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Zhang KK, Matin R, Gorodetsky C, Ibrahim GM, Gouveia FV. Systematic review of rodent studies of deep brain stimulation for the treatment of neurological, developmental and neuropsychiatric disorders. Transl Psychiatry 2024; 14:186. [PMID: 38605027 PMCID: PMC11009311 DOI: 10.1038/s41398-023-02727-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 12/19/2023] [Accepted: 12/22/2023] [Indexed: 04/13/2024] Open
Abstract
Deep brain stimulation (DBS) modulates local and widespread connectivity in dysfunctional networks. Positive results are observed in several patient populations; however, the precise mechanisms underlying treatment remain unknown. Translational DBS studies aim to answer these questions and provide knowledge for advancing the field. Here, we systematically review the literature on DBS studies involving models of neurological, developmental and neuropsychiatric disorders to provide a synthesis of the current scientific landscape surrounding this topic. A systematic analysis of the literature was performed following PRISMA guidelines. 407 original articles were included. Data extraction focused on study characteristics, including stimulation protocol, behavioural outcomes, and mechanisms of action. The number of articles published increased over the years, including 16 rat models and 13 mouse models of transgenic or healthy animals exposed to external factors to induce symptoms. Most studies targeted telencephalic structures with varying stimulation settings. Positive behavioural outcomes were reported in 85.8% of the included studies. In models of psychiatric and neurodevelopmental disorders, DBS-induced effects were associated with changes in monoamines and neuronal activity along the mesocorticolimbic circuit. For movement disorders, DBS improves symptoms via modulation of the striatal dopaminergic system. In dementia and epilepsy models, changes to cellular and molecular aspects of the hippocampus were shown to underlie symptom improvement. Despite limitations in translating findings from preclinical to clinical settings, rodent studies have contributed substantially to our current knowledge of the pathophysiology of disease and DBS mechanisms. Direct inhibition/excitation of neural activity, whereby DBS modulates pathological oscillatory activity within brain networks, is among the major theories of its mechanism. However, there remain fundamental questions on mechanisms, optimal targets and parameters that need to be better understood to improve this therapy and provide more individualized treatment according to the patient's predominant symptoms.
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Affiliation(s)
- Kristina K Zhang
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
- Program in Neuroscience and Mental Health, The Hospital for Sick Children, Toronto, ON, Canada
| | - Rafi Matin
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
- Program in Neuroscience and Mental Health, The Hospital for Sick Children, Toronto, ON, Canada
| | | | - George M Ibrahim
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
- Program in Neuroscience and Mental Health, The Hospital for Sick Children, Toronto, ON, Canada
- Division of Neurosurgery, The Hospital for Sick Children, Toronto, ON, Canada
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2
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Campos ACP, Pople C, Silk E, Surendrakumar S, Rabelo TK, Meng Y, Gouveia FV, Lipsman N, Giacobbe P, Hamani C. Neurochemical mechanisms of deep brain stimulation for depression in animal models. Eur Neuropsychopharmacol 2023; 68:11-26. [PMID: 36640729 DOI: 10.1016/j.euroneuro.2022.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 12/12/2022] [Accepted: 12/14/2022] [Indexed: 01/13/2023]
Abstract
Deep brain stimulation (DBS) has emerged as a neuromodulation therapy for treatment-resistant depression, but its actual efficacy and mechanisms of action are still unclear. Changes in neurochemical transmission are important mechanisms of antidepressant therapies. Here, we review the preclinical DBS literature reporting behavioural and neurochemical data associated with its antidepressant-like effects. The most commonly studied target in preclinical models was the ventromedial prefrontal cortex (vmPFC). In rodents, DBS delivered to this target induced serotonin (5-HT) release and increased 5-HT1B receptor expression. The antidepressant-like effects of vmPFC DBS seemed to be independent of the serotonin transporter and potentially mediated by the direct modulation of prefrontal projections to the raphe. Adenosinergic and glutamatergic transmission might have also play a role. Medial forebrain bundle (MFB) DBS increased dopamine levels and reduced D2 receptor expression, whereas nucleus accumbens (NAcc), and lateral habenula (LHb) stimulation increased catecholamine levels in different brain regions. In rodents, subthalamic nucleus (STN) DBS induced robust depression-like responses associated with a reduction in serotonergic transmission, as revealed by a decrease in serotonin release. Some of these effects seemed to be mediated by 5HT1A receptors. In conclusion, the antidepressant-like effects of DBS in preclinical models have been well documented in multiple targets. Though variable mechanisms have been proposed, DBS-induced acute and long-term changes in neurochemical substrates seem to play an important role in the antidepressant-like effects of this therapy.
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Affiliation(s)
- Ana Carolina P Campos
- Harquail Centre for Neuromodulation, Sunnybrook Health Sciences Centre, Sunnybrook Research Institute, Toronto, ON M4N 3M5, Canada
| | - Christopher Pople
- Harquail Centre for Neuromodulation, Sunnybrook Health Sciences Centre, Sunnybrook Research Institute, Toronto, ON M4N 3M5, Canada
| | - Esther Silk
- Harquail Centre for Neuromodulation, Sunnybrook Health Sciences Centre, Sunnybrook Research Institute, Toronto, ON M4N 3M5, Canada
| | - Shanan Surendrakumar
- Harquail Centre for Neuromodulation, Sunnybrook Health Sciences Centre, Sunnybrook Research Institute, Toronto, ON M4N 3M5, Canada
| | - Thallita K Rabelo
- Harquail Centre for Neuromodulation, Sunnybrook Health Sciences Centre, Sunnybrook Research Institute, Toronto, ON M4N 3M5, Canada
| | - Ying Meng
- Harquail Centre for Neuromodulation, Sunnybrook Health Sciences Centre, Sunnybrook Research Institute, Toronto, ON M4N 3M5, Canada
| | - Flavia Venetucci Gouveia
- Harquail Centre for Neuromodulation, Sunnybrook Health Sciences Centre, Sunnybrook Research Institute, Toronto, ON M4N 3M5, Canada
| | - Nir Lipsman
- Harquail Centre for Neuromodulation, Sunnybrook Health Sciences Centre, Sunnybrook Research Institute, Toronto, ON M4N 3M5, Canada; Hurvitz Brain Sciences Centre, Sunnybrook Research Institute, Toronto, ON M4N 3M5, Canada; Division of Neurosurgery, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON M4N 3M5, Canada
| | - Peter Giacobbe
- Harquail Centre for Neuromodulation, Sunnybrook Health Sciences Centre, Sunnybrook Research Institute, Toronto, ON M4N 3M5, Canada; Hurvitz Brain Sciences Centre, Sunnybrook Research Institute, Toronto, ON M4N 3M5, Canada; Neuropsychiatry Program, Department of Psychiatry, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
| | - Clement Hamani
- Harquail Centre for Neuromodulation, Sunnybrook Health Sciences Centre, Sunnybrook Research Institute, Toronto, ON M4N 3M5, Canada; Hurvitz Brain Sciences Centre, Sunnybrook Research Institute, Toronto, ON M4N 3M5, Canada; Division of Neurosurgery, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON M4N 3M5, Canada.
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Yuen J, Goyal A, Rusheen AE, Kouzani AZ, Berk M, Kim JH, Tye SJ, Blaha CD, Bennet KE, Lee KH, Shin H, Oh Y. High frequency deep brain stimulation can mitigate the acute effects of cocaine administration on tonic dopamine levels in the rat nucleus accumbens. Front Neurosci 2023; 17:1061578. [PMID: 36793536 PMCID: PMC9922701 DOI: 10.3389/fnins.2023.1061578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 01/09/2023] [Indexed: 01/31/2023] Open
Abstract
Cocaine's addictive properties stem from its capacity to increase tonic extracellular dopamine levels in the nucleus accumbens (NAc). The ventral tegmental area (VTA) is a principal source of NAc dopamine. To investigate how high frequency stimulation (HFS) of the rodent VTA or nucleus accumbens core (NAcc) modulates the acute effects of cocaine administration on NAcc tonic dopamine levels multiple-cyclic square wave voltammetry (M-CSWV) was used. VTA HFS alone decreased NAcc tonic dopamine levels by 42%. NAcc HFS alone resulted in an initial decrease in tonic dopamine levels followed by a return to baseline. VTA or NAcc HFS following cocaine administration prevented the cocaine-induced increase in NAcc tonic dopamine. The present results suggest a possible underlying mechanism of NAc deep brain stimulation (DBS) in the treatment of substance use disorders (SUDs) and the possibility of treating SUD by abolishing dopamine release elicited by cocaine and other drugs of abuse by DBS in VTA, although further studies with chronic addiction models are required to confirm that. Furthermore, we demonstrated the use of M-CSWV can reliably measure tonic dopamine levels in vivo with both drug administration and DBS with minimal artifacts.
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Affiliation(s)
- Jason Yuen
- Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, United States
- The Institute for Mental and Physical Health and Clinical Translation (IMPACT), Barwon Health, Deakin University, Geelong, VIC, Australia
| | - Abhinav Goyal
- Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, United States
- Medical Scientist Training Program, Mayo Clinic, Rochester, MN, United States
| | - Aaron E. Rusheen
- Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, United States
- Medical Scientist Training Program, Mayo Clinic, Rochester, MN, United States
| | - Abbas Z. Kouzani
- School of Engineering, Deakin University, Geelong, VIC, Australia
| | - Michael Berk
- The Institute for Mental and Physical Health and Clinical Translation (IMPACT), Barwon Health, Deakin University, Geelong, VIC, Australia
| | - Jee Hyun Kim
- The Institute for Mental and Physical Health and Clinical Translation (IMPACT), Barwon Health, Deakin University, Geelong, VIC, Australia
| | - Susannah J. Tye
- Queensland Brain Institute, The University of Queensland, St Lucia, QLD, Australia
| | - Charles D. Blaha
- Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, United States
| | - Kevin E. Bennet
- Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, United States
- Division of Engineering, Mayo Clinic, Rochester, MN, United States
| | - Kendall H. Lee
- Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, United States
- Department of Biomedical Engineering, Mayo Clinic, Rochester, MN, United States
| | - Hojin Shin
- Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, United States
- Department of Biomedical Engineering, Mayo Clinic, Rochester, MN, United States
| | - Yoonbae Oh
- Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, United States
- Department of Biomedical Engineering, Mayo Clinic, Rochester, MN, United States
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Shi Y, Wang M, Xiao L, Gui L, Zheng W, Bai L, Su B, Li B, Xu Y, Pan W, Zhang J, Wang W. Potential therapeutic mechanism of deep brain stimulation of the nucleus accumbens in obsessive-compulsive disorder. Front Cell Neurosci 2023; 16:1057887. [PMID: 36687525 PMCID: PMC9845878 DOI: 10.3389/fncel.2022.1057887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 12/12/2022] [Indexed: 01/05/2023] Open
Abstract
Deep brain stimulation (DBS) of the nucleus accumbens (NAc) (NAc-DBS) is an effective solution to refractory obsessive-compulsive disorder (OCD). However, evidence for the neurobiological mechanisms of OCD and the effect of NAc-DBS is still lacking. One hypothesis is that the electrophysiological activities in the NAc are modulated by DBS, and another hypothesis is that the activities of neurotransmitters in the NAc are influenced by DBS. To investigate these potential alterations, rats with quinpirole (QNP)- induced OCD were treated with DBS of the core part of NAc. Then, extracellular spikes (SPK) and local field potentials (LFP) in the NAc were recorded, and the levels of relevant neurotransmitters and related proteins were measured. Analysis of SPK revealed that the firing rate was decreased and the firing pattern was changed after NAc-DBS, and analysis of LFP showed that overall power spectral density (PSD) levels were reduced after NAc-DBS. Additionally, we found that the relative powers of the theta band, alpha band and beta band were increased in OCD status, while the relative powers of the delta band and gamma band were decreased. This pathological pattern of power distribution was reformed by NAc-DBS. Furthermore, we found that the local levels of monoamines [dopamine (DA) and serotonin (5-HT)] and amino acids [glutamate (Glu) and gamma-aminobutyric acid (GABA)] in the NAc were increased in OCD status, and that the expression of the two types of DA receptors in the NAc exhibited an opposite change. These abnormalities could be reversed by NAc-DBS. These findings provide a more comprehensive understanding about the function of the NAc in the pathophysiology of OCD and provide more detailed evidence for the potential effect of NAc-DBS.
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Affiliation(s)
- Yifeng Shi
- Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Mengqi Wang
- Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Linglong Xiao
- Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Luolan Gui
- Laboratory of Clinical Proteomics and Metabolomics, Frontiers Science Center for Disease-Related Molecular Network, National Clinical Research Center for Geriatrics, West China Hospital, Institutes for Systems Genetics, Sichuan University, Chengdu, Sichuan, China
| | - Wen Zheng
- Laboratory of Clinical Proteomics and Metabolomics, Frontiers Science Center for Disease-Related Molecular Network, National Clinical Research Center for Geriatrics, West China Hospital, Institutes for Systems Genetics, Sichuan University, Chengdu, Sichuan, China
| | - Lin Bai
- Histology and Imaging Platform, Core Facilities of West China Hospital, Sichuan University, Chengdu, Sichuan, China,Key Laboratory of Transplant Engineering and Immunology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Bo Su
- Histology and Imaging Platform, Core Facilities of West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Bin Li
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yangyang Xu
- Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Wei Pan
- Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Jie Zhang
- Histology and Imaging Platform, Core Facilities of West China Hospital, Sichuan University, Chengdu, Sichuan, China,Key Laboratory of Transplant Engineering and Immunology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Wei Wang
- Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China,*Correspondence: Wei Wang,
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Yuen J, Rusheen AE, Price JB, Barath AS, Shin H, Kouzani AZ, Berk M, Blaha CD, Lee KH, Oh Y. Biomarkers for Deep Brain Stimulation in Animal Models of Depression. Neuromodulation 2022; 25:161-170. [PMID: 35125135 PMCID: PMC8655028 DOI: 10.1111/ner.13483] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 04/20/2021] [Accepted: 05/11/2021] [Indexed: 02/03/2023]
Abstract
OBJECTIVES Despite recent advances in depression treatment, many patients still do not respond to serial conventional therapies and are considered "treatment resistant." Deep brain stimulation (DBS) has therapeutic potential in this context. This comprehensive review of recent studies of DBS for depression in animal models identifies potential biomarkers for improving therapeutic efficacy and predictability of conventional DBS to aid future development of closed-loop control of DBS systems. MATERIALS AND METHODS A systematic search was performed in Pubmed, EMBASE, and Cochrane Review using relevant keywords. Overall, 56 animal studies satisfied the inclusion criteria. RESULTS Outcomes were divided into biochemical/physiological, electrophysiological, and behavioral categories. Promising biomarkers include biochemical assays (in particular, microdialysis and electrochemical measurements), which provide real-time results in awake animals. Electrophysiological tests, showing changes at both the target site and downstream structures, also revealed characteristic changes at several anatomic targets (such as the medial prefrontal cortex and locus coeruleus). However, the substantial range of models and DBS targets limits the ability to draw generalizable conclusions in animal behavioral models. CONCLUSIONS Overall, DBS is a promising therapeutic modality for treatment-resistant depression. Different outcomes have been used to assess its efficacy in animal studies. From the review, electrophysiological and biochemical markers appear to offer the greatest potential as biomarkers for depression. However, to develop closed-loop DBS for depression, additional preclinical and clinical studies with a focus on identifying reliable, safe, and effective biomarkers are warranted.
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Affiliation(s)
- Jason Yuen
- Department of Neurologic Surgery, Mayo Clinic, Rochester, MN 55905, USA,Deakin University, IMPACT – the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong VIC 3216, Australia
| | - Aaron E. Rusheen
- Department of Neurologic Surgery, Mayo Clinic, Rochester, MN 55905, USA,Medical Scientist Training Program, Mayo Clinic, Rochester, MN 55905, USA
| | - J. Blair Price
- Department of Neurologic Surgery, Mayo Clinic, Rochester, MN 55905, USA
| | | | - Hojin Shin
- Department of Neurologic Surgery, Mayo Clinic, Rochester, MN 55905, USA,Department of Biomedical Engineering, Mayo Clinic, Rochester, MN 55905, USA
| | - Abbas Z. Kouzani
- School of Engineering, Deakin University, Geelong VIC 3216, Australia
| | - Michael Berk
- Deakin University, IMPACT – the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong VIC 3216, Australia
| | - Charles D. Blaha
- Department of Neurologic Surgery, Mayo Clinic, Rochester, MN 55905, USA
| | - Kendall H. Lee
- Department of Neurologic Surgery, Mayo Clinic, Rochester, MN 55905, USA,Department of Biomedical Engineering, Mayo Clinic, Rochester, MN 55905, USA
| | - Yoonbae Oh
- Department of Neurologic Surgery, Mayo Clinic, Rochester, MN 55905, USA,Department of Biomedical Engineering, Mayo Clinic, Rochester, MN 55905, USA
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Dandekar MP, Diaz AP, Rahman Z, Silva RH, Nahas Z, Aaronson S, Selvaraj S, Fenoy AJ, Sanches M, Soares JC, Riva-Posse P, Quevedo J. A narrative review on invasive brain stimulation for treatment-resistant depression. ACTA ACUST UNITED AC 2021; 44:317-330. [PMID: 34468549 PMCID: PMC9169472 DOI: 10.1590/1516-4446-2021-1874] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Accepted: 04/22/2021] [Indexed: 12/20/2022]
Abstract
While most patients with depression respond to pharmacotherapy and psychotherapy, about one-third will present treatment resistance to these interventions. For patients with treatment-resistant depression (TRD), invasive neurostimulation therapies such as vagus nerve stimulation, deep brain stimulation, and epidural cortical stimulation may be considered. We performed a narrative review of the published literature to identify papers discussing clinical studies with invasive neurostimulation therapies for TRD. After a database search and title and abstract screening, relevant English-language articles were analyzed. Vagus nerve stimulation, approved by the U.S. Food and Drug Administration as a TRD treatment, may take several months to show therapeutic benefits, and the average response rate varies from 15.2-83%. Deep brain stimulation studies have shown encouraging results, including rapid response rates (> 30%), despite conflicting findings from randomized controlled trials. Several brain regions, such as the subcallosal-cingulate gyrus, nucleus accumbens, ventral capsule/ventral striatum, anterior limb of the internal capsule, medial-forebrain bundle, lateral habenula, inferior-thalamic peduncle, and the bed-nucleus of the stria terminalis have been identified as key targets for TRD management. Epidural cortical stimulation, an invasive intervention with few reported cases, showed positive results (40-60% response), although more extensive trials are needed to confirm its potential in patients with TRD.
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Affiliation(s)
- Manoj P Dandekar
- Department of Pharmacology & Toxicology, National Institute of Pharmaceutical Education and Research, Hyderabad, Telangana, India
| | - Alexandre P Diaz
- Center of Excellence on Mood Disorders, Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
| | - Ziaur Rahman
- Department of Pharmacology & Toxicology, National Institute of Pharmaceutical Education and Research, Hyderabad, Telangana, India
| | - Ritele H Silva
- Laboratório de Psiquiatria Translacional, Programa de Pós-Graduação em Ciências da Saúde, Universidade do Extremo Sul Catarinense (UNESC), Criciúma, SC, Brazil
| | - Ziad Nahas
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, USA
| | - Scott Aaronson
- Clinical Research Programs, Sheppard Pratt Health System, Baltimore, MD, USA
| | - Sudhakar Selvaraj
- Center of Excellence on Mood Disorders, Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
| | - Albert J Fenoy
- Center of Excellence on Mood Disorders, Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA.,Deep Brain Stimulation Program, Department of Neurosurgery, McGovern Medical School, UTHealth, Houston, TX, USA
| | - Marsal Sanches
- Center of Excellence on Mood Disorders, Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
| | - Jair C Soares
- Center of Excellence on Mood Disorders, Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA.,Neuroscience Graduate Program, The University of Texas MD Anderson Cancer Center UTHealth Graduate School of Biomedical Sciences, Houston, TX, USA
| | - Patricio Riva-Posse
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, USA
| | - Joao Quevedo
- Center of Excellence on Mood Disorders, Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA.,Laboratório de Psiquiatria Translacional, Programa de Pós-Graduação em Ciências da Saúde, Universidade do Extremo Sul Catarinense (UNESC), Criciúma, SC, Brazil.,Neuroscience Graduate Program, The University of Texas MD Anderson Cancer Center UTHealth Graduate School of Biomedical Sciences, Houston, TX, USA.,Translational Psychiatry Program, Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, UTHealth, Houston, TX, USA
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Jørgensen LM, Henriksen T, Mardosiene S, Keller SH, Stenbæk DS, Hansen HD, Jespersen B, Thomsen C, Weikop P, Svarer C, Knudsen GM. Parkinson patients have a presynaptic serotonergic deficit: A dynamic deep brain stimulation PET study. J Cereb Blood Flow Metab 2021; 41:1954-1963. [PMID: 33461410 PMCID: PMC8327106 DOI: 10.1177/0271678x20982389] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Patients with Parkinson's disease (PD) often suffer from non-motor symptoms, which may be caused by serotonergic dysfunction. Apart from alleviating the motor symptoms, Deep Brain Stimulation (DBS) in the subthalamic nucleus (STN) may also influence non-motor symptoms. The aim of this study is to investigate how turning DBS off affects the serotonergic system. We here exploit a novel functional PET neuroimaging methodology to evaluate the preservation of serotonergic neurons and capacity to release serotonin. We measured cerebral 5-HT1BR binding in 13 DBS-STN treated PD patients, at baseline and after turning DBS off. Ten age-matched volunteers served as controls. Clinical measures of motor symptoms were assessed under the two conditions and correlated to the PET measures of the static and dynamic integrity of the serotonergic system. PD patients exhibited a significant loss of frontal and parietal 5-HT1BR, and the loss was significantly correlated to motor symptom severity. We saw a corresponding release of serotonin, but only in brain regions with preserved 5-HT1BR, suggesting the presence of a presynaptic serotonergic deficit. Our study demonstrates that DBS-STN dynamically regulates the serotonin system in PD, and that preservation of serotonergic functions may be predictive of DBS-STN effects.
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Affiliation(s)
- Louise M Jørgensen
- Neurobiology Research Unit, Department of Neurology, Rigshospitalet, Copenhagen, Denmark.,Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Tove Henriksen
- Department of Neurology, Bispebjerg Hospital, Copenhagen, Denmark
| | | | - Sune H Keller
- Department of Clinical Physiology, Nuclear Medicine and PET, Rigshospitalet, Copenhagen, Denmark
| | - Dea S Stenbæk
- Neurobiology Research Unit, Department of Neurology, Rigshospitalet, Copenhagen, Denmark
| | - Hanne D Hansen
- Neurobiology Research Unit, Department of Neurology, Rigshospitalet, Copenhagen, Denmark
| | - Bo Jespersen
- Department of Neurosurgery, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Carsten Thomsen
- Department of Radiology, Rigshospitalet, University of Copenhagen, Denmark.,Research Center for Advanced Imaging, Zealand University Hospital, Roskilde, Denmark
| | - Pia Weikop
- Center for Basic and Translational Neuroscience, Nedergaard Laboratory, Division of Glial Disease and Therapeutics, University of Copenhagen, Copenhagen, Denmark
| | - Claus Svarer
- Neurobiology Research Unit, Department of Neurology, Rigshospitalet, Copenhagen, Denmark
| | - Gitte M Knudsen
- Neurobiology Research Unit, Department of Neurology, Rigshospitalet, Copenhagen, Denmark.,Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
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Jakobs M, Fomenko A, Lozano AM, Kiening KL. Cellular, molecular, and clinical mechanisms of action of deep brain stimulation-a systematic review on established indications and outlook on future developments. EMBO Mol Med 2019; 11:e9575. [PMID: 30862663 PMCID: PMC6460356 DOI: 10.15252/emmm.201809575] [Citation(s) in RCA: 114] [Impact Index Per Article: 22.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Revised: 12/23/2018] [Accepted: 02/20/2019] [Indexed: 12/31/2022] Open
Abstract
Deep brain stimulation (DBS) has been successfully used to treat movement disorders, such as Parkinson's disease, for more than 25 years and heralded the advent of electrical neuromodulation to treat diseases with dysregulated neuronal circuits. DBS is now superseding ablative techniques, such as stereotactic radiofrequency lesions. While serendipity has played a role in developing DBS as a therapy, research during the past two decades has shown that electrical neuromodulation is far more than a functional lesion that can be switched on and off. This understanding broadens the field to enable new types of stimulation, clinical indications, and research. This review highlights the complex effects of DBS from the single cell to the neuronal network. Specifically, we examine the electrical, cellular, molecular, and neurochemical mechanisms of DBS as applied to Parkinson's disease and other emerging applications.
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Affiliation(s)
- Martin Jakobs
- Department of Neurosurgery, University Hospital Heidelberg, Heidelberg, Germany
- Division of Neurosurgery, Toronto Western Hospital, University Health Network, Toronto, ON, Canada
| | - Anton Fomenko
- Division of Neurosurgery, Toronto Western Hospital, University Health Network, Toronto, ON, Canada
| | - Andres M Lozano
- Division of Neurosurgery, Toronto Western Hospital, University Health Network, Toronto, ON, Canada
| | - Karl L Kiening
- Department of Neurosurgery, University Hospital Heidelberg, Heidelberg, Germany
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9
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Monitoring deep brain stimulation by measuring regional brain oxygen responses in freely moving mice. J Neurosci Methods 2019; 317:20-28. [PMID: 30716350 DOI: 10.1016/j.jneumeth.2019.01.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Revised: 01/16/2019] [Accepted: 01/19/2019] [Indexed: 01/02/2023]
Abstract
BACKGROUND Translational studies investigating the effects of deep brain stimulation (DBS) on brain function up to now mainly relied on BOLD responses measured with fMRI. However, fMRI studies in rodents face technical and practical limitations (e.g., immobilization, sedation or anesthesia, spatial and temporal resolution of data). Direct measurement of oxygen concentration in the brain using electrochemical sensors is a promising alternative to the use of fMRI. Here, we tested for the first time if such measurements can be combined with DBS. NEW METHOD We combined bilateral DBS in the internal capsule (IC-DBS) with simultaneous amperometric measurements of oxygen in the medial prefrontal cortex (prelimbic area) and striatum of freely moving mice. Using a two-day within-animal experimental design, we tested the effects of DBS on baseline oxygen concentrations, and on novelty- and restraint-induced increases in oxygen concentration. RESULTS Basal oxygen levels were stable across the daily sampling periods. Exposure to novelty and immobilization reproducibly increased oxygen concentrations in both areas. IC-DBS did not significantly alter basal oxygen, but reduced the novelty-induced increase in the striatum. COMPARISON WITH EXISTING METHOD(S) Amperometric detection of brain oxygen concentration with high temporal and spatial resolution can be performed in a number of key brain areas to study the effects of DBS in animal models of disease. The method is easily implemented and does not require expensive equipment or complicated data analysis processes. CONCLUSIONS Direct and simultaneous measurement of brain oxygen concentration in multiple brain areas can be used to study the effects of bilateral DBS neuromodulation on brain activity in freely moving mice.
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Höflich A, Michenthaler P, Kasper S, Lanzenberger R. Circuit Mechanisms of Reward, Anhedonia, and Depression. Int J Neuropsychopharmacol 2018; 22:105-118. [PMID: 30239748 PMCID: PMC6368373 DOI: 10.1093/ijnp/pyy081] [Citation(s) in RCA: 124] [Impact Index Per Article: 20.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Accepted: 09/12/2018] [Indexed: 12/23/2022] Open
Abstract
Pleasure and motivation are important factors for goal-directed behavior and well-being in both animals and humans. Intact hedonic capacity requires an undisturbed interplay between a number of different brain regions and transmitter systems. Concordantly, dysfunction of networks encoding for reward have been shown in depression and other psychiatric disorders. The development of technological possibilities to investigate connectivity on a functional level in humans and to directly influence networks in animals using optogenetics among other techniques has provided new important insights in this field of research.In this review, we aim to provide an overview on the neurobiological substrates of anhedonia on a network level. For this purpose, definition of anhedonia and the involved reward components are described first, then current data on reward networks in healthy individuals and in depressed patients are summarized, and the roles of different neurotransmitter systems involved in reward processing are specified. Based on this information, the impact of different therapeutic approaches on reward processing is described with a particular focus on deep brain stimulation (DBS) as a possibility for a direct modulation of human brain structures in vivo.Overall, results of current studies emphasize the importance of anhedonia in psychiatric disorders and the relevance of targeting this phenotype for a successful psychiatric treatment. However, more data incorporating these results for the refinement of methodological approaches are needed to be able to develop individually tailored therapeutic concepts based on both clinical and neurobiological profiles of patients.
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Affiliation(s)
- Anna Höflich
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Austria
| | - Paul Michenthaler
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Austria
| | - Siegfried Kasper
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Austria
| | - Rupert Lanzenberger
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Austria,Correspondence: Rupert Lanzenberger, MD, PD, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Waehringer Guertel 18–20, 1090 Vienna, Austria ()
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Dandekar MP, Fenoy AJ, Carvalho AF, Soares JC, Quevedo J. Deep brain stimulation for treatment-resistant depression: an integrative review of preclinical and clinical findings and translational implications. Mol Psychiatry 2018; 23:1094-1112. [PMID: 29483673 DOI: 10.1038/mp.2018.2] [Citation(s) in RCA: 177] [Impact Index Per Article: 29.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Revised: 12/05/2017] [Accepted: 12/15/2017] [Indexed: 02/07/2023]
Abstract
Although deep brain stimulation (DBS) is an established treatment choice for Parkinson's disease (PD), essential tremor and movement disorders, its effectiveness for the management of treatment-resistant depression (TRD) remains unclear. Herein, we conducted an integrative review on major neuroanatomical targets of DBS pursued for the treatment of intractable TRD. The aim of this review article is to provide a critical discussion of possible underlying mechanisms for DBS-generated antidepressant effects identified in preclinical studies and clinical trials, and to determine which brain target(s) elicited the most promising outcomes considering acute and maintenance treatment of TRD. Major electronic databases were searched to identify preclinical and clinical studies that have investigated the effects of DBS on depression-related outcomes. Overall, 92 references met inclusion criteria, and have evaluated six unique DBS targets namely the subcallosal cingulate gyrus (SCG), nucleus accumbens (NAc), ventral capsule/ventral striatum or anterior limb of internal capsule (ALIC), medial forebrain bundle (MFB), lateral habenula (LHb) and inferior thalamic peduncle for the treatment of unrelenting TRD. Electrical stimulation of these pertinent brain regions displayed differential effects on mood transition in patients with TRD. In addition, 47 unique references provided preclinical evidence for putative neurobiological mechanisms underlying antidepressant effects of DBS applied to the ventromedial prefrontal cortex, NAc, MFB, LHb and subthalamic nucleus. Preclinical studies suggest that stimulation parameters and neuroanatomical locations could influence DBS-related antidepressant effects, and also pointed that modulatory effects on monoamine neurotransmitters in target regions or interconnected brain networks following DBS could have a role in the antidepressant effects of DBS. Among several neuromodulatory targets that have been investigated, DBS in the neuroanatomical framework of the SCG, ALIC and MFB yielded more consistent antidepressant response rates in samples with TRD. Nevertheless, more well-designed randomized double-blind, controlled trials are warranted to further assess the efficacy, safety and tolerability of these more promising DBS targets for the management of TRD as therapeutic effects have been inconsistent across some controlled studies.
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Affiliation(s)
- M P Dandekar
- Translational Psychiatry Program, Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
| | - A J Fenoy
- Department of Neurosurgery, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
| | - A F Carvalho
- Department of Clinical Medicine and Translational Psychiatry Research Group, Faculty of Medicine, Federal University of Ceará, Fortaleza, Brazil
| | - J C Soares
- Center of Excellence on Mood Disorders, Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - J Quevedo
- Translational Psychiatry Program, Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA.,Center of Excellence on Mood Disorders, Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA.,Neuroscience Graduate Program, The University of Texas Graduate School of Biomedical Sciences at Houston, Houston, TX, USA.,Laboratory of Neurosciences, Graduate Program in Health Sciences, Health Sciences Unit, University of Southern Santa Catarina, Criciúma, Brazil
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12
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Dandekar MP, Luse D, Hoffmann C, Cotton P, Peery T, Ruiz C, Hussey C, Giridharan VV, Soares JC, Quevedo J, Fenoy AJ. Increased dopamine receptor expression and anti-depressant response following deep brain stimulation of the medial forebrain bundle. J Affect Disord 2017; 217:80-88. [PMID: 28395208 DOI: 10.1016/j.jad.2017.03.074] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Revised: 03/24/2017] [Accepted: 03/30/2017] [Indexed: 12/28/2022]
Abstract
BACKGROUND Among several potential neuroanatomical targets pursued for deep brain stimulation (DBS) for treating those with treatment-resistant depression (TRD), the superolateral-branch of the medial forebrain bundle (MFB) is emerging as a privileged location. We investigated the antidepressant-like phenotypic and chemical changes associated with reward-processing dopaminergic systems in rat brains after MFB-DBS. METHODS Male Wistar rats were divided into three groups: sham-operated, DBS-Off, and DBS-On. For DBS, a concentric bipolar electrode was stereotactically implanted into the right MFB. Exploratory activity and depression-like behavior were evaluated using the open-field and forced-swimming test (FST), respectively. MFB-DBS effects on the dopaminergic system were evaluated using immunoblotting for tyrosine hydroxylase (TH), dopamine transporter (DAT), and dopamine receptors (D1-D5), and high-performance liquid chromatography for quantifying dopamine, 3,4-dihydroxyphenylacetic acid (DOPAC), and homovanillic acid (HVA) in brain homogenates of prefrontal cortex (PFC), hippocampus, amygdala, and nucleus accumbens (NAc). RESULTS Animals receiving MFB-DBS showed a significant increase in swimming time without alterations in locomotor activity, relative to the DBS-Off (p<0.039) and sham-operated groups (p<0.014), indicating an antidepressant-like response. MFB-DBS led to a striking increase in protein levels of dopamine D2 receptors and DAT in the PFC and hippocampus, respectively. However, we did not observe appreciable differences in the expression of other dopamine receptors, TH, or in the concentrations of dopamine, DOPAC, and HVA in PFC, hippocampus, amygdala, and NAc. LIMITATIONS This study was not performed on an animal model of TRD. CONCLUSION MFB-DBS rescues the depression-like phenotypes and selectively activates expression of dopamine receptors in brain regions distant from the target area of stimulation.
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Affiliation(s)
- Manoj P Dandekar
- Translational Psychiatry Program, Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston (UTHealth) McGovern Medical School, Houston, TX, USA
| | - Dustin Luse
- The University of Texas Health Science Center at Houston (UTHealth) McGovern Medical School, Department of Neurosurgery, Houston, TX, USA
| | - Carson Hoffmann
- The University of Texas Health Science Center at Houston (UTHealth) McGovern Medical School, Department of Neurosurgery, Houston, TX, USA
| | - Patrick Cotton
- The University of Texas Health Science Center at Houston (UTHealth) McGovern Medical School, Department of Neurosurgery, Houston, TX, USA
| | - Travis Peery
- The University of Texas Health Science Center at Houston (UTHealth) McGovern Medical School, Department of Neurosurgery, Houston, TX, USA
| | - Christian Ruiz
- The University of Texas Health Science Center at Houston (UTHealth) McGovern Medical School, Department of Neurosurgery, Houston, TX, USA
| | - Caroline Hussey
- Translational Psychiatry Program, Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston (UTHealth) McGovern Medical School, Houston, TX, USA
| | - Vijayasree V Giridharan
- Translational Psychiatry Program, Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston (UTHealth) McGovern Medical School, Houston, TX, USA
| | - Jair C Soares
- Center of Excellence on Mood Disorders, Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston (UTHealth) McGovern Medical School, Houston, TX, USA
| | - Joao Quevedo
- Translational Psychiatry Program, Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston (UTHealth) McGovern Medical School, Houston, TX, USA; Center of Excellence on Mood Disorders, Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston (UTHealth) McGovern Medical School, Houston, TX, USA; Neuroscience Graduate Program, The University of Texas Graduate School of Biomedical Sciences at Houston, Houston, TX, USA; Laboratory of Neurosciences, Graduate Program in Health Sciences, Health Sciences Unit, University of Southern Santa Catarina (UNESC), Criciúma, SC, Brazil
| | - Albert J Fenoy
- The University of Texas Health Science Center at Houston (UTHealth) McGovern Medical School, Department of Neurosurgery, Houston, TX, USA.
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Schippers MC, Gaastra M, Mesman T, Schetters D, van Mourik Y, Denys D, Pattij T, De Vries TJ. Deep brain stimulation of the nucleus accumbens core but not shell reduces motivational components of heroin taking and seeking in rats. Brain Neurosci Adv 2017; 1:2398212817711083. [PMID: 32166132 PMCID: PMC7058223 DOI: 10.1177/2398212817711083] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Accepted: 04/21/2017] [Indexed: 12/04/2022] Open
Abstract
Background: Deep brain stimulation is explored as a new intervention for treatment-resistant substance use dependence. A candidate brain region is the nucleus accumbens, due to its involvement in reward and motivation. This study aimed to explore effects of NAcore and NAshell deep brain stimulation on aspects of heroin taking and seeking in a self-administration model for rats. Methods: NAcore and NAshell deep brain stimulation was applied during 25 or 100 µg/kg/infusion heroin self-administration on an FR4 schedule of reinforcement and during cue- and heroin-induced reinstatement. In a separate group, effects of NAcore deep brain stimulation on heroin self-administration on a progressive ratio schedule and the first extinction session were examined. Results: NAcore and NAshell deep brain stimulation did not alter heroin self-administration on an FR4 schedule. NAcore deep brain stimulation decreased cue – but not drug-induced reinstatement of heroin seeking, whereas NAshell deep brain stimulation did not affect reinstatement responding. In the second experiment, NAcore deep brain stimulation reduced responding during a progressive ratio schedule of heroin reinforcement. Finally, deep brain stimulation facilitated extinction from day 1 throughout the course of extinction learning. Conclusion: Taken together, the differential effects of NAcore and NAshell deep brain stimulation on heroin taking and seeking are in line with the distinct functional roles of these sub-regions therein. Conditioned cues have been shown to be very powerful stimuli for the persistence of addiction and relapse to drug use. Therefore, the present findings that NAcore deep brain stimulation decreases motivation for heroin taking and cue-conditioned behaviour and facilitates extinction learning are very promising, supporting the positive findings from clinical case studies.
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Affiliation(s)
- Maria C Schippers
- Department of Anatomy & Neurosciences, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, The Netherlands
| | - Mathijs Gaastra
- Department of Anatomy & Neurosciences, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, The Netherlands
| | - Tanja Mesman
- Department of Anatomy & Neurosciences, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, The Netherlands
| | - Dustin Schetters
- Department of Anatomy & Neurosciences, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, The Netherlands
| | - Yvar van Mourik
- Department of Anatomy & Neurosciences, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, The Netherlands
| | - Damiaan Denys
- Department of Psychiatry, Amsterdam Neuroscience, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Tommy Pattij
- Department of Anatomy & Neurosciences, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, The Netherlands
| | - Taco J De Vries
- Department of Anatomy & Neurosciences, Amsterdam Neuroscience, VU University Medical Center, Amsterdam, The Netherlands
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Schippers MC, Bruinsma B, Gaastra M, Mesman TI, Denys D, De Vries TJ, Pattij T. Deep Brain Stimulation of the Nucleus Accumbens Core Affects Trait Impulsivity in a Baseline-Dependent Manner. Front Behav Neurosci 2017; 11:52. [PMID: 28386221 PMCID: PMC5362621 DOI: 10.3389/fnbeh.2017.00052] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Accepted: 03/07/2017] [Indexed: 12/29/2022] Open
Abstract
Deep brain stimulation (DBS) of the nucleus accumbens (NA) is explored as a treatment for refractory psychiatric disorders, such as obsessive-compulsive disorder (OCD), depressive disorder (MDD), and substance use disorder (SUD). A common feature of some of these disorders is pathological impulsivity. Here, the effects of NAcore DBS on impulsive choice and impulsive action, two distinct forms of impulsive behavior, were investigated in translational animal tasks, the delayed reward task (DRT) and five-choice serial reaction time task (5-CSRTT), respectively. In both tasks, the effects of NAcore DBS were negatively correlated with baseline impulsive behavior, with more pronounced effects in the 5-CSRTT. To further examine the effects of DBS on trait impulsive action, rats were screened for high (HI) and low (LI) impulsive responding in the 5-CSRTT. NAcore DBS decreased impulsive, premature responding in HI rats under conventional conditions. However, upon challenged conditions to increase impulsive responding, NAcore DBS did not alter impulsivity. These results strongly suggest a baseline-dependent effect of DBS on impulsivity, which is in line with clinical observations.
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Affiliation(s)
- Maria C Schippers
- Amsterdam Neuroscience, Department of Anatomy and Neurosciences, VU University Medical Center Amsterdam, Netherlands
| | - Bastiaan Bruinsma
- Amsterdam Neuroscience, Department of Anatomy and Neurosciences, VU University Medical Center Amsterdam, Netherlands
| | - Mathijs Gaastra
- Amsterdam Neuroscience, Department of Anatomy and Neurosciences, VU University Medical Center Amsterdam, Netherlands
| | - Tanja I Mesman
- Amsterdam Neuroscience, Department of Anatomy and Neurosciences, VU University Medical Center Amsterdam, Netherlands
| | - Damiaan Denys
- Amsterdam Neuroscience, Department of Psychiatry, Academic Medical Center, University of Amsterdam Amsterdam, Netherlands
| | - Taco J De Vries
- Amsterdam Neuroscience, Department of Anatomy and Neurosciences, VU University Medical Center Amsterdam, Netherlands
| | - Tommy Pattij
- Amsterdam Neuroscience, Department of Anatomy and Neurosciences, VU University Medical Center Amsterdam, Netherlands
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Torres-Sanchez S, Perez-Caballero L, Berrocoso E. Cellular and molecular mechanisms triggered by Deep Brain Stimulation in depression: A preclinical and clinical approach. Prog Neuropsychopharmacol Biol Psychiatry 2017; 73:1-10. [PMID: 27644164 DOI: 10.1016/j.pnpbp.2016.09.005] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Revised: 09/09/2016] [Accepted: 09/15/2016] [Indexed: 12/20/2022]
Abstract
Deep Brain Stimulation (DBS) was originally developed as a therapeutic approach to manage movement disorders, in particular Parkinson's Disease. However, DBS also seems to be an effective treatment against refractory depression when patients fail to respond satisfactorily to conventional therapies. Thus, DBS targeting specific brain areas can produce an antidepressant response that improves depressive symptomatology, these areas including the subcallosal cingulate region, nucleus accumbens, ventral capsule/ventral striatum, medial forebrain bundle, the inferior thalamic peduncle and lateral habenula. Although the efficacy and safety of this therapy has been demonstrated in some clinical trials and preclinical studies, the intrinsic mechanisms underlying its antidepressant effect remain poorly understood. This review aims to provide a comprehensive overview of DBS, focusing on the molecular and cellular changes reported after its use that could shed light on the mechanisms underpinning its antidepressant effect. Several potential mechanisms of action of DBS are considered, including monoaminergic and glutamatergic neurotransmission, neurotrophic and neuroinflammatory mechanisms, as well as potential effects on certain intracellular signaling pathways. Although future studies will be necessary to determine the key molecular events underlying the antidepressant effect of DBS, the findings presented provide an insight into some of its possible modes of action.
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Affiliation(s)
- S Torres-Sanchez
- Department of Neuroscience, Pharmacology and Psychiatry, University of Cádiz, Neuropsychopharmacology & Psychobiology Research Group, CIBER for Mental Health (CIBERSAM), Spain
| | - L Perez-Caballero
- Department of Psychology, Area of Psychobiology, University of Cádiz, Neuropsychopharmacology & Psychobiology Research Group, CIBER for Mental Health (CIBERSAM), Spain
| | - E Berrocoso
- Department of Psychology, Area of Psychobiology, University of Cádiz, Neuropsychopharmacology & Psychobiology Research Group, CIBER for Mental Health (CIBERSAM), Spain.
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Varatharajan R, Joseph K, Neto SC, Hofmann UG, Moser A, Tronnier V. Electrical high frequency stimulation modulates GABAergic activity in the nucleus accumbens of freely moving rats. Neurochem Int 2015; 90:255-60. [DOI: 10.1016/j.neuint.2015.10.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2015] [Revised: 09/30/2015] [Accepted: 10/01/2015] [Indexed: 01/24/2023]
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Herrington TM, Cheng JJ, Eskandar EN. Mechanisms of deep brain stimulation. J Neurophysiol 2015; 115:19-38. [PMID: 26510756 DOI: 10.1152/jn.00281.2015] [Citation(s) in RCA: 290] [Impact Index Per Article: 32.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Accepted: 10/22/2015] [Indexed: 12/31/2022] Open
Abstract
Deep brain stimulation (DBS) is widely used for the treatment of movement disorders including Parkinson's disease, essential tremor, and dystonia and, to a lesser extent, certain treatment-resistant neuropsychiatric disorders including obsessive-compulsive disorder. Rather than a single unifying mechanism, DBS likely acts via several, nonexclusive mechanisms including local and network-wide electrical and neurochemical effects of stimulation, modulation of oscillatory activity, synaptic plasticity, and, potentially, neuroprotection and neurogenesis. These different mechanisms vary in importance depending on the condition being treated and the target being stimulated. Here we review each of these in turn and illustrate how an understanding of these mechanisms is inspiring next-generation approaches to DBS.
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Affiliation(s)
- Todd M Herrington
- Nayef Al-Rodhan Laboratories, Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts; Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts; and
| | - Jennifer J Cheng
- Nayef Al-Rodhan Laboratories, Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts; Department of Neurosurgery, The Johns Hopkins Hospital, Baltimore, Maryland
| | - Emad N Eskandar
- Nayef Al-Rodhan Laboratories, Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
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Lucas-Neto L, Reimão S, Oliveira E, Rainha-Campos A, Sousa J, Nunes RG, Gonçalves-Ferreira A, Campos JG. Advanced MR Imaging of the Human Nucleus Accumbens-Additional Guiding Tool for Deep Brain Stimulation. Neuromodulation 2015; 18:341-8. [DOI: 10.1111/ner.12289] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2014] [Revised: 01/24/2015] [Accepted: 02/13/2015] [Indexed: 11/30/2022]
Affiliation(s)
- Lia Lucas-Neto
- Anatomy Department; Lisbon Medical School; Lisboa Portugal
- Neuroradiology Department; North Lisbon Medical Center; Lisboa Portugal
| | - Sofia Reimão
- Neuroradiology Department; North Lisbon Medical Center; Lisboa Portugal
| | - Edson Oliveira
- Anatomy Department; Lisbon Medical School; Lisboa Portugal
- Neurosurgery Department; North Lisbon Medical Center; Lisboa Portugal
| | - Alexandre Rainha-Campos
- Anatomy Department; Lisbon Medical School; Lisboa Portugal
- Neurosurgery Department; North Lisbon Medical Center; Lisboa Portugal
| | - João Sousa
- Instituto de Biofísica e Engenharia Biomédica; Faculdade de Ciências; University of Lisbon; Lisboa Portugal
| | - Rita G. Nunes
- Instituto de Biofísica e Engenharia Biomédica; Faculdade de Ciências; University of Lisbon; Lisboa Portugal
| | - António Gonçalves-Ferreira
- Anatomy Department; Lisbon Medical School; Lisboa Portugal
- Neurosurgery Department; North Lisbon Medical Center; Lisboa Portugal
| | - Jorge G. Campos
- Neuroradiology Department; North Lisbon Medical Center; Lisboa Portugal
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van Westen M, Rietveld E, Figee M, Denys D. Clinical Outcome and Mechanisms of Deep Brain Stimulation for Obsessive-Compulsive Disorder. Curr Behav Neurosci Rep 2015; 2:41-48. [PMID: 26317062 PMCID: PMC4544542 DOI: 10.1007/s40473-015-0036-3] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Clinical outcome of deep brain stimulation (DBS) for obsessive-compulsive disorder (OCD) shows robust effects in terms of a mean Yale-Brown Obsessive-Compulsive Scale (YBOCS) reduction of 47.7 % and a mean response percentage (minimum 35 % YBOCS reduction) of 58.2 %. It appears that most patients regain a normal quality of life (QoL) after DBS. Reviewing the literature of the last 4 years, we argue that the mechanisms of action of DBS are a combination of excitatory and inhibitory as well as local and distal effects. Evidence from DBS animal models converges with human DBS EEG and imaging findings, in that DBS may be effective for OCD by reduction of hyperconnectivity between frontal and striatal areas. This is achieved through reduction of top-down-directed synchrony and reduction of frontal low-frequency oscillations. DBS appears to counteract striatal dysfunction through an increase in striatal dopamine and through improvement of reward processing. DBS affects anxiety levels through reduction of stress hormones and improvement of fear extinction.
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Affiliation(s)
- Maarten van Westen
- Department of Psychiatry, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - Erik Rietveld
- Department of Psychiatry, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands ; Amsterdam Brain and Cognition Center, University of Amsterdam, Nieuwe Achtergracht 129 (Building L), 1018 WS Amsterdam, The Netherlands ; Department of Philosophy, Institute for Logic, Language and Computation, University of Amsterdam, Science Park 107, 1098 XG Amsterdam, The Netherlands
| | - Martijn Figee
- Department of Psychiatry, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands ; Amsterdam Brain and Cognition Center, University of Amsterdam, Nieuwe Achtergracht 129 (Building L), 1018 WS Amsterdam, The Netherlands
| | - Damiaan Denys
- Department of Psychiatry, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands ; Amsterdam Brain and Cognition Center, University of Amsterdam, Nieuwe Achtergracht 129 (Building L), 1018 WS Amsterdam, The Netherlands ; The Netherlands Institute for Neuroscience, Royal Netherlands Academy of Arts and Sciences, Meibergdreef 47, 1105 BA Amsterdam, The Netherlands
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Lucas-Neto L, Mourato B, Neto D, Oliveira E, Martins H, Correia F, Gonçalves-Ferreira A. The nucleus accumbens beyond the anterior commissure: implications for psychosurgery. Stereotact Funct Neurosurg 2014; 92:291-9. [PMID: 25247282 DOI: 10.1159/000365115] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2013] [Accepted: 06/09/2014] [Indexed: 11/19/2022]
Abstract
INTRODUCTION The nucleus accumbens (Acc) is a basal forebrain structure integrated in the dopaminergic cerebral rewarding circuits and implicated in some neuropsychiatric disorders. It has become a target for deep brain stimulation for some of these disorders when refractory to medical treatment. However, it is controversial as to which target is the best and similar results have been achieved with the stimulation of neighboring structures such as the bed nucleus of the stria terminalis (BNST). Previous studies have established the stereotactic anatomy of the human Acc, but some difficulties remain concerning its precise posterior limit, which is assumed to be at the level of the anterior commissure (AC). It is our purpose to clarify the anatomy of this zone, given the importance of its exact identification in psychosurgery. METHODS A total of 16 Acc were collected by autopsy, fixed, dissected, embedded and cut in coronal 5-µm slices. The slices were stained with hematoxylin and eosin, marked with anti-D1 and anti-D2 antibodies and analyzed under a microscope. RESULTS The human Acc has the same cellular structure as the dorsal striatum, except in its posterior subcommissural part where voluminous neurons prevail, similar to and contiguous with the BNST. CONCLUSIONS The Acc is longer than previously described, with a sub- and postcommissural extension behind the AC, continuous with the BNST.
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Affiliation(s)
- Lia Lucas-Neto
- Department of Anatomy, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
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Deep brain stimulation induces striatal dopamine release in obsessive-compulsive disorder. Biol Psychiatry 2014; 75:647-52. [PMID: 23938318 DOI: 10.1016/j.biopsych.2013.06.021] [Citation(s) in RCA: 76] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2013] [Revised: 05/22/2013] [Accepted: 06/14/2013] [Indexed: 11/20/2022]
Abstract
BACKGROUND Obsessive-compulsive disorder is a chronic psychiatric disorder related to dysfunctional dopaminergic neurotransmission. Deep brain stimulation (DBS) targeted at the nucleus accumbens (NAc) has recently become an effective treatment for therapy-refractory obsessive-compulsive disorder, but its effect on dopaminergic transmission is unknown. METHODS We measured the effects of NAc DBS in 15 patients on the dopamine D2/3 receptor availability in the striatum with [(123)I]iodobenzamide ([(123)I]IBZM) single photon emission computed tomography. We correlated changes in [(123)I]IBZM binding potential (BP) with plasma levels of homovanillic acid (HVA) and clinical symptoms. RESULTS Acute (1-hour) and chronic (1-year) DBS decreased striatal [(123)I]IBZM BP compared with the nonstimulated condition in the putamen. BP decreases were observed after 1 hour of stimulation, and chronic stimulation was related to concurrent HVA plasma elevations, implying DBS-induced dopamine release. BP decreases in the area directly surrounding the electrodes were significantly correlated with changes in clinical symptoms (45% symptom decrease). CONCLUSIONS NAc DBS induced striatal dopamine release, which was associated with increased HVA plasma levels and improved clinical symptoms, suggesting that DBS may compensate for a defective dopaminergic system.
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Lucas-Neto L, Neto D, Oliveira E, Martins H, Mourato B, Correia F, Rainha-Campos A, Gonçalves-Ferreira A. Three dimensional anatomy of the human nucleus accumbens. Acta Neurochir (Wien) 2013; 155:2389-98. [PMID: 23913108 DOI: 10.1007/s00701-013-1820-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2013] [Accepted: 07/03/2013] [Indexed: 11/24/2022]
Abstract
BACKGROUND The Nucleus accumbens (Acc) is the main structure of the ventral striatum. It acts as a motor-limbic interface, being involved in emotional and psychomotor functions, frequently disturbed in neuropsychiatric disorders such as obsessive compulsive disorder and addiction. Most of the studies concerning the Acc were made in animals and those performed in humans are contradictory. Nevertheless, it has become a target for stereotactic deep brain stimulation for some of those diseases, when refractory to medical treatment. Previous studies performed by our group have established the localization, limits and dimensions of the human Acc and its stereotactic coordinates. Now it is our purpose to perform the Acc anatomical three-dimensional (3D) reconstruction in order to clarify its shape and topography and to render this nucleus a safer target for stereotactic procedures. METHODS Anatomical coronal slicing of ten Acc from human brains was performed, perpendicular to the anterior commissure-posterior commissure line and to the midline; then the Acc contours were traced and its dimensions and 3D stereotactic coordinates measured, on each slice. Finally a 3D computerized model was created. RESULTS The human Acc was identified as a distinct brain structure, with clear-cut limits on its posterior half. It lies parallel to the midline, descends caudally, and progresses from a globose to a flattened and dorsolateral concave shape. Its main expression is subcomissural. CONCLUSION This study defined more accurately the 3D anatomy of the human Acc, providing new tools for stereotactic procedures.
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Affiliation(s)
- L Lucas-Neto
- Anatomy Department, Lisbon Medical School, Lisbon, Portugal,
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Do-Monte FH, Rodriguez-Romaguera J, Rosas-Vidal LE, Quirk GJ. Deep brain stimulation of the ventral striatum increases BDNF in the fear extinction circuit. Front Behav Neurosci 2013; 7:102. [PMID: 23964215 PMCID: PMC3737469 DOI: 10.3389/fnbeh.2013.00102] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2013] [Accepted: 07/19/2013] [Indexed: 01/06/2023] Open
Abstract
Deep brain stimulation (DBS) of the ventral capsule/ventral striatum (VC/VS) reduces the symptoms of treatment-resistant obsessive compulsive disorder (OCD), and improves response to extinction-based therapies. We recently reported that DBS-like stimulation of a rat homologue of VC/VS, the dorsal-VS, reduced conditioned fear and enhanced extinction memory (Rodriguez-Romaguera et al., 2012). In contrast, DBS of the ventral-VS had the opposite effects. To examine possible mechanisms of these effects, we assessed the effects of VS DBS on the expression of the neural activity marker Fos and brain-derived neurotrophic factor (BDNF), a key mediator of extinction plasticity in prefrontal-amygdala circuits. Consistent with decreased fear expression, DBS of dorsal-VS increased Fos expression in prelimbic and infralimbic prefrontal cortices and in the lateral division of the central nucleus of amygdala, an area that inhibits amygdala output. Consistent with improved extinction memory, we found that DBS of dorsal-VS, but not ventral-VS, increased neuronal BDNF expression in prelimbic and infralimbic prefrontal cortices. These rodent findings are consistent with the idea that clinical DBS of VC/VS may augment fear extinction through an increase in BDNF expression.
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Affiliation(s)
- Fabricio H. Do-Monte
- Departments of Psychiatry and Anatomy and Neurobiology, University of Puerto Rico School of MedicineSan Juan, Puerto Rico
| | - Jose Rodriguez-Romaguera
- Departments of Psychiatry and Anatomy and Neurobiology, University of Puerto Rico School of MedicineSan Juan, Puerto Rico
| | - Luis E. Rosas-Vidal
- Departments of Psychiatry and Anatomy and Neurobiology, University of Puerto Rico School of MedicineSan Juan, Puerto Rico
| | - Gregory J. Quirk
- Departments of Psychiatry and Anatomy and Neurobiology, University of Puerto Rico School of MedicineSan Juan, Puerto Rico
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Deep brain stimulation affects conditioned and unconditioned anxiety in different brain areas. Transl Psychiatry 2013; 3:e289. [PMID: 23900312 PMCID: PMC3731788 DOI: 10.1038/tp.2013.56] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2013] [Accepted: 05/25/2013] [Indexed: 12/14/2022] Open
Abstract
Deep brain stimulation (DBS) of the nucleus accumbens (NAc) has proven to be an effective treatment for therapy refractory obsessive-compulsive disorder. Clinical observations show that anxiety symptoms decrease rapidly following DBS. As in clinical studies different regions are targeted, it is of principal interest to understand which brain area is responsible for the anxiolytic effect and whether high-frequency stimulation of different areas differentially affect unconditioned (innate) and conditioned (learned) anxiety. In this study, we examined the effect of stimulation in five brain areas in rats (NAc core and shell, bed nucleus of the stria terminalis (BNST), internal capsule (IC) and the ventral medial caudate nucleus (CAU)). The elevated plus maze was used to test the effect of stimulation on unconditioned anxiety, the Vogel conflict test for conditioned anxiety, and an activity test for general locomotor behaviour. We found different anxiolytic effects of stimulation in the five target areas. Stimulation of the CAU decreased both conditioned and unconditioned anxiety, while stimulation of the IC uniquely reduced conditioned anxiety. Remarkably, neither the accumbens nor the BNST stimulation affected conditioned or unconditioned anxiety. Locomotor activity increased with NAc core stimulation but decreased with the BNST. These findings suggest that (1) DBS may have a differential effect on unconditioned and conditioned anxiety depending on the stimulation area, and that (2) stimulation of the IC exclusively reduces conditioned anxiety. This suggests that the anxiolytic effects of DBS seen in OCD patients may not be induced by stimulation of the NAc, but rather by the IC.
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Whittle N, Schmuckermair C, Gunduz Cinar O, Hauschild M, Ferraguti F, Holmes A, Singewald N. Deep brain stimulation, histone deacetylase inhibitors and glutamatergic drugs rescue resistance to fear extinction in a genetic mouse model. Neuropharmacology 2013; 64:414-23. [PMID: 22722028 PMCID: PMC3474950 DOI: 10.1016/j.neuropharm.2012.06.001] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2012] [Revised: 05/31/2012] [Accepted: 06/06/2012] [Indexed: 12/16/2022]
Abstract
Anxiety disorders are characterized by persistent, excessive fear. Therapeutic interventions that reverse deficits in fear extinction represent a tractable approach to treating these disorders. We previously reported that 129S1/SvImJ (S1) mice show no extinction learning following normal fear conditioning. We now demonstrate that weak fear conditioning does permit fear reduction during massed extinction training in S1 mice, but reveals specific deficiency in extinction memory consolidation/retrieval. Rescue of this impaired extinction consolidation/retrieval was achieved with d-cycloserine (N-methly-d-aspartate partial agonist) or MS-275 (histone deacetylase (HDAC) inhibitor), applied after extinction training. We next examined the ability of different drugs and non-pharmacological manipulations to rescue the extreme fear extinction deficit in S1 following normal fear conditioning with the ultimate aim to produce low fear levels in extinction retrieval tests. Results showed that deep brain stimulation (DBS) by applying high frequency stimulation to the nucleus accumbens (ventral striatum) during extinction training, indeed significantly reduced fear during extinction retrieval compared to sham stimulation controls. Rescue of both impaired extinction acquisition and deficient extinction consolidation/retrieval was achieved with prior extinction training administration of valproic acid (a GABAergic enhancer and HDAC inhibitor) or AMN082 [metabotropic glutamate receptor 7 (mGlu7) agonist], while MS-275 or PEPA (AMPA receptor potentiator) failed to affect extinction acquisition in S1 mice. Collectively, these data identify potential beneficial effects of DBS and various drug treatments, including those with HDAC inhibiting or mGlu7 agonism properties, as adjuncts to overcome treatment resistance in exposure-based therapies. This article is part of a Special Issue entitled 'Cognitive Enhancers'.
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Affiliation(s)
- Nigel Whittle
- Department of Pharmacology and Toxicology, Institute of Pharmacy and Center for Molecular Biosciences Innsbruck (CMBI), University of Innsbruck, Innrain 80 - 82/III, A-6020 Innsbruck, Austria.
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van Dijk A, Klompmakers AA, Feenstra MGP, Denys D. Deep brain stimulation of the accumbens increases dopamine, serotonin, and noradrenaline in the prefrontal cortex. J Neurochem 2012; 123:897-903. [PMID: 23061486 DOI: 10.1111/jnc.12054] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2012] [Revised: 08/31/2012] [Accepted: 10/04/2012] [Indexed: 11/29/2022]
Abstract
Deep brain stimulation (DBS) of the nucleus accumbens (NAc) is effective in treatment-refractory obsessive-compulsive disorder and major depressive disorder. However, little is known about the neurobiological mechanisms underlying the rapid and effective changes of DBS. One of the hypotheses is that DBS modulates activity of monoamine neurotransmitters. In this study, we evaluated the effects of DBS in the NAc core on the extracellular concentration of monoaminergic neurotransmitters in the medial (mPFC) and orbital prefrontal cortex (OFC). Freely moving rats were bilaterally stimulated in the NAc core for 2 h while dopamine, serotonin, and noradrenaline were measured using in vivo microdialysis in the mPFC and the OFC. We report rapid increases in the release of dopamine and serotonin to a maximum of 177% and 127% in the mPFC and an increase up to 171% and 166% for dopamine and noradrenaline in the OFC after onset of stimulation in the NAc core. These results provide further evidence for the distal effects of DBS and corroborate previous clinical and pre-clinical findings of altered neuronal activity in prefrontal areas.
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Affiliation(s)
- Addy van Dijk
- Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
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Ewing SG, Grace AA. Long-term high frequency deep brain stimulation of the nucleus accumbens drives time-dependent changes in functional connectivity in the rodent limbic system. Brain Stimul 2012; 6:274-85. [PMID: 22981894 DOI: 10.1016/j.brs.2012.07.007] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2012] [Revised: 06/25/2012] [Accepted: 07/24/2012] [Indexed: 11/28/2022] Open
Abstract
Deep brain stimulation of the ventral striatum is an effective treatment for a variety of treatment refractory psychiatric disorders yet the mechanism of action remains elusive. We examined how five days of stimulation affected rhythmic brain activity in freely moving rats in terms of oscillatory power within, and coherence between, selected limbic regions bilaterally. Custom made bipolar stimulating/recording electrodes were implanted, bilaterally, in the nucleus accumbens core. Local field potential (LFP) recording electrodes were implanted, bilaterally in the prelimbic and orbitofrontal cortices and mediodorsal thalamic nucleus. Stimulation was delivered bilaterally with 100 μs duration constant current pulses at a frequency of 130 Hz delivered at an amplitude of 100 μA using a custom-made stimulation device. Synchronized video and LFP data were collected from animals in their home cages before, during and after stimulation. Signals were processed to remove movement and stimulation artifacts, and analyzed to determine changes in spectral power within, and coherence between regions. Five days stimulation of the nucleus accumbens core yielded temporally dynamic modulation of LFP power in multiple bandwidths across multiple brain regions. Coherence was seen to decrease in the alpha band between the mediodorsal thalamic nucleus and core of the nucleus accumbens. Coherence between each core of the nucleus accumbens bilaterally showed rich temporal dynamics throughout the five day stimulation period. Stimulation cessation revealed significant "rebound" effects in both power and coherence in multiple brain regions. Overall, the initial changes in power observed with short-term stimulation are replaced by altered coherence, which may reflect the functional action of DBS.
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Affiliation(s)
- Samuel G Ewing
- Department of Neuroscience, Psychiatry and Psychology, University of Pittsburgh, Pittsburgh, PA 15260, USA.
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Bourne SK, Eckhardt CA, Sheth SA, Eskandar EN. Mechanisms of deep brain stimulation for obsessive compulsive disorder: effects upon cells and circuits. Front Integr Neurosci 2012; 6:29. [PMID: 22712007 PMCID: PMC3375018 DOI: 10.3389/fnint.2012.00029] [Citation(s) in RCA: 94] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2012] [Accepted: 05/24/2012] [Indexed: 12/28/2022] Open
Abstract
Deep brain stimulation (DBS) has emerged as a safe, effective, and reversible treatment for a number of movement disorders. This has prompted investigation of its use for other applications including psychiatric disorders. In recent years, DBS has been introduced for the treatment of obsessive compulsive disorder (OCD), which is characterized by recurrent unwanted thoughts or ideas (obsessions) and repetitive behaviors or mental acts performed in order to relieve these obsessions (compulsions). Abnormal activity in cortico-striato-thalamo-cortical (CSTC) circuits including the orbitofrontal cortex (OFC), anterior cingulate cortex (ACC), ventral striatum, and mediodorsal (MD) thalamus has been implicated in OCD. To this end a number of DBS targets including the anterior limb of the internal capsule (ALIC), ventral capsule/ventral striatum (VC/VS), ventral caudate nucleus, subthalamic nucleus (STN), and nucleus accumbens (NAc) have been investigated for the treatment of OCD. Despite its efficacy and widespread use in movement disorders, the mechanism of DBS is not fully understood, especially as it relates to psychiatric disorders. While initially thought to create a functional lesion akin to ablative procedures, it is increasingly clear that DBS may induce clinical benefit through activation of axonal fibers spanning the CSTC circuits, alteration of oscillatory activity within this network, and/or release of critical neurotransmitters. In this article we review how the use of DBS for OCD informs our understanding of both the mechanisms of DBS and the circuitry of OCD. We review the literature on DBS for OCD and discuss potential mechanisms of action at the neuronal level as well as the broader circuit level.
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Affiliation(s)
- Sarah K Bourne
- Department of Neurosurgery, Massachusetts General Hospital, Boston MA, USA
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