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Woodbury A, Staats P. Editorial: Non-invasive and minimally invasive vagus nerve stimulation for chronic pain. FRONTIERS IN PAIN RESEARCH 2024; 5:1402918. [PMID: 38812854 PMCID: PMC11133698 DOI: 10.3389/fpain.2024.1402918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Accepted: 04/23/2024] [Indexed: 05/31/2024] Open
Affiliation(s)
- Anna Woodbury
- Division of Pain Medicine, Department of Anesthesiology, School of Medicine, Emory University, Atlanta, GA, United States
- Atlanta VA Health Care System, Veterans Health Administration, United States Department of Veterans Affairs, Decatur, GA, United States
| | - Peter Staats
- electroCore LLC, Basking Ridge, NJ, United States
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Zou W, Guo Z, Suo L, Zhu J, He H, Li X, Wang K, Chen R. Nucleus accumbens shell modulates seizure propagation in a mouse temporal lobe epilepsy model. Front Cell Dev Biol 2022; 10:1031872. [PMID: 36589737 PMCID: PMC9797862 DOI: 10.3389/fcell.2022.1031872] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 11/28/2022] [Indexed: 12/23/2022] Open
Abstract
Temporal lobe epilepsy (TLE) is the most common form of epilepsy with focal seizures which in some conditions can develop into secondarily generalized tonic-clonic seizures by the propagation of epileptic activities in the temporal lobe to other brain areas. The nucleus accumbens (NAc) has been suggested as a treatment target for TLE as accumulating evidence indicates that the NAc, especially its shell, participates in the process of epileptic seizures of patients and animal models with TLE. The majority of neurons in the NAc are GABAergic medium spiny neurons (MSNs) expressing dopamine receptor D1 (D1R) or dopamine receptor D2 (D2R). However, the direct evidence of the NAc shell participating in the propagation of TLE seizures is missing, and its cell type-specific modulatory roles in TLE seizures are unknown. In this study, we microinjected kainic acid into basolateral amygdala (BLA) to make a mouse model of TLE with initial focal seizures and secondarily generalized seizures (SGSs). We found that TLE seizures caused robust c-fos expression in the NAc shell and increased neuronal excitability of D1R-expressing MSN (D1R-MSN) and D2R-expressing MSN (D2R-MSN). Pharmacological inhibition of the NAc shell alleviated TLE seizures by reducing the number of SGSs and seizure stages. Cell-type-specific chemogenetic inhibition of either D1R-MSN or D2R-MSN showed similar effects with pharmacological inhibition of the NAc shell. Both pharmacological and cell-type-specific chemogenetic inhibition of the NAc shell did not alter the onset time of focal seizures. Collectively, these findings indicate that the NAc shell and its D1R-MSN or D2R-MSN mainly participate in the propagation and generalization of the TLE seizures.
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Affiliation(s)
- Wenjie Zou
- Guangdong Province Key Laboratory of Psychiatric Disorders, Department of Neurobiology, School of Basic Medical Sciences, Southern Medical University, Guangzhou, China
| | - Zhipeng Guo
- Guangdong Province Key Laboratory of Psychiatric Disorders, Department of Neurobiology, School of Basic Medical Sciences, Southern Medical University, Guangzhou, China
| | - Longge Suo
- Guangdong Province Key Laboratory of Psychiatric Disorders, Department of Neurobiology, School of Basic Medical Sciences, Southern Medical University, Guangzhou, China
| | - Jianping Zhu
- Guangdong Province Key Laboratory of Psychiatric Disorders, Department of Neurobiology, School of Basic Medical Sciences, Southern Medical University, Guangzhou, China
| | - Haiyang He
- Guangdong Province Key Laboratory of Psychiatric Disorders, Department of Neurobiology, School of Basic Medical Sciences, Southern Medical University, Guangzhou, China
| | - Xiufeng Li
- Guangdong Province Key Laboratory of Psychiatric Disorders, Department of Neurobiology, School of Basic Medical Sciences, Southern Medical University, Guangzhou, China
| | - Kewan Wang
- Department of Neurosurgery, Nanfang Hospital, Southern Medical University, Guangzhou, China,*Correspondence: Kewan Wang, ; Rongqing Chen,
| | - Rongqing Chen
- Guangdong Province Key Laboratory of Psychiatric Disorders, Department of Neurobiology, School of Basic Medical Sciences, Southern Medical University, Guangzhou, China,Key Laboratory of Mental Health of the Ministry of Education, Guangdong-Hong Kong-Macao Greater Bay Area Center for Brain Science and Brain-Inspired Intelligence, Southern Medical University, Guangzhou, China,*Correspondence: Kewan Wang, ; Rongqing Chen,
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Woodbury A, Krishnamurthy LC, Bohsali A, Krishnamurthy V, Smith JL, Gebre M, Tyler K, Vernon M, Crosson B, Kalangara JP, Napadow V, Allen JW, Harper D. Percutaneous electric nerve field stimulation alters cortical thickness in a pilot study of veterans with fibromyalgia. NEUROBIOLOGY OF PAIN (CAMBRIDGE, MASS.) 2022; 12:100093. [PMID: 35733704 PMCID: PMC9207563 DOI: 10.1016/j.ynpai.2022.100093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 04/29/2022] [Accepted: 05/11/2022] [Indexed: 11/29/2022]
Abstract
Objective To evaluate changes in cortical thickness and right posterior insula (r-pIns) gamma-aminobutyric acid (GABA) concentrations in veterans with fibromyalgia treated with auricular percutaneous electric nerve field stimulation (PENFS). Materials & methods This was a randomized, controlled, open label investigation conducted in a government hospital. Twenty-one veterans with fibromyalgia were randomized to receive either standard therapy (ST; i.e., 4 weekly visits with a pain practitioner) or ST with auricular PENFS (ST + PENFS). Neuroimaging data was collected at baseline (i.e. before the first treatment session) and again within 2 weeks post-treatment. Clinical pain and physical function were also assessed at these timepoints. Single-voxel magnetic resonance spectroscopy was carried out in r-pIns to assess changes in r-pIns GABA concentrations and high-resolution T1-weighted images were collected to assess changes in regional gray matter volume using cortical thickness. Results Both the ST + PENFS and ST groups reported a decrease in pain with treatment. Volumetric: Cortical thickness significantly decreased in the left middle posterior cingulate (p = 0.018) and increased in the left cuneus (p = 0.014) following ST + PENFS treatment. These findings were significant following FDR correction for multiple comparisons. ST group right hemisphere insula cortical thickness increased post-treatment and was significantly (p = 0.02) inversely correlated with pain scores. ST + PENFS group right hemisphere posterior dorsal cingulate size significantly (p = 0.044) positively correlated with pain scores. GABA: There were no significant correlations with GABA, though a trend was noted towards increased GABA following treatment in both groups (p = 0.083) using a linear mixed effects model. Conclusions Results suggest a novel effect of PENFS reflected by differential volumetric changes compared to ST. The changes in GABA that occur in both groups are more likely related to ST. Insular GABA and cortical thickness in key regions of interest may be developed as potential biomarkers for evaluating chronic pain pathology and treatment outcomes.
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Affiliation(s)
- Anna Woodbury
- Emory University School of Medicine, Atlanta, GA, USA
- Atlanta Veterans Affairs Healthcare System, Atlanta, GA, USA
| | - Lisa C. Krishnamurthy
- Emory University School of Medicine, Atlanta, GA, USA
- Atlanta Veterans Affairs Healthcare System, Atlanta, GA, USA
- Georgia State University, Atlanta, GA, USA
| | | | - Venkatagiri Krishnamurthy
- Emory University School of Medicine, Atlanta, GA, USA
- Atlanta Veterans Affairs Healthcare System, Atlanta, GA, USA
| | | | - Melat Gebre
- Emory University School of Medicine, Atlanta, GA, USA
| | - Kari Tyler
- Emory University School of Medicine, Atlanta, GA, USA
- Atlanta Veterans Affairs Healthcare System, Atlanta, GA, USA
| | - Mark Vernon
- Atlanta Veterans Affairs Healthcare System, Atlanta, GA, USA
| | - Bruce Crosson
- Emory University School of Medicine, Atlanta, GA, USA
- Atlanta Veterans Affairs Healthcare System, Atlanta, GA, USA
| | - Jerry P. Kalangara
- Emory University School of Medicine, Atlanta, GA, USA
- Atlanta Veterans Affairs Healthcare System, Atlanta, GA, USA
| | - Vitaly Napadow
- Spaulding Rehabilitation Network, Harvard Medical School, Charlestown, MA, USA
| | | | - Daniel Harper
- Emory University School of Medicine, Atlanta, GA, USA
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