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Krämer SD, Schuhmann MK, Volkmann J, Fluri F. Deep Brain Stimulation in the Subthalamic Nucleus Can Improve Skilled Forelimb Movements and Retune Dynamics of Striatal Networks in a Rat Stroke Model. Int J Mol Sci 2022; 23:ijms232415862. [PMID: 36555504 PMCID: PMC9779486 DOI: 10.3390/ijms232415862] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 12/03/2022] [Accepted: 12/11/2022] [Indexed: 12/15/2022] Open
Abstract
Recovery of upper limb (UL) impairment after stroke is limited in stroke survivors. Since stroke can be considered as a network disorder, neuromodulation may be an approach to improve UL motor dysfunction. Here, we evaluated the effect of high-frequency stimulation (HFS) of the subthalamic nucleus (STN) in rats on forelimb grasping using the single-pellet reaching (SPR) test after stroke and determined costimulated brain regions during STN-HFS using 2-[18F]Fluoro-2-deoxyglucose-([18F]FDG)-positron emission tomography (PET). After a 4-week training of SPR, photothrombotic stroke was induced in the sensorimotor cortex of the dominant hemisphere. Thereafter, an electrode was implanted in the STN ipsilateral to the infarction, followed by a continuous STN-HFS or sham stimulation for 7 days. On postinterventional day 2 and 7, an SPR test was performed during STN-HFS. Success rate of grasping was compared between these two time points. [18F]FDG-PET was conducted on day 2 and 3 after stroke, without and with STN-HFS, respectively. STN-HFS resulted in a significant improvement of SPR compared to sham stimulation. During STN-HFS, a significantly higher [18F]FDG-uptake was observed in the corticosubthalamic/pallidosubthalamic circuit, particularly ipsilateral to the stimulated side. Additionally, STN-HFS led to an increased glucose metabolism within the brainstem. These data demonstrate that STN-HFS supports rehabilitation of skilled forelimb movements, probably by retuning dysfunctional motor centers within the cerebral network.
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Affiliation(s)
- Stefanie D. Krämer
- Radiopharmaceutical Sciences/Biopharmacy, Institute of Pharmaceutical Sciences, Department of Chemistry and Applied Biosciences, ETH Zurich, 8093 Zurich, Switzerland
| | - Michael K. Schuhmann
- Department of Neurology, University Hospital Würzburg, Josef-Schneider Strasse 11, 97080 Würzburg, Germany
| | - Jens Volkmann
- Department of Neurology, University Hospital Würzburg, Josef-Schneider Strasse 11, 97080 Würzburg, Germany
| | - Felix Fluri
- Department of Neurology, University Hospital Würzburg, Josef-Schneider Strasse 11, 97080 Würzburg, Germany
- Correspondence: author: ; Tel.: +49-931-201-23653
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Casquero-Veiga M, Bueno-Fernandez C, Romero-Miguel D, Lamanna-Rama N, Nacher J, Desco M, Soto-Montenegro ML. Exploratory study of the long-term footprint of deep brain stimulation on brain metabolism and neuroplasticity in an animal model of obesity. Sci Rep 2021; 11:5580. [PMID: 33692388 PMCID: PMC7946931 DOI: 10.1038/s41598-021-82987-7] [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: 07/22/2020] [Accepted: 12/29/2020] [Indexed: 12/20/2022] Open
Abstract
Deep brain stimulation (DBS) is a powerful neurostimulation therapy proposed for the treatment of several neuropsychiatric disorders. However, DBS mechanism of action remains unclear, being its effects on brain dynamics of particular interest. Specifically, DBS reversibility is a major point of debate. Preclinical studies in obesity showed that the stimulation of the lateral hypothalamus (LH) and nucleus accumbens (NAcc), brain centers involved in satiety and reward circuits, are able to modulate the activity of brain structures impaired in this pathology. Nevertheless, the long-term persistence of this modulation after DBS withdrawal was unexplored. Here we examine the in vivo presence of such changes 1 month after LH- and NAcc-DBS, along with differences in synaptic plasticity, following an exploratory approach. Thus, both stimulated and non-stimulated animals with electrodes in the NAcc showed a common pattern of brain metabolism modulation, presumably derived from the electrodes' presence. In contrast, animals stimulated in the LH showed a relative metabolic invariance, and a reduction of neuroplasticity molecules, evidencing long-lasting neural changes. Our findings suggest that the reversibility or persistence of DBS modulation in the long-term depends on the selected DBS target. Therefore, the DBS footprint would be influenced by the stability achieved in the neural network involved during the stimulation.
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Affiliation(s)
- Marta Casquero-Veiga
- Laboratorio de Imagen Médica, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain. .,Centro de Investigación Biomédica en Red de Salud Mental, Madrid, Spain.
| | - Clara Bueno-Fernandez
- Neurobiology Unit, Cell Biology Department, Interdisciplinary Research Structure for Biotechnology and Biomedicine (BIOTECMED), Universitat de València, Madrid, Spain
| | - Diego Romero-Miguel
- Laboratorio de Imagen Médica, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - Nicolás Lamanna-Rama
- Laboratorio de Imagen Médica, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - Juan Nacher
- Centro de Investigación Biomédica en Red de Salud Mental, Madrid, Spain.,Neurobiology Unit, Cell Biology Department, Interdisciplinary Research Structure for Biotechnology and Biomedicine (BIOTECMED), Universitat de València, Madrid, Spain.,Fundación Investigación Hospital Clínico de Valencia, INCLIVA, Madrid, Spain
| | - Manuel Desco
- Laboratorio de Imagen Médica, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain. .,Centro de Investigación Biomédica en Red de Salud Mental, Madrid, Spain. .,Departamento de Bioingeniería e Ingeniería Aeroespacial, Universidad Carlos III de Madrid, Madrid, Spain. .,Centro Nacional de Investigaciones Cardiovasculares, Madrid, Spain.
| | - María Luisa Soto-Montenegro
- Laboratorio de Imagen Médica, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain. .,Centro de Investigación Biomédica en Red de Salud Mental, Madrid, Spain.
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Apetz N, Paralikar K, Neumaier B, Drzezga A, Wiedermann D, Iyer R, Munns G, Scott E, Timmermann L, Endepols H. Towards chronic deep brain stimulation in freely moving hemiparkinsonian rats: Applicability and functionality of a fully implantable stimulation system. J Neural Eng 2021; 18. [PMID: 33607640 DOI: 10.1088/1741-2552/abe806] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 02/19/2021] [Indexed: 12/23/2022]
Abstract
Objective This study aimed at investigating a novel fully implantable deep brain stimulation system and its ability to modulate brain metabolism and behavior through subthalamic nucleus stimulation in a hemiparkinsonian rat model. Approach Twelve male rats were unilaterally lesioned with 6-hydroxydopamine in the medial forebrain bundle and received a fully implantable deep brain stimulation system aiming at the ipsilesional subthalamic nucleus. Each rat underwent three cylinder tests to analyze front paw use: A PRE test before any surgical intervention, an OFF test after surgery but before stimulation onset and an ON test under deep brain stimulation. To visualize brain glucose metabolism in the awake animal, two [18F]FDG scans were conducted in the OFF and ON condition. At least four weeks after surgery, an [18F]FDOPA scan was used to check for dopaminergic integrity. Main results In general, STN DBS increased [18F]FDG uptake ipsilesionally and decreased it contralesionally. More specifically, bilateral orbitofrontal cortex, ipsilateral caudate putamen, sensorimotor cortex and nucleus accumbens showed significantly higher tracer uptake in ON compared to OFF condition. Contralateral cingulate and secondary motor cortex, caudate putamen, amygdala, hippocampus, retrosplenial granular cortex, superior colliculus, and parts of the cerebellum exhibited significantly higher [18F]FDG uptake in the OFF condition. On the behavioral level, stimulation was able improve use of the contralesional affected front paw suggesting an effective stimulation produced by the implanted system. Significance The fully implantable stimulation system developed by us and presented here offers the output of arbitrary user-defined waveforms, patterns and stimulation settings and allows tracer accumulation in freely moving animals. It is therefore a suitable device for implementing behavioral PET studies. It contributes immensely to the possibilities to characterize and unveil the effects and mechanisms of deep brain stimulation offering valuable clues for future improvements of this therapy.
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Affiliation(s)
- Nadine Apetz
- Institute of Radiochemistry and Experimental Molegular Imaging, University Hospital Cologne, Kerpener Str. 62, Koln, Nordrhein-Westfalen, 50937, GERMANY
| | - Kunal Paralikar
- Medtronic Inc, 7000 Central Avenue NE Friedley, Minneapolis, Minnesota, 55432-5604, UNITED STATES
| | - Bernd Neumaier
- Nuclear Chemistry (INM-5), Forschungszentrum Jülich GmbH, Wilhelm-Johnen-Straße, Julich, Nordrhein-Westfalen, 52428, GERMANY
| | - Alexander Drzezga
- Department of Nuclear Medicine, University Hospital Cologne, Kerpener Str. 62, Koln, Nordrhein-Westfalen, 50937, GERMANY
| | - Dirk Wiedermann
- Multimodal Imaging Group, Max Planck Institute for Metabolism Research, Gleueler Str. 50, Köln, 50931, GERMANY
| | - Rajesh Iyer
- Medtronic Inc, 7000 Central Avenue NE Fridley, Minneapolis, Minnesota, 55432-5604, UNITED STATES
| | - Gordon Munns
- Medtronic Inc, 7000 Central Avenue NE Friedley, Minneapolis, Minnesota, 55432-5604, UNITED STATES
| | - Erik Scott
- Medtronic Inc, 7000 Central Avenue NE Friedley, Minneapolis, Minnesota, 55432-5604, UNITED STATES
| | - Lars Timmermann
- Department of Neurology, University Hospital Marburg Center of Neurology, Baldingerstraße, Marburg, Hessen, 35039, GERMANY
| | - Heike Endepols
- Institute of Radiochemistry and Experimental Molecular Imaging, University Hospital Cologne, Kerpener Str. 62, Koln, Nordrhein-Westfalen, 50937, GERMANY
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Fleischer M, Endres H, Sendtner M, Volkmann J. Development of a Fully Implantable Stimulator for Deep Brain Stimulation in Mice. Front Neurosci 2020; 14:726. [PMID: 32792895 PMCID: PMC7385305 DOI: 10.3389/fnins.2020.00726] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Accepted: 06/18/2020] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION Deep brain stimulation is an established method for the treatment of neurological and psychiatric disorders. To elicit the underlying mechanisms and explore new stimulation targets, rodent models are necessary. Cable bound external stimulation or portable devices limit movement of the animals and influence behavioral experiments. Therefore, implantable, individually programmed devices are required. EXPERIMENTAL PROCEDURE The stimulator consists of an 8bit-microcontroller mounted on a square electrical board (10 × 10 mm). External control is enabled by a magnetic reed contact, as running control serves a white LED, running modes are displayed by flash codes. Stimulation parameters could be programmed in the range of pulse width: 60-500 μs, amplitude: up to 300 μA and frequency: 10-500 Hz. Power is supplied by two standard batteries. The device was implanted in 8-10 weeks old BALBc-mice. Functionality was examined by electrical stimulation of nucleus accumbens area with standard parameters for mice and determination of c-fos levels in vitro in brain slices. RESULTS The implanted microstimulators were well-tolerated by the mice, without impairment of free movement. Coating, external control, and monitoring of function with LED flash code proved to be fully adequate. Stimulation with standard stimulating parameters of nucleus accumbens elicited strong c-fos elevation on simulation site. CONCLUSION We present a fully implantable stimulator for freely moving mice that meets the urgent need for further research on the effects of deep brain stimulation in rodent models. It offers the possibility to conduct behavioral experiments for up to 30 days of stimulation.
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Affiliation(s)
- Michael Fleischer
- Department of Neurology, University Hospital Würzburg, Würzburg, Germany
- Department of Neurology, Essen University Hospital, Essen, Germany
| | - Heinz Endres
- University of Applied Science Würzburg-Schweinfurt, Schweinfurt, Germany
| | - Michael Sendtner
- Institute of Clinical Neurobiology, University Hospital Würzburg, Würzburg, Germany
| | - Jens Volkmann
- Department of Neurology, University Hospital Würzburg, Würzburg, Germany
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Pietraszko W, Furgala A, Gorecka-Mazur A, Kwinta B, Kaszuba-Zwoinska J, Polak J, Fiszer U, Gil K, Krygowska-Wajs A. Assessments of plasma acyl-ghrelin levels in Parkinson's disease patients treated with deep brain stimulation. Peptides 2020; 128:170299. [PMID: 32305796 DOI: 10.1016/j.peptides.2020.170299] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 02/26/2020] [Accepted: 03/12/2020] [Indexed: 12/26/2022]
Abstract
Gastrointestinal dysfunction is the most common non-motor symptom in Parkinson's disease (PD) with rates rising as the disease progresses. Deep brain stimulation of subthalamic nucleus (STN DBS) improves motor functions in advanced PD. However, the effect of STN DBS on ghrelin concentration and consequently on motility disturbances as well as body weight is unclear. The objective of this study was to assess acyl-ghrelin levels in comparison to weight in advanced PD patients treated with STN DBS. Plasma concentrations of acyl-ghrelin was measured in 29 PD patients in the fasting state and at 30, 60, 120, and 180 min after a standard meal preoperatively and 3 months after surgery. The level of acyl-ghrelin in PD patients were compared with 30 age and sex-matched healthy controls. We reported that mean plasma acyl-ghrelin levels were decreased in PD patients before STN DBS in fasting (p = 0.0003) and in 30 min postprandial phase (p = 0.04) compared with healthy controls. The plasma acyl-ghrelin levels after STN DBS increased in pre-prandial and postprandial phase in PD patients at the investigated time points. Body weight gained on average 2.33 kg during the first 3 months after surgery. There was no correlation between the acyl-ghrelin plasma levels and BMI. After STN DBS in fasting and postprandial phase plasma acyl-ghrelin levels were increased. The results showed that STN DBS therapy elicited a modification of ghrelin levels, increasing its concentration in pre- and postprandial state. In addition, body weight was increased during 3 months after surgery.
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Affiliation(s)
- Wojciech Pietraszko
- Department of Neurosurgery, Jagiellonian University, Medical College, Krakow, Botaniczna 3, Poland
| | - Agata Furgala
- Department of Pathophysiology, Jagiellonian University, Medical College, Krakow, Czysta 18, Poland
| | - Agnieszka Gorecka-Mazur
- Department of Pathophysiology, Jagiellonian University, Medical College, Krakow, Czysta 18, Poland
| | - Borys Kwinta
- Department of Neurosurgery, Jagiellonian University, Medical College, Krakow, Botaniczna 3, Poland
| | - Jolanta Kaszuba-Zwoinska
- Department of Pathophysiology, Jagiellonian University, Medical College, Krakow, Czysta 18, Poland
| | - Jaroslaw Polak
- Department of Neurosurgery, Jagiellonian University, Medical College, Krakow, Botaniczna 3, Poland
| | - Urszula Fiszer
- Department of Neurology and Epileptology, Centre of Postgraduate Medical Education, Warsaw, Czerniakowska 231, Poland
| | - Krzysztof Gil
- Department of Pathophysiology, Jagiellonian University, Medical College, Krakow, Czysta 18, Poland
| | - Anna Krygowska-Wajs
- Department of Neurology, Jagiellonian University, Medical College, Krakow, Botaniczna 3, Poland.
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Gerardo CM, Manuel MMV. The thalamic reticular nucleus: A common nucleus of neuropsychiatric diseases and deep brain stimulation. J Clin Neurosci 2020; 73:1-7. [PMID: 32001110 DOI: 10.1016/j.jocn.2020.01.061] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Accepted: 01/12/2020] [Indexed: 11/18/2022]
Abstract
This review focuses on the studies that have been reviewed to determine the influence of the thalamic reticular nucleus on neuropsychiatric diseases and deep brain stimulation. The literature reviewed to date describes how alterations in the thalamic reticular nucleus affect several functions that regulated brain rhythms and provokes symptoms of many disorders. The observations as the basis for the renewed interest in the thalamic reticular nucleus in experimental models and testing its effectiveness in patients with resistant neuropsychiatric disorders. The preclinical studies showed that deep brain stimulation in the thalamic reticular nucleus could have beneficial effects on EEG activity, including synchronization and desynchronization activity of the brain, as well as promoting an alleviate to neuropsychiatric diseases. These observations open up the possibility of studying the role played by neurotransmitters in the pathologic process and the deep brain stimulation in the thalamic reticular nucleus in experimental animal models and offer evidence of its possible action in the human brain.
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Affiliation(s)
- Contreras-Murillo Gerardo
- Laboratorio del Control y la Regulación, Dirección de Investigaciones en Neurociencias, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de México, Mexico
| | - Magdaleno-Madrigal Víctor Manuel
- Laboratorio del Control y la Regulación, Dirección de Investigaciones en Neurociencias, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Ciudad de México, Mexico.
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Apetz N, Kordys E, Simon M, Mang B, Aswendt M, Wiedermann D, Neumaier B, Drzezga A, Timmermann L, Endepols H. Effects of subthalamic deep brain stimulation on striatal metabolic connectivity in a rat hemiparkinsonian model. Dis Model Mech 2019; 12:dmm.039065. [PMID: 31064773 PMCID: PMC6550046 DOI: 10.1242/dmm.039065] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Accepted: 04/30/2019] [Indexed: 12/16/2022] Open
Abstract
Deep brain stimulation (DBS) in the subthalamic nucleus (STN) has been successfully used for the treatment of advanced Parkinson's disease, although the underlying mechanisms are complex and not well understood. There are conflicting results about the effects of STN-DBS on neuronal activity of the striatum, and its impact on functional striatal connectivity is entirely unknown. We therefore investigated how STN-DBS changes cerebral metabolic activity in general and striatal connectivity in particular. We used ipsilesional STN stimulation in a hemiparkinsonian rat model in combination with [18F]FDOPA-PET, [18F]FDG-PET and metabolic connectivity analysis. STN-DBS reversed ipsilesional hypometabolism and contralesional hypermetabolism in hemiparkinsonian rats by increasing metabolic activity in the ipsilesional ventrolateral striatum and by decreasing it in the contralesional hippocampus and brainstem. Other STN-DBS effects were subject to the magnitude of dopaminergic lesion severity measured with [18F]FDOPA-PET, e.g. activation of the infralimbic cortex was negatively correlated to lesion severity. Connectivity analysis revealed that, in healthy control animals, left and right striatum formed a bilateral functional unit connected by shared cortical afferents, which was less pronounced in hemiparkinsonian rats. The healthy striatum was metabolically connected to the ipsilesional substantia nigra in hemiparkinsonian rats only (OFF condition). STN-DBS (ON condition) established a new functional striatal network, in which interhemispheric striatal connectivity was strengthened, and both the dopamine-depleted and the healthy striatum were functionally connected to the healthy substantia nigra. We conclude that both unilateral dopamine depletion and STN-DBS affect the whole brain and alter complex interhemispheric networks. Summary: Deep brain stimulation in the subthalamic nucleus in rats with a unilateral dopaminergic lesion established a new functional interhemispheric striatal network.
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Affiliation(s)
- Nadine Apetz
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Institute of Radiochemistry and Experimental Molecular Imaging, Kerpener Str. 62, 50937 Köln, Germany
| | - Elena Kordys
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Institute of Radiochemistry and Experimental Molecular Imaging, Kerpener Str. 62, 50937 Köln, Germany
| | - Mascha Simon
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Institute of Radiochemistry and Experimental Molecular Imaging, Kerpener Str. 62, 50937 Köln, Germany
| | - Britta Mang
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Institute of Radiochemistry and Experimental Molecular Imaging, Kerpener Str. 62, 50937 Köln, Germany
| | - Markus Aswendt
- Max Planck Institute for Metabolism Research, Department of In-vivo NMR, Gleueler Str. 50, 50931 Köln, Germany
| | - Dirk Wiedermann
- Max Planck Institute for Metabolism Research, Department of In-vivo NMR, Gleueler Str. 50, 50931 Köln, Germany
| | - Bernd Neumaier
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Institute of Radiochemistry and Experimental Molecular Imaging, Kerpener Str. 62, 50937 Köln, Germany.,Forschungszentrum Jülich GmbH, Institute of Neuroscience and Medicine, Nuclear Chemistry (INM-5), Wilhelm-Johnen-Straβe, 52428 Jülich, Germany
| | - Alexander Drzezga
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Nuclear Medicine, Kerpener Str. 62, 50937 Köln, Germany
| | - Lars Timmermann
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Neurology, Kerpener Str. 62, 50937 Köln, Germany
| | - Heike Endepols
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Institute of Radiochemistry and Experimental Molecular Imaging, Kerpener Str. 62, 50937 Köln, Germany .,Forschungszentrum Jülich GmbH, Institute of Neuroscience and Medicine, Nuclear Chemistry (INM-5), Wilhelm-Johnen-Straβe, 52428 Jülich, Germany.,University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Nuclear Medicine, Kerpener Str. 62, 50937 Köln, Germany
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Gimenes C, Malheiros JM, Battapady H, Tannus A, Hamani C, Covolan L. The neural response to deep brain stimulation of the anterior nucleus of the thalamus: A MEMRI and c-Fos study. Brain Res Bull 2019; 147:133-139. [PMID: 30658130 DOI: 10.1016/j.brainresbull.2019.01.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 01/07/2019] [Accepted: 01/09/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND Deep brain stimulation (DBS) refers to the delivery of electric current to specific deep brain structures through implanted electrodes. Recently approved for use in United States, DBS to the anterior nucleus of thalamus (ANT) is a safe and effective alternative treatment for medically refractory seizures. Despite the anti-seizure effects of ANT DBS, preclinical and clinical studies have failed to demonstrate it actions at a whole brain level. OBJECTIVE Here, we used a magnetic resonance imaging (MRI)-based approach in healthy adult rats to investigate the effects of ANT DBS through the circuit of Papez, which has central role in the generation and propagation of limbic seizures, in temporal lobe epilepsy (TLE). METHODS After ANT electrode implantation and recovery, ANT DBS and SHAM (sham animals had electrodes implanted but were not stimulated) rats received one single injection of the contrast enhancer, manganese chloride (60 mg/kg, ip). Twelve hours after, rats underwent the baseline scan using the MEMRI (Manganese-Enhanced Magnetic Resonance Imaging) technique. We used the same MEMRI and parvalbumin sequence to follow the DBS delivered during 1 h (130 Hz and 200 μA). Perfusion was followed by subsequent c-Fos and parvalbumin immunostaining of brain sections. RESULTS Acute unilateral ANT DBS significantly reduced the overall manganese uptake and consequently, the MEMRI contrast in the circuit of Papez. Additionally, c-Fos expression was bilaterally increased in the cingulate cortex and posterior hypothalamus, areas directly connected to ANT, as well as in amygdala and subiculum, within the limbic circuitry. CONCLUSION Our data indicate that MEMRI can be used to detect whole-brain responses to DBS, as the high frequency stimulation parameters used here caused a significant reduction of cell activity in the circuit of Papez that might help to explain the antiepileptic effects of ANT DBS.
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Affiliation(s)
- Christiane Gimenes
- Department of Physiology, Universidade Federal de Sao Paulo, Sao Paulo, Brazil
| | | | | | - Alberto Tannus
- Physics Institute of Sao Carlos, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Clement Hamani
- Harquail Centre for Neuromodulation, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
| | - Luciene Covolan
- Department of Physiology, Universidade Federal de Sao Paulo, Sao Paulo, Brazil; Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA.
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Casquero-Veiga M, García-García D, Pascau J, Desco M, Soto-Montenegro ML. Stimulating the nucleus accumbens in obesity: A positron emission tomography study after deep brain stimulation in a rodent model. PLoS One 2018; 13:e0204740. [PMID: 30261068 PMCID: PMC6160153 DOI: 10.1371/journal.pone.0204740] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Accepted: 09/13/2018] [Indexed: 12/17/2022] Open
Abstract
PURPOSE The nucleus accumbens (NAcc) has been suggested as a possible target for deep brain stimulation (DBS) in the treatment of obesity. Our hypothesis was that NAcc-DBS would modulate brain regions related to reward and food intake regulation, consequently reducing the food intake and, finally, the weight gain. Therefore, we examined changes in brain glucose metabolism, weight gain and food intake after NAcc-DBS in a rat model of obesity. PROCEDURES Electrodes were bilaterally implanted in 2 groups of obese Zucker rats targeting the NAcc. One group received stimulation one hour daily during 15 days, while the other remained as control. Weight and daily consumption of food and water were everyday registered the days of stimulation, and twice per week during the following month. Positron emission tomography (PET) studies with 2-deoxy-2-[18F]fluoro-D-glucose (FDG) were performed 1 day after the end of DBS. PET data was assessed by statistical parametric mapping (SPM12) software and region of interest (ROI) analyses. RESULTS NAcc-DBS lead to increased metabolism in the cingulate-retrosplenial-parietal association cortices, and decreased metabolism in the NAcc, thalamic and pretectal nuclei. Furthermore, ROIs analyses confirmed these results by showing a significant striatal and thalamic hypometabolism, and a cortical hypermetabolic region. However, NAcc-DBS did not induce a decrease in either weight gain or food intake. CONCLUSIONS NAcc-DBS led to changes in the metabolism of regions associated with cognitive and reward systems, whose impairment has been described in obesity.
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Affiliation(s)
| | | | - Javier Pascau
- Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
- CIBER de Salud Mental (CIBERSAM), Madrid, Spain
- Departamento de Bioingeniería e Ingeniería Aeroespacial, Universidad Carlos III de Madrid, Leganés, Spain
| | - Manuel Desco
- Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
- CIBER de Salud Mental (CIBERSAM), Madrid, Spain
- Departamento de Bioingeniería e Ingeniería Aeroespacial, Universidad Carlos III de Madrid, Leganés, Spain
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain
| | - María Luisa Soto-Montenegro
- Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
- CIBER de Salud Mental (CIBERSAM), Madrid, Spain
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10
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Casquero-Veiga M, Hadar R, Pascau J, Winter C, Desco M, Soto-Montenegro ML. Response to Deep Brain Stimulation in Three Brain Targets with Implications in Mental Disorders: A PET Study in Rats. PLoS One 2016; 11:e0168689. [PMID: 28033356 PMCID: PMC5199108 DOI: 10.1371/journal.pone.0168689] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Accepted: 12/05/2016] [Indexed: 12/11/2022] Open
Abstract
Objective To investigate metabolic changes in brain networks by deep brain stimulation (DBS) of the medial prefrontal cortex (mPFC), nucleus accumbens (NAcc) and dorsomedial thalamus (DM) using positron emission tomography (PET) in naïve rats. Methods 43 male Wistar rats underwent stereotactic surgery and concentric bipolar platinum-iridium electrodes were bilaterally implanted into one of the three brain sites. [18F]-fluoro-2-deoxy-glucose-PET (18FDG-PET) and computed tomography (CT) scans were performed at the 7th (without DBS) and 9th day (with DBS) after surgery. Stimulation period matched tracer uptake period. Images were acquired with a small-animal PET-CT scanner. Differences in glucose uptake between groups were assessed with Statistical Parametric Mapping. Results DBS induced site-specific metabolic changes, although a common increased metabolic activity in the piriform cortex was found for the three brain targets. mPFC-DBS increased metabolic activity in the striatum, temporal and amygdala, and reduced it in the cerebellum, brainstem (BS) and periaqueductal gray matter (PAG). NAcc-DBS increased metabolic activity in the subiculum and olfactory bulb, and decreased it in the BS, PAG, septum and hypothalamus. DM-DBS increased metabolic activity in the striatum, NAcc and thalamus and decreased it in the temporal and cingulate cortex. Conclusions DBS induced significant changes in 18FDG uptake in brain regions associated with the basal ganglia-thalamo-cortical circuitry. Stimulation of mPFC, NAcc and DM induced different patterns of 18FDG uptake despite interacting with the same circuitries. This may have important implications to DBS research suggesting individualized target selection according to specific neural modulatory requirements.
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Affiliation(s)
- Marta Casquero-Veiga
- CIBER de Salud Mental (CIBERSAM), Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - Ravit Hadar
- Department of Psychiatry and Psychotherapy, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Javier Pascau
- CIBER de Salud Mental (CIBERSAM), Madrid, Spain
- Departamento de Bioingeniería e Ingeniería Aeroespacial, Universidad Carlos III de Madrid, Spain
| | - Christine Winter
- Department of Psychiatry and Psychotherapy, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Manuel Desco
- CIBER de Salud Mental (CIBERSAM), Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
- Departamento de Bioingeniería e Ingeniería Aeroespacial, Universidad Carlos III de Madrid, Spain
- * E-mail:
| | - María Luisa Soto-Montenegro
- CIBER de Salud Mental (CIBERSAM), Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
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Bikovsky L, Hadar R, Soto-Montenegro ML, Klein J, Weiner I, Desco M, Pascau J, Winter C, Hamani C. Deep brain stimulation improves behavior and modulates neural circuits in a rodent model of schizophrenia. Exp Neurol 2016; 283:142-50. [PMID: 27302677 DOI: 10.1016/j.expneurol.2016.06.012] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Revised: 03/07/2016] [Accepted: 06/10/2016] [Indexed: 12/11/2022]
Abstract
Schizophrenia is a debilitating psychiatric disorder with a significant number of patients not adequately responding to treatment. Deep brain stimulation (DBS) is a surgical technique currently investigated for medically-refractory psychiatric disorders. Here, we use the poly I:C rat model of schizophrenia to study the effects of medial prefrontal cortex (mPFC) and nucleus accumbens (Nacc) DBS on two behavioral schizophrenia-like deficits, i.e. sensorimotor gating, as reflected by disrupted prepulse inhibition (PPI), and attentional selectivity, as reflected by disrupted latent inhibition (LI). In addition, the neurocircuitry influenced by DBS was studied using FDG PET. We found that mPFC- and Nacc-DBS alleviated PPI and LI abnormalities in poly I:C offspring, whereas Nacc- but not mPFC-DBS disrupted PPI and LI in saline offspring. In saline offspring, mPFC-DBS increased metabolism in the parietal cortex, striatum, ventral hippocampus and Nacc, while reducing it in the brainstem, cerebellum, hypothalamus and periaqueductal gray. Nacc-DBS, on the other hand, increased activity in the ventral hippocampus and olfactory bulb and reduced it in the septal area, brainstem, periaqueductal gray and hypothalamus. In poly I:C offspring changes in metabolism following mPFC-DBS were similar to those recorded in saline offspring, except for a reduced activity in the brainstem and hypothalamus. In contrast, Nacc-DBS did not induce any statistical changes in brain metabolism in poly I:C offspring. Our study shows that mPFC- or Nacc-DBS delivered to the adult progeny of poly I:C treated dams improves deficits in PPI and LI. Despite common behavioral responses, stimulation in the two targets induced different metabolic effects.
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Affiliation(s)
- Lior Bikovsky
- School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel
| | - Ravit Hadar
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany
| | | | - Julia Klein
- Department of Psychiatry and Psychotherapy, Charité University Medicine Berlin, Campus Charité Mitte, Berlin, Germany
| | - Ina Weiner
- School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel; Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
| | - Manuel Desco
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; CIBERSAM, Madrid, Spain; Departamento de Bioingeniería e Ingeniería Aeroespacial, Universidad Carlos III de Madrid, Spain
| | - Javier Pascau
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; CIBERSAM, Madrid, Spain; Departamento de Bioingeniería e Ingeniería Aeroespacial, Universidad Carlos III de Madrid, Spain
| | - Christine Winter
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany.
| | - Clement Hamani
- Behavioural Neurobiology Laboratory, Centre for Addiction and Mental Health, 250 College Street, Toronto, ON, M5T 1R8, Canada; Campbell Family Mental Health Research Institute, CAMH, Canada; Division of Neurosurgery, Toronto Western Hospital, 399 Bathurst Street, Toronto, ON, M5T 2S8, Canada
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Van Den Berge N, Vanhove C, Descamps B, Dauwe I, van Mierlo P, Vonck K, Keereman V, Raedt R, Boon P, Van Holen R. Functional MRI during Hippocampal Deep Brain Stimulation in the Healthy Rat Brain. PLoS One 2015; 10:e0133245. [PMID: 26193653 PMCID: PMC4508110 DOI: 10.1371/journal.pone.0133245] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Accepted: 06/24/2015] [Indexed: 01/12/2023] Open
Abstract
Deep Brain Stimulation (DBS) is a promising treatment for neurological and psychiatric disorders. The mechanism of action and the effects of electrical fields administered to the brain by means of an electrode remain to be elucidated. The effects of DBS have been investigated primarily by electrophysiological and neurochemical studies, which lack the ability to investigate DBS-related responses on a whole-brain scale. Visualization of whole-brain effects of DBS requires functional imaging techniques such as functional Magnetic Resonance Imaging (fMRI), which reflects changes in blood oxygen level dependent (BOLD) responses throughout the entire brain volume. In order to visualize BOLD responses induced by DBS, we have developed an MRI-compatible electrode and an acquisition protocol to perform DBS during BOLD fMRI. In this study, we investigate whether DBS during fMRI is valuable to study local and whole-brain effects of hippocampal DBS and to investigate the changes induced by different stimulation intensities. Seven rats were stereotactically implanted with a custom-made MRI-compatible DBS-electrode in the right hippocampus. High frequency Poisson distributed stimulation was applied using a block-design paradigm. Data were processed by means of Independent Component Analysis. Clusters were considered significant when p-values were <0.05 after correction for multiple comparisons. Our data indicate that real-time hippocampal DBS evokes a bilateral BOLD response in hippocampal and other mesolimbic structures, depending on the applied stimulation intensity. We conclude that simultaneous DBS and fMRI can be used to detect local and whole-brain responses to circuit activation with different stimulation intensities, making this technique potentially powerful for exploration of cerebral changes in response to DBS for both preclinical and clinical DBS.
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Affiliation(s)
- Nathalie Van Den Berge
- Medical Image and Signal Processing Group, Ghent University-iMinds Medical IT department, Ghent, Belgium
- * E-mail:
| | - Christian Vanhove
- Medical Image and Signal Processing Group, Ghent University-iMinds Medical IT department, Ghent, Belgium
| | - Benedicte Descamps
- Medical Image and Signal Processing Group, Ghent University-iMinds Medical IT department, Ghent, Belgium
| | - Ine Dauwe
- Laboratory for Clinical and Experimental Neurophysiology, Neurobiology and Neuropsychology, Ghent University Hospital, Ghent, Belgium
| | - Pieter van Mierlo
- Medical Image and Signal Processing Group, Ghent University-iMinds Medical IT department, Ghent, Belgium
| | - Kristl Vonck
- Laboratory for Clinical and Experimental Neurophysiology, Neurobiology and Neuropsychology, Ghent University Hospital, Ghent, Belgium
| | - Vincent Keereman
- Medical Image and Signal Processing Group, Ghent University-iMinds Medical IT department, Ghent, Belgium
| | - Robrecht Raedt
- Laboratory for Clinical and Experimental Neurophysiology, Neurobiology and Neuropsychology, Ghent University Hospital, Ghent, Belgium
| | - Paul Boon
- Laboratory for Clinical and Experimental Neurophysiology, Neurobiology and Neuropsychology, Ghent University Hospital, Ghent, Belgium
| | - Roel Van Holen
- Medical Image and Signal Processing Group, Ghent University-iMinds Medical IT department, Ghent, Belgium
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Furlanetti LL, Döbrössy MD, Aranda IA, Coenen VA. Feasibility and safety of continuous and chronic bilateral deep brain stimulation of the medial forebrain bundle in the naïve Sprague-Dawley rat. Behav Neurol 2015; 2015:256196. [PMID: 25960609 PMCID: PMC4414266 DOI: 10.1155/2015/256196] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2015] [Accepted: 03/29/2015] [Indexed: 01/20/2023] Open
Abstract
OBJECTIVE Deep brain stimulation (DBS) of the superolateral branch of the medial forebrain bundle (MFB) has provided rapid and dramatic reduction of depressive symptoms in a clinical trial. Early intracranial self-stimulation experiments of the MFB suggested detrimental side effects on the animals' health; therefore, the current study looked at the viability of chronic and continuous MFB-DBS in rodents, with particular attention given to welfare issues and identification of stimulated pathways. METHODS Sprague-Dawley female rats were submitted to stereotactic microelectrode implantation into the MFB. Chronic continuous DBS was applied for 3-6 weeks. Welfare monitoring and behavior changes were assessed. Postmortem histological analysis of c-fos protein expression was carried out. RESULTS MFB-DBS resulted in mild and temporary weight loss in the animals, which was regained even with continuing stimulation. MFB-DBS led to increased and long-lasting c-fos expression in target regions of the mesolimbic/mesocortical system. CONCLUSIONS Bilateral continuous chronic MFB-DBS is feasible, safe, and without impact on the rodent's health. MFB-DBS results in temporary increase in exploration, which could explain the initial weight loss, and does not produce any apparent behavioral abnormalities. This platform represents a powerful tool for further preclinical investigation of the MFB stimulation in the treatment of depression.
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Affiliation(s)
- Luciano L. Furlanetti
- Laboratory of Stereotaxy and Interventional Neurosciences, Department of Stereotactic and Functional Neurosurgery, University Medical Center Freiburg, Breisacher Strasse 64, 79106 Freiburg, Germany
| | - Máté D. Döbrössy
- Laboratory of Stereotaxy and Interventional Neurosciences, Department of Stereotactic and Functional Neurosurgery, University Medical Center Freiburg, Breisacher Strasse 64, 79106 Freiburg, Germany
| | - Iñigo A. Aranda
- Laboratory of Stereotaxy and Interventional Neurosciences, Department of Stereotactic and Functional Neurosurgery, University Medical Center Freiburg, Breisacher Strasse 64, 79106 Freiburg, Germany
| | - Volker A. Coenen
- Laboratory of Stereotaxy and Interventional Neurosciences, Department of Stereotactic and Functional Neurosurgery, University Medical Center Freiburg, Breisacher Strasse 64, 79106 Freiburg, Germany
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14
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Hippocampal Deep Brain Stimulation Reduces Glucose Utilization in the Healthy Rat Brain. Mol Imaging Biol 2014; 17:373-83. [DOI: 10.1007/s11307-014-0801-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Response to deep brain stimulation in the lateral hypothalamic area in a rat model of obesity: in vivo assessment of brain glucose metabolism. Mol Imaging Biol 2014; 16:830-7. [PMID: 24903031 DOI: 10.1007/s11307-014-0753-0] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2014] [Revised: 04/29/2014] [Accepted: 05/16/2014] [Indexed: 01/02/2023]
Abstract
PURPOSE To investigate changes in glucose brain metabolism after deep brain stimulation (DBS) in the lateral hypothalamic area (LHA) in a rat model of obesity. PROCEDURES Ten obese male Zucker rats were divided into two groups: LHA-control and LHA-DBS. Concentric bipolar platinum-iridium electrodes were implanted bilaterally. After 7 days, DBS was applied for 15 days. Weight and food and water intake were monitored. 2-Deoxy-2-[(18)F]fluoro-D-glucose ([(18)F]FDG) PET-CT imaging studies were performed the day after the end of DBS. Differences in glucose uptake between the groups were assessed with statistical parametric mapping. RESULTS A difference in weight gain of 3.19 percentage points was found between groups. Average food consumption during the first 15 days was lower in DBS-treated animals than in non-stimulated animals. DBS increased metabolism in the mammillary body, subiculum-hippocampal area, and amygdala, while a decrease in metabolism was recorded in the thalamus, caudate, temporal cortex, and cerebellum. CONCLUSIONS DBS produced significant changes in brain regions associated with the control of food intake and the brain reward system. DBS seems to normalize the impaired hippocampal functioning that has been described in obese rats. The smaller weight gain in the DBS group suggests that this technique could be considered an option for the treatment of obesity.
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Marrinan S, Emmanuel AV, Burn DJ. Delayed gastric emptying in Parkinson's disease. Mov Disord 2013; 29:23-32. [PMID: 24151126 DOI: 10.1002/mds.25708] [Citation(s) in RCA: 102] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2013] [Revised: 07/30/2013] [Accepted: 09/03/2013] [Indexed: 12/16/2022] Open
Abstract
Gastrointestinal symptoms are evident in all stages of Parkinson's disease (PD). Most of the gastrointestinal abnormalities associated with PD are attributable to impaired motility. At the level of the stomach, this results in delayed gastric emptying. The etiology of delayed gastric emptying in PD is probably multifactorial but is at least partly related to Lewy pathology in the enteric nervous system and discrete brainstem nuclei. Delayed gastric emptying occurs in both early and advanced PD but is underdetected in routine clinical practice. Recognition of delayed gastric emptying is important because it can cause an array of upper gastrointestinal symptoms, but additionally it has important implications for the absorption and action of levodopa. Delayed gastric emptying contributes significantly to response fluctuations seen in people on long-term l-dopa therapy. Neurohormonal aspects of the brain-gut axis are pertinent to discussions regarding the pathophysiology of delayed gastric emptying in PD and are also hypothesized to contribute to the pathogenesis of PD itself. Ghrelin is a gastric-derived hormone with potential as a therapeutic agent for delayed gastric emptying and also as a novel neuroprotective agent in PD. Recent findings relating to ghrelin in the context of PD and gastric emptying are considered. This article highlights the pathological abnormalities that may account for delayed gastric emptying in PD. It also considers the wider relevance of abnormal gastric pathology to our current understanding of the etiology of PD.
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Affiliation(s)
- Sarah Marrinan
- Institute for Ageing and Health, Newcastle University, Newcastle upon Tyne, United Kingdom
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17
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Klein J, Hadar R, Götz T, Männer A, Eberhardt C, Baldassarri J, Schmidt TT, Kupsch A, Heinz A, Morgenstern R, Schneider M, Weiner I, Winter C. Mapping brain regions in which deep brain stimulation affects schizophrenia-like behavior in two rat models of schizophrenia. Brain Stimul 2012; 6:490-9. [PMID: 23085443 DOI: 10.1016/j.brs.2012.09.004] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2012] [Revised: 08/16/2012] [Accepted: 09/14/2012] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND AND OBJECTIVES The development of more efficient treatment remains a major unmet need in the realm of schizophrenia disease. Using the maternal immune stimulation and the pubertal cannabinoid administration rat model of schizophrenia, the present study aimed at testing the hypothesis that deep brain stimulation (DBS) serves as a novel therapeutic technique for this disorder. METHODS Adult offspring of dams, treated with the immune activating agent poly I:C (4 mg/kg, n = 50) or saline (n = 50), underwent bilateral stereotactic electrode implantation into one of the following brain regions: subthalamic nucleus (STN, n = 12/10), entopeduncularis nucleus (EP, n = 10/11), globus pallidus (GP, n = 10/10), medial prefrontal cortex (mPFC, n = 8/8), or dorsomedial thalamus (DM, n = 10/11). Adult rats treated with the CB1 receptor agonist WIN 55,212-2 (WIN, n = 16) or saline (n = 12) during puberty were bilaterally implanted with electrodes into either the mPFC (n = 8/6) or the DM (n = 8/6). After a post-operative recovery period of one week, all rats were tested on a well-established cross-species phenomenon that is disrupted in schizophrenia, the pre-pulse inhibition (PPI) of the acoustic startle reflex (ASR) under different DBS conditions. RESULTS Poly I:C induced deficits in PPI of the ASR were normalized upon DBS. DBS effects depended on both stimulation target and stimulation parameters. Most prominent effects were found under DBS at high frequencies in the mPFC and DM. These effects were replicated in the pubertal WIN administration rat model of schizophrenia. CONCLUSIONS Brain regions, in which DBS normalized PPI deficits, might be of therapeutic relevance to the treatment of schizophrenia. Results imply that DBS could be considered a plausible therapeutic technique in the realm of schizophrenia disease.
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Affiliation(s)
- Julia Klein
- Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Germany
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Arai E, Arai M, Uchiyama T, Higuchi Y, Aoyagi K, Yamanaka Y, Yamamoto T, Nagano O, Shiina A, Maruoka D, Matsumura T, Nakagawa T, Katsuno T, Imazeki F, Saeki N, Kuwabara S, Yokosuka O. Subthalamic deep brain stimulation can improve gastric emptying in Parkinson's disease. Brain 2012; 135:1478-85. [PMID: 22522940 DOI: 10.1093/brain/aws086] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
It is established that deep brain stimulation of the subthalamic nucleus improves motor function in advanced Parkinson's disease, but its effects on autonomic function remain to be elucidated. The present study was undertaken to investigate the effects of subthalamic deep brain stimulation on gastric emptying. A total of 16 patients with Parkinson's disease who underwent bilateral subthalamic deep brain stimulation were enrolled. Gastric emptying was expressed as the peak time of (13)CO(2) excretion (T(max)) in the (13)C-acetate breath test and was assessed in patients with and without administration of 100-150 mg levodopa/decarboxylase inhibitor before surgery, and with and without subthalamic deep brain stimulation at 3 months post-surgery. The pattern of (13)CO(2) excretion curve was analysed. To evaluate potential factors related to the effect of subthalamic deep brain stimulation on gastric emptying, we also examined the association between gastric emptying, clinical characteristics, the equivalent dose of levodopa and serum ghrelin levels. The peak time of (13)CO(2) excretion (T(max)) values for gastric emptying in patients without and with levodopa/decarboxylase inhibitor treatment were 45.6 ± 22.7 min and 42.5 ± 13.6 min, respectively (P = not significant), thus demonstrating levodopa resistance. The peak time of (13)CO(2) excretion (T(max)) values without and with subthalamic deep brain stimulation after surgery were 44.0 ± 17.5 min and 30.0 ± 12.5 min (P < 0.001), respectively, which showed that subthalamic deep brain stimulation was effective. Simultaneously, the pattern of the (13)CO(2) excretion curve was also significantly improved relative to surgery with no stimulation (P = 0.002), although the difference with and without levodopa/decarboxylase inhibitor was not significant. The difference in peak time of (13)CO(2) excretion (T(max)) values without levodopa/decarboxylase inhibitor before surgery and without levodopa/decarboxylase inhibitor and subthalamic deep brain stimulation after surgery was not significant, although motor dysfunction improved and the levodopa equivalent dose decreased after surgery. There was little association between changes in ghrelin levels (Δghrelin) and changes in T(max) values (ΔT(max)) in the subthalamic deep brain stimulation trial after surgery (r = -0.20), and no association between changes in other characteristics and ΔT(max) post-surgery in the subthalamic deep brain stimulation trial. These results showed that levodopa/decarboxylase inhibitor did not influence gastric emptying and that subthalamic deep brain stimulation can improve the dysfunction in patients with Parkinson's disease possibly by altering the neural system that controls gastrointestinal function after subthalamic deep brain stimulation. This is the first report to show the effectiveness of subthalamic deep brain stimulation on gastrointestinal dysfunction as a non-motor symptom in Parkinson's disease.
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Affiliation(s)
- Eiji Arai
- Department of Medicine and Clinical Oncology (K1), Graduate School of Medicine, Chiba University, Inohana 1-8-1, Chiba-City, Japan.
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