS), Transcranial Magnetic Stimulation (TMS) and Deep Brain Stimulation (DBS) are neuromodulation therapies that have been used to treat Status Epilepticus (SE). OBJECTIVE Review the literature about the efficacy and safety of neuromodulation therapies in SE in humans. METHODS We searched studies in PubMed, Scopus, Google Scholar and Science Direct (inception to June 2018). Four review authors independently selected the studies, extracted data and assessed the methodological quality of the studies using the recommendations of the Cochrane Handbook for Systematic Reviews of Interventions, PRISMA guidelines, Oxford and GRADE scales, and Murad et al., 2018 methodological quality and synthesis of case series and case reports. RESULTS We analyzed 27 articles (45 patients) with 4 different neuromodulation therapies. In ECT we found 80% rate of disruption of SE and 5% of adverse events was reported. Using iVNS 15/16 (93.7%) patients resolved the SE. All patients who underwent TMS and DBS aborted SE, however, 50% of patients with DBS had severe adverse events. CONCLUSIONS Case series and case reports suggest that neuromodulation therapies can abort SE in 80-100% of patients (Oxford scale and GRADE were level 4 and D) with a wide range of adverse effects, which claims for prospective studies on the relationship be-tween efficacy and safety.
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Affiliation(s)
- Daniel San-Juan
- Neurophysiology Department, National Institute of Neurology and Neurosurgery Manuel Velasco Suárez, Mexico City, Mexico.
| | | | - Christian Ramos Jiménez
- Faculty of Medicine, Autonomous University of State of Mexico, Toluca de Lerdo, State of Mexico, Mexico
| | | | | | - Jesús Ricardo Hernández Mendoza
- Faculty of Medicine Mexicali, Autonomous University of Baja California, Dr. Humberto Torres Sangines, Mexicali, Baja California, Mexico
| | - David J Anschel
- Comprehensive Epilepsy Center of Long Island, Port Jefferson, NY, USA
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20
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Lillethorup TP, Glud AN, Alstrup AKO, Noer O, Nielsen EHT, Schacht AC, Landeck N, Kirik D, Orlowski D, Sørensen JCH, Doudet DJ, Landau AM. Longitudinal monoaminergic PET imaging of chronic proteasome inhibition in minipigs. Sci Rep 2018; 8:15715. [PMID: 30356172 PMCID: PMC6200778 DOI: 10.1038/s41598-018-34084-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Accepted: 10/11/2018] [Indexed: 02/08/2023] Open
Abstract
Impairment of the ubiquitin proteasome system has been implicated in Parkinson’s disease. We used positron emission tomography to investigate longitudinal effects of chronic intracerebroventricular exposure to the proteasome inhibitor lactacystin on monoaminergic projections and neuroinflammation. Göttingen minipigs were implanted in the cisterna magna with a catheter connected to a subcutaneous injection port. Minipigs were imaged at baseline and after cumulative doses of 200 and 400 μg lactacystin, respectively. Main radioligands included [11C]-DTBZ (vesicular monoamine transporter type 2) and [11C]-yohimbine (α2-adrenoceptor). [11C]-DASB (serotonin transporter) and [11C]-PK11195 (activated microglia) became available later in the study and we present their results in a smaller subset of animals for information purposes only. Striatal [11C]-DTBZ binding potentials decreased significantly by 16% after 200 μg compared to baseline, but the decrease was not sustained after 400 μg (n = 6). [11C]-yohimbine volume of distribution increased by 18–25% in the pons, grey matter and the thalamus after 200 μg, which persisted at 400 μg (n = 6). In the later subset of minipigs, we observed decreased [11C]-DASB (n = 5) and increased [11C]-PK11195 (n = 3) uptake after 200 μg. These changes may mimic monoaminergic changes and compensatory responses in early Parkinson’s disease.
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Affiliation(s)
- Thea P Lillethorup
- Department of Nuclear Medicine and PET Center, Department of Clinical Medicine, Aarhus University and Hospital, Aarhus, Denmark
| | - Andreas N Glud
- Center for Experimental Neuroscience (CENSE), Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Aage K O Alstrup
- Department of Nuclear Medicine and PET Center, Department of Clinical Medicine, Aarhus University and Hospital, Aarhus, Denmark
| | - Ove Noer
- Department of Nuclear Medicine and PET Center, Department of Clinical Medicine, Aarhus University and Hospital, Aarhus, Denmark
| | - Erik H T Nielsen
- Department of Nuclear Medicine and PET Center, Department of Clinical Medicine, Aarhus University and Hospital, Aarhus, Denmark
| | - Anna C Schacht
- Department of Nuclear Medicine and PET Center, Department of Clinical Medicine, Aarhus University and Hospital, Aarhus, Denmark
| | - Natalie Landeck
- Brain Repair and Imaging in Neural Systems (BRAINS) Unit, Department of Experimental Medical Science, Lund University, Lund, Sweden
| | - Deniz Kirik
- Brain Repair and Imaging in Neural Systems (BRAINS) Unit, Department of Experimental Medical Science, Lund University, Lund, Sweden
| | - Dariusz Orlowski
- Center for Experimental Neuroscience (CENSE), Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Jens Christian H Sørensen
- Center for Experimental Neuroscience (CENSE), Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Doris J Doudet
- Department of Medicine/Neurology, University of British Columbia, Vancouver, BC, Canada
| | - Anne M Landau
- Department of Nuclear Medicine and PET Center, Department of Clinical Medicine, Aarhus University and Hospital, Aarhus, Denmark. .,Translational Neuropsychiatry Unit, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
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Mertens A, Raedt R, Gadeyne S, Carrette E, Boon P, Vonck K. Recent advances in devices for vagus nerve stimulation. Expert Rev Med Devices 2018; 15:527-539. [DOI: 10.1080/17434440.2018.1507732] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- Ann Mertens
- Department of Neurology, Ghent University Hospital, Gent, Belgium
| | - Robrecht Raedt
- Department of Neurology, Ghent University Hospital, Gent, Belgium
| | - Stefanie Gadeyne
- Department of Neurology, Ghent University Hospital, Gent, Belgium
| | - Evelien Carrette
- Department of Neurology, Ghent University Hospital, Gent, Belgium
| | - Paul Boon
- Department of Neurology, Ghent University Hospital, Gent, Belgium
| | - Kristl Vonck
- Department of Neurology, Ghent University Hospital, Gent, Belgium
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22
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Landau AM, Alstrup AK, Audrain H, Jakobsen S, Simonsen M, Møller A, Videbech P, Wegener G, Gjedde A, Doudet DJ. Elevated dopamine D1 receptor availability in striatum of Göttingen minipigs after electroconvulsive therapy. J Cereb Blood Flow Metab 2018; 38:881-887. [PMID: 28509598 PMCID: PMC5987930 DOI: 10.1177/0271678x17705260] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Electroconvulsive therapy (ECT), a direct form of brain stimulation, is an effective antidepressant. We hypothesized that the beneficial effects of ECT are mediated by increased dopaminergic neurotransmission, in which the baseline activity of D1 receptors may predict the response to ECT. We established a novel model of brain stimulation in Göttingen minipigs based on the protocol of ECT applied in humans. With positron emission tomography (PET), we determined a measure of dopaminergic neurotransmission with the dopamine D1 receptor antagonist [11C]SCH23390. Seven minipigs were anesthetized and completed PET at baseline, prior to the onset of ECT treatment, and at 24-48 h and 8-10 days after the end of a clinical course of ECT, consisting of 10 ECT sessions over a 3.5-week period. In all pigs, the binding of [11C]SCH23390 to striatal D1 receptors had increased by 24-48 h after ECT, and in most, binding returned towards baseline at 8-10 days. Increased binding was observed in inverse proportion to baseline binding rates. Increased binding to dopamine D1 receptors suggests facilitation of dopaminergic neurotransmission, which may contribute to the therapeutic effects of ECT. Importantly, the baseline binding capacity of D1 receptors predicts the magnitude of increased binding, up to a maximum binding capacity.
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Affiliation(s)
- Anne M Landau
- 1 Department of Nuclear Medicine and PET Center, Aarhus University and Hospital, Aarhus C, Denmark.,2 Translational Neuropsychiatry Unit, Aarhus University and Hospital, Aarhus C, Denmark.,3 Center of Functionally Integrative Neuroscience, Aarhus University and Hospital, Aarhus C, Denmark
| | - Aage Ko Alstrup
- 1 Department of Nuclear Medicine and PET Center, Aarhus University and Hospital, Aarhus C, Denmark
| | - Helene Audrain
- 1 Department of Nuclear Medicine and PET Center, Aarhus University and Hospital, Aarhus C, Denmark
| | - Steen Jakobsen
- 1 Department of Nuclear Medicine and PET Center, Aarhus University and Hospital, Aarhus C, Denmark
| | - Mette Simonsen
- 1 Department of Nuclear Medicine and PET Center, Aarhus University and Hospital, Aarhus C, Denmark
| | - Arne Møller
- 1 Department of Nuclear Medicine and PET Center, Aarhus University and Hospital, Aarhus C, Denmark.,3 Center of Functionally Integrative Neuroscience, Aarhus University and Hospital, Aarhus C, Denmark
| | - Poul Videbech
- 4 Centre of Mental Health, Glostrup & University of Copenhagen, Denmark
| | - Gregers Wegener
- 2 Translational Neuropsychiatry Unit, Aarhus University and Hospital, Aarhus C, Denmark
| | - Albert Gjedde
- 1 Department of Nuclear Medicine and PET Center, Aarhus University and Hospital, Aarhus C, Denmark.,5 Center for Neuroscience, University of Copenhagen, Copenhagen, Denmark.,6 Department of Nuclear Medicine, University of Southern Denmark & Odense University Hospital, Odense, Denmark
| | - Doris J Doudet
- 1 Department of Nuclear Medicine and PET Center, Aarhus University and Hospital, Aarhus C, Denmark.,7 Department of Medicine/Neurology, University of British Columbia, Vancouver, BC, Canada
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Abstract
Major depressive disorder (MDD) is prevalent. Although standards antidepressants are more effective than placebo, up to 35% of patients do not respond to 4 or more conventional treatments and are considered to have treatment-resistant depression (TRD). Considerable effort has been devoted to trying to find effective treatments for TRD. This review focuses on vagus nerve stimulation (VNS), approved for TRD in 2005 by the Food and Drugs Administration. Stimulation is carried by bipolar electrodes on the left cervical vagus nerve, which are attached to an implanted stimulator generator. The vagus bundle contains about 80% of afferent fibers terminating in the medulla, from which there are projections to many areas of brain, including the limbic forebrain. Various types of brain imaging studies reveal widespread functional effects in brain after either acute or chronic VNS. Although more randomized control trials of VNS need to be carried out before a definitive conclusion can be reached about its efficacy, the results of open studies, carried out over period of 1 to 2 years, show much more efficacy when compared with results from treatment as usual studies. There is an increase in clinical response to VNS between 3 and 12 months, which is quite different from that seen with standard antidepressant treatment of MDD. Preclinically, VNS affects many of the same brain areas, neurotransmitters (serotonin, norepinephrine) and signal transduction mechanisms (brain-derived neurotrophic factor-tropomyosin receptor kinase B) as those found with traditional antidepressants. Nevertheless, the mechanisms by which VNS benefits patients nonresponsive to conventional antidepressants is unclear, with further research needed to clarify this.
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Affiliation(s)
- Flavia R Carreno
- Department of Pharmacology, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.
- Center for Biomedical Neuroscience, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA.
| | - Alan Frazer
- Department of Pharmacology, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
- Center for Biomedical Neuroscience, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
- South Texas Veterans Health Care System, San Antonio, TX, USA
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24
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Neonatal domoic acid alters in vivo binding of [ 11C]yohimbine to α 2-adrenoceptors in adult rat brain. Psychopharmacology (Berl) 2016; 233:3779-3785. [PMID: 27557950 DOI: 10.1007/s00213-016-4416-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Accepted: 08/10/2016] [Indexed: 12/31/2022]
Abstract
RATIONALE Epilepsy is a debilitating seizure disorder that affects approximately 50 million people. Noradrenaline reduces neuronal excitability, has anticonvulsant effects and is protective against seizure onset. OBJECTIVE We investigated the role of α2-adrenoceptors in vivo in a neonatal domoic acid (DOM) rat model of epilepsy. METHODS We injected male Sprague-Dawley rats daily from postnatal day 8-14 with saline or one of two sub-convulsive doses, 20 μg/kg (DOM20) or 60 μg/kg (DOM60) DOM, an AMPA/kainate receptor agonist. The rats were observed in open field, social interaction and forced swim tests at day 50, 75 and 98, respectively. At ~120 days of age, four rats per group were injected and scanned with [11C]yohimbine, an α2-adrenoceptor antagonist, and scanned in a Mediso micro positron emission tomography (PET) scanner to measure α2-adrenoceptor binding. RESULTS DOM60-treated rats spent more time in the periphery during the open field test and had a significant 26-33 % reduction in [11C]yohimbine binding in the hypothalamus, hippocampus and orbital prefrontal cortex compared to saline-treated rats. On the other hand, DOM20 rats had a significant 34-40 % increase in [11C]yohimbine binding in the hypothalamus, amygdala and entorhinal cortex compared to saline-treated rats, with no obvious behavioural differences. CONCLUSIONS The current data clearly indicate that low concentrations of DOM given to rats in their second week of life induces long-term changes in α2-adrenoceptor binding in rat brain that may have relevance to the progression of an epilepsy phenotype.
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Guiraud D, Andreu D, Bonnet S, Carrault G, Couderc P, Hagège A, Henry C, Hernandez A, Karam N, Le Rolle V, Mabo P, Maciejasz P, Malbert CH, Marijon E, Maubert S, Picq C, Rossel O, Bonnet JL. Vagus nerve stimulation: state of the art of stimulation and recording strategies to address autonomic function neuromodulation. J Neural Eng 2016; 13:041002. [PMID: 27351347 DOI: 10.1088/1741-2560/13/4/041002] [Citation(s) in RCA: 64] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Neural signals along the vagus nerve (VN) drive many somatic and autonomic functions. The clinical interest of VN stimulation (VNS) is thus potentially huge and has already been demonstrated in epilepsy. However, side effects are often elicited, in addition to the targeted neuromodulation. APPROACH This review examines the state of the art of VNS applied to two emerging modulations of autonomic function: heart failure and obesity, especially morbid obesity. MAIN RESULTS We report that VNS may benefit from improved stimulation delivery using very advanced technologies. However, most of the results from fundamental animal studies still need to be demonstrated in humans.
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Affiliation(s)
- David Guiraud
- Inria, DEMAR, Montpellier, France. University of Montpellier, DEMAR, Montpellier, France
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26
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Rong P, Liu J, Wang L, Liu R, Fang JL, Zhao J, Zhao Y, Wang H, Vangel M, Sun S, Ben H, Park J, Li S, Meng H, Zhu B, Kong J. Effect of transcutaneous auricular vagus nerve stimulation on major depressive disorder: A nonrandomized controlled pilot study. J Affect Disord 2016; 195:172-9. [PMID: 26896810 PMCID: PMC4828906 DOI: 10.1016/j.jad.2016.02.031] [Citation(s) in RCA: 144] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2015] [Revised: 01/29/2016] [Accepted: 02/06/2016] [Indexed: 12/28/2022]
Abstract
BACKGROUND Depression presents a significant burden to both patients and society. One treatment that has emerged is vagus nerve stimulation (VNS), an FDA-approved physical treatment for depressive disorders. However, the application of this intervention has been limited by the involvement of surgery and potential side effects. The aim of this study is to explore the effectiveness of stimulating the superficial branches of the vagus nerve as a solo treatment for MDD. METHODS This is a nonrandomized, controlled study. The first cohort of patients (n=91) only received transcutaneous auricular VNS (taVNS) for 12 weeks. In the second cohort (n=69), patients first received 4 weeks of sham taVNS followed by 8 weeks of taVNS. All treatments were self-administered by the patients at home after they received training from the hospitals. The primary outcome measurement was the 24-item Hamilton Depression Rating Scale measured at weeks 0, 4, 8, and 12. Data analysis included a timelag analysis comparing (1) real and sham taVNS groups at week 4; (2) the real taVNS group at week 4 vs the sham taVNS group at week 8 (fourth week of real taVNS following 4 weeks of sham); and (3) the real taVNS group at week 8 vs the sham taVNS group at week 12 (eighth week of real taVNS following sham). RESULTS After four weeks of treatment, MDD patients in the taVNS group showed greater improvement than patients in the sham taVNS group as indicated by Hamilton score changes as well as response and remission rates at week four. In addition, we also found that the clinical improvements continued until week 12 during taVNS. LIMITATIONS Patients were not randomized in this study. CONCLUSIONS Our results suggest that taVNS is a promising, safe, and cost-effective therapeutic method for mild and moderate MDD.
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Affiliation(s)
- Peijing Rong
- Institute of Acu-Mox, China Academy of Chinese Medical Sciences, Beijing 100700, China.
| | - Jun Liu
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China
| | - Liping Wang
- Huguosi TCM Hospital, Beijing University of TCM, Beijing, 100035, China
| | - Rupeng Liu
- Institute of Acu-Mox, China Academy of Chinese Medical Sciences, Beijing 100700, China
| | - Ji-Liang Fang
- Institute of Acu-Mox, China Academy of Chinese Medical Sciences, Beijing 100700, China,Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China
| | - Jingjun Zhao
- Institute of Acu-Mox, China Academy of Chinese Medical Sciences, Beijing 100700, China
| | - Yufeng Zhao
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing 100700, China
| | - Honghong Wang
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China
| | - Mark Vangel
- Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Sharon Sun
- Psychiatry Department, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Hui Ben
- Institute of Acu-Mox, China Academy of Chinese Medical Sciences, Beijing 100700, China
| | - Joel Park
- Psychiatry Department, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA,Correspondence to: Institute of Acu-Mox, China Academy of Chinese Medical Sciences, Beijing 100700, China. Tel: 8610-64089302 Fax: 8610-64032682. ; Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA. Tel: 617-726-7893 Fax: 617-643-7340,
| | - Shaoyuan Li
- Institute of Acu-Mox, China Academy of Chinese Medical Sciences, Beijing 100700, China
| | - Hong Meng
- Institute of Acu-Mox, China Academy of Chinese Medical Sciences, Beijing 100700, China
| | - Bing Zhu
- Institute of Acu-Mox, China Academy of Chinese Medical Sciences, Beijing 100700, China
| | - Jian Kong
- Psychiatry Department, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
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27
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Hulsey DR, Hays SA, Khodaparast N, Ruiz A, Das P, Rennaker RL, Kilgard MP. Reorganization of Motor Cortex by Vagus Nerve Stimulation Requires Cholinergic Innervation. Brain Stimul 2016; 9:174-81. [PMID: 26822960 DOI: 10.1016/j.brs.2015.12.007] [Citation(s) in RCA: 105] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Revised: 12/23/2015] [Accepted: 12/28/2015] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Vagus nerve stimulation (VNS) paired with forelimb training drives robust, specific reorganization of movement representations in the motor cortex. The mechanisms that underlie VNS-dependent enhancement of map plasticity are largely unknown. The cholinergic nucleus basalis (NB) is a critical substrate in cortical plasticity, and several studies suggest that VNS activates cholinergic circuitry. OBJECTIVE We examined whether the NB is required for VNS-dependent enhancement of map plasticity in the motor cortex. METHODS Rats were trained to perform a lever pressing task and then received injections of the immunotoxin 192-IgG-saporin to selectively lesion cholinergic neurons of the NB. After lesion, rats underwent five days of motor training during which VNS was paired with successful trials. At the conclusion of behavioral training, intracortical microstimulation was used to document movement representations in motor cortex. RESULTS VNS paired with forelimb training resulted in a substantial increase in the representation of proximal forelimb in rats with an intact NB compared to untrained controls. NB lesions prevent this VNS-dependent increase in proximal forelimb area and result in representations similar to untrained controls. Motor performance was similar between groups, suggesting that differences in forelimb function cannot account for the difference in proximal forelimb representation. CONCLUSIONS Together, these findings indicate that the NB is required for VNS-dependent enhancement of plasticity in the motor cortex and may provide insight into the mechanisms that underlie the benefits of VNS therapy.
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Affiliation(s)
- Daniel R Hulsey
- School of Behavioral Brain Sciences, The University of Texas at Dallas, 800 West Campbell Road, GR41, Richardson, TX 75080-3021, USA
| | - Seth A Hays
- School of Behavioral Brain Sciences, The University of Texas at Dallas, 800 West Campbell Road, GR41, Richardson, TX 75080-3021, USA; Erik Jonsson School of Engineering and Computer Science, The University of Texas at Dallas, 800 West Campbell Road, Richardson, TX 75080-3021, USA; Texas Biomedical Device Center, The University of Texas at Dallas, 800 West Campbell Road, Richardson, TX 75080-3021, USA.
| | - Navid Khodaparast
- School of Behavioral Brain Sciences, The University of Texas at Dallas, 800 West Campbell Road, GR41, Richardson, TX 75080-3021, USA; Texas Biomedical Device Center, The University of Texas at Dallas, 800 West Campbell Road, Richardson, TX 75080-3021, USA
| | - Andrea Ruiz
- Texas Biomedical Device Center, The University of Texas at Dallas, 800 West Campbell Road, Richardson, TX 75080-3021, USA
| | - Priyanka Das
- Erik Jonsson School of Engineering and Computer Science, The University of Texas at Dallas, 800 West Campbell Road, Richardson, TX 75080-3021, USA
| | - Robert L Rennaker
- School of Behavioral Brain Sciences, The University of Texas at Dallas, 800 West Campbell Road, GR41, Richardson, TX 75080-3021, USA; Erik Jonsson School of Engineering and Computer Science, The University of Texas at Dallas, 800 West Campbell Road, Richardson, TX 75080-3021, USA; Texas Biomedical Device Center, The University of Texas at Dallas, 800 West Campbell Road, Richardson, TX 75080-3021, USA
| | - Michael P Kilgard
- School of Behavioral Brain Sciences, The University of Texas at Dallas, 800 West Campbell Road, GR41, Richardson, TX 75080-3021, USA; Texas Biomedical Device Center, The University of Texas at Dallas, 800 West Campbell Road, Richardson, TX 75080-3021, USA
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28
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The antidepressant mechanism of action of vagus nerve stimulation: Evidence from preclinical studies. Neurosci Biobehav Rev 2015; 56:26-34. [DOI: 10.1016/j.neubiorev.2015.06.019] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2015] [Revised: 06/19/2015] [Accepted: 06/21/2015] [Indexed: 01/22/2023]
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