Increased spinal c-Fos expression with noxious and non-noxious peripheral stimulation after severe spinal contusion

Cold Allodynia after C2 Root Resection in Sprague-Dawley Rats

Objective

The purpose of this study was to evaluate pain-related behaviors after bilateral C2 root resection and change in pain patterns in the suboccipital region in rats.

Methods

Male Sprague-Dawley rats were randomly assigned to three groups (n=25/group); näive, sham, and C2 resection. Three, 7, 10, and 14 days after surgery, cold allodynia was assessed using 20 μL of 99.7% acetone. c-Fos and c-Jun were immunohistochemically stained to evaluate activation of dorsal horn gray matter in C2 segments of the spinal cord 2 hours, 1 day, 7 days, and 14 days after surgery.

Results

Three days after surgery, the response to acetone in the sham group was significantly greater than in the näive group, and this significant difference between the näive and sham groups was maintained throughout the experimental period (p<0.05 at 3, 7, 10, and 14 days). Seven, 10, and 14 days after surgery, the C2 root resection group exhibited a significantly greater response to acetone than the näive group (p<0.05), and both the sham and C2 resection groups exhibited significantly greater responses to acetone compared with 3 days after surgery. No significant difference in cold allodynia was observed between the sham and C2 root resection groups throughout the experimental period. Two hours after surgery, both the sham and C2 root resection groups exhibited significant increases in c-Fos- and c-Jun-positive neurons compared with the naive group (p=0.0021 and p=0.0358 for the sham group, and p=0.0135 and p=0.014 for the C2 root resection group, respectively). One day after surgery, both the sham and C2 root resection groups exhibited significant decreases in c-Fos -positive neurons compared with two hours after surgery (p=0.0169 and p=0.0123, respectively), and these significant decreases in c-Fos immunoreactivity were maintained in both the sham and C2 root resection groups 7 and 14 days after surgery. The sham and C2 root resection groups presented a tendency toward a decrease in c-Jun-positive neurons 1, 7, and 14 days after surgery, but the decrease did not reach statistical significance.

Conclusion

We found no significant difference in cold allodynia and the early expression of c-Fos and c-Jun between the sham and C2 resection groups. Our results may support the routine resection of the C2 nerve root for posterior C1–2 fusion, but, further studies are needed.

Loss of central inhibition: implications for behavioral hypersensitivity after contusive spinal cord injury in rats

Behavioral hypersensitivity is common following spinal cord injury (SCI), producing significant discomfort and often developing into chronic pain syndromes. While the mechanisms underlying the development of behavioral hypersensitivity after SCI are poorly understood, previous studies of SCI contusion have shown an increase in amino acids, namely, aspartate and glutamate, along with a decrease in GABA and glycine, particularly below the injury. The current study sought to identify alterations in key enzymes and receptors involved in mediating central inhibition via GABA and glycine after a clinically-relevant contusion SCI model. Following thoracic (T8) 25.0 mm NYU contusion SCI in rodents, significant and persistent behavioral hypersensitivity developed as evidenced by cutaneous allodynia and thermal hyperalgesia. Biochemical analyses confirmed upregulation of glutamate receptor GluR3 with downregulation of the GABA synthesizing enzyme (GAD_65/67) and the glycine receptor α3 (GLRA3), notably below the injury. Combined, these changes result in the disinhibition of excitatory impulses and contribute to behavioral hyperexcitability. This study demonstrates a loss of central inhibition and the development of behavioral hypersensitivity in a contusive SCI paradigm. Future use of this model will permit the evaluation of different antinociceptive strategies and help in the elucidation of new targets for the treatment of neuropathic pain.

Expression of c-Fos and c-Jun in adjacent cervical spinal cord segments following C7 nerve root rhizotomy in rats: Indication of a neural pathway between adjacent cervical spinal cord segments

Cervical radiculopathy is a common disease in clinical practice. However, the symptoms are not confined to the affected spinal cord segment indicated by magnetic resonance imaging (MRI) findings. In the present study, we measured c-Fos and c-Jun expression in ipsilateral and adjacent cervical spinal cord segments following C₇ nerve root rhizotomy, to determine whether there is a neural pathway between adjacent cervical spinal cord segments. Forty-eight adult male Wistar rats were randomly divided into two groups: the C₇ rhizotomy group (rhizotomy group, n=24) and the sham-operated group (sham group, n=24). The right C₇ nerve root was completely cut off in the rhizotomy group, while it was exposed but not cut in the sham group. The expression of c-Fos and c-Jun in cervical spinal cord segments was detected by immunohistochemistry at 2 and 4 h after surgery. We observed that the number of c-Fos- and c-Jun-positive neurons in ipsilateral C_5–7 segments were significantly increased at 2 and 4 h after C₇ nerve root rhizotomy (P<0.05 vs. the sham group). The location of c-Fosand c-Jun-positive neurons in C_5–7 gray matter was similar in the rhizotomy and sham groups, which was mainly in lamina IX of the anterior horn and laminae I–II of the dorsal horn of the spinal cord. However, the number of c-Fos- and c-Jun-positive neurons in the C_5–7 gray matter was significantly reduced at 4 h after surgery compared with the number 2 h after surgery. The location of c-Fos- and c-Jun-positive neurons at 4 h was similar with that at 2 h. Therefore, there may be a neural pathway between ipsilateral adjacent cervical spinal cord segments. This may be one possible explanation as to why the radicular symptoms of cervical radiculopathy are not confined to the affected spinal cord segment shown by MRI.

The therapeutic profile of rolipram, PDE target and mechanism of action as a neuroprotectant following spinal cord injury

The extent of damage following spinal cord injury (SCI) can be reduced by various neuroprotective regimens that include maintaining levels of cyclic adenosine monophosphate (cyclic AMP), via administration of the phosphodiesterase 4 (PDE4) inhibitor Rolipram. The current study sought to determine the optimal neuroprotective dose, route and therapeutic window for Rolipram following contusive SCI in rat as well as its prominent PDE target and putative mechanism of protection. Rolipram or vehicle control (10% ethanol) was given subcutaneously (s.c.) daily for 2 wk post-injury (PI) after which the preservation of oligodendrocytes, neurons and central myelinated axons was stereologically assessed. Doses of 0.1 mg/kg to 1.0 mg/kg (given at 1 h PI) increased neuronal survival; 0.5 mg to 1.0 mg/kg protected oligodendrocytes and 1.0 mg/kg produced optimal preservation of central myelinated axons. Ethanol also demonstrated significant neuronal and oligo-protection; though the preservation provided was significantly less than Rolipram. Subsequent use of this optimal Rolipram dose, 1.0 mg/kg, via different routes (i.v., s.c. or oral, 1 h PI), demonstrated that i.v. administration produced the most significant and consistent cyto- and axo- protection, although all routes were effective. Examination of the therapeutic window for i.v. Rolipram (1.0 mg/kg), when initiated between 1 and 48 h after SCI, revealed maximal neuroprotection at 2 h post-SCI, although the protective efficacy of Rolipram could still be observed when administration was delayed for up to 48 h PI. Importantly, use of the optimal Rolipram regimen significantly improved locomotor function after SCI as measured by the BBB score. Lastly we show SCI-induced changes in PDE4A, B and D expression and phosphorylation as well as cytokine expression and immune cell infiltration. We demonstrate that Rolipram abrogates SCI-induced PDE4B1 and PDE4A5 production, PDE4A5 phosphorylation, MCP-1 expression and immune cell infiltration, while preventing post-injury reductions in IL-10. This work supports the use of Rolipram as an acute neuroprotectant following SCI and defines an optimal administration protocol and target for its therapeutic application.

The changing field of rehabilitation: optimizing spontaneous regeneration and functional recovery

For neurorehabilitation of patients with spinal cord injury (SCI), the traditional emphasis on social adaptation is being expanded to include strategies that promote plasticity and regeneration in the central nervous system. Such strategies are needed to optimize recovery of neurological function. For example, the known dependence of most cellular processes on physical activity has led to the novel concept that activity is important in neural repair. This hypothesis has given rise to activity-based restoration therapies (ABRT), which aim to optimize neural activity in the damaged spinal cord, particularly below the injury level. Here, we review the basic science and clinical evidence supporting the lifelong use of ABRT for recovery from spinal cord injury. We define and describe ABRT, and discuss its components, its clinical applications, its relationship to medical management of spinal cord injury, and the potential influences of medications on recovery. We also discuss the health benefits of ABRT under physiological and pathological conditions. We stress that lifelong ABRT is required to optimize return of function and to allow patients to benefit from any "cures" that will be discovered.

Motor unit number estimation may be a useful method to evaluate motor function recovery after spinal cord transection in rats

STUDY DESIGN

Experimental rat study.

OBJECTIVE

To investigate changes in motor unit number estimation (MUNE) value of the medial gastrocnemius (MG) muscle after thoracic spinal cord transection in rats and to correlate the MUNE with hindlimb motor function recovery.

SETTING

China Rehabilitation Research Center, Beijing, China.

METHODS

Twelve rats were subjected to spinal cord transection or sham surgery and then evaluated by MUNE and the Basso, Beattie and Bresnahan (BBB) behavioral scale 56 days after the surgery.

RESULTS

The MUNE values of the MG muscle were significantly decreased from baseline at 14-49 days after surgery. However, they returned to near pre-injury levels after 56 days. Rats recovered progressively from the severely impaired hindlimb motor function induced by spinal cord injury, as indicated by a gradual increase in BBB score during days 3-49 after surgery. However, this behavioral recovery was only partial and reached a plateau on day 49. Finally, there was a U-shape-like correlation between changes in MUNE values and BBB scores after thoracic spinal cord transection.

CONCLUSIONS

Time-dependent changes in the functional motor unit number may occur in spinal segments caudal to the transection level, and MUNE could be a useful method to evaluate motor function recovery.

Effects of Etanercept and Minocycline in a rat model of spinal cord injury

Loss of function is usually considered the major consequence of spinal cord injury (SCI). However, pain severely compromises the quality of life in nearly 70% of SCI patients. The principal aim of this study was to assess the contribution of Tumor necrosis factor alpha (TNF-alpha) to SCI pain. TNF-alpha blockers have already been successfully used to treat inflammatory disorders but there are few studies on its effect on neuropathic pain, especially following SCI. Following T13 spinal cord hemisection, we examined the effects on mechanical allodynia and microglial activation of immediate and delayed chronic intrathecal treatment with etanercept, a fusion protein blocker of TNF-alpha. Immediate treatment (starting at the time of injury) with etanercept resulted in markedly reduced mechanical allodynia 1, 2, 3 and 4 weeks after SCI. Delayed treatment had no effect. Immediate etanercept treatment also reduced spinal microglial activation assessed by OX-42 immunostaining, a putative marker of activated microglia. To assess whether the effects of etanercept were mediated via decreased microglial activation, we examined the effects of the microglial inhibitor, minocycline which significantly reduced the development of pain behaviours at 1 and 2 weeks after SCI compared to saline treatment. Minocycline also significantly reduced microglial OX-42 expression. Furthermore, minocycline decreased the expression of noxious-stimulation-induced c-Fos, suggesting an effect on evoked neuronal activity. This study demonstrates that TNF-alpha plays an important role in the establishment of neuropathic pain following SCI, seemingly dependent on microglial activation. Pharmacological targeting of TNF-alpha may offer therapeutic opportunities for treating SCI pain.

Prolonged nociceptive responses to hind paw formalin injection in rats with a spinal cord injury

Unilateral lesioning of the spinal dorsal horn with the excitotoxin quisqualic acid (QUIS) leads to robust degeneration of dorsal horn grey matter, and robust pain-related symptoms, such as cutaneous hypersensitivity, persist long after injury. A possible mechanism that underlies the pain-related symptoms is the disruption of dorsal horn inhibitory neuron function, leading to decreased inhibition of nociceptive neurons. Five percent formalin was injected into the hind paw of rats with either a QUIS lesion or sham lesion. Both QUIS- and sham-lesioned rats displayed bi-phasic hind paw flinches following formalin injection, but a prolonged response was observed in QUIS-lesioned rats. The expression of the immediate-early gene product Fos in the dorsal horn ipsilateral to formalin injection was similar between QUIS- and sham-lesioned rats. In QUIS-lesioned rats, however, there was a marked absence of dorsal horn neurons, particularly GABAergic neurons, compared to sham-lesioned rats. The prolonged nociceptive response observed with a unilateral QUIS lesion may be due to generalized changes in dorsal horn neuron function including a loss of inhibitory neuron function.

Visceral sensitivity and expression of 5-hydroxytryptamine and c-fos in the spinal dorsal horn in a rat model with irritable bowel syndrome

AIM: To study the visceral sensitivity by rectal balloon distension and expression of 5-hydroxy-tryptamine (5-HT) and c-fos in the spinal dorsal horn of a rat model with constipation-predominant irritable bowel syndrome (C-IBS).

METHODS: The rat model was established by intragastric injection with ice-cold water (0-4℃). The perception thresholds and the number of abdominal withdrawal reflexes (AWRs) were recorded during rectal balloon distention in order to evaluate visceral sensitivity in the model group (A, n = 10) and control group (B, n = 10). Expression of 5-HT and c-fos in the spinal dorsal horn was shown by immunohistochemical staining, and analyzed semi-quantitatively by computerized color image analyzer using immunoreactive areas and optical density (OD). The statistical difference of the OD and immunoreactive areas between the two groups was examined by t test.

RESULTS: The perception threshold in group A was slightly higher than that in group B during rectal balloon distention, but there was no significant difference (0.59 ± 0.09 vs 0.57 ± 0.13, P > 0.05). The number of AWRs to the lower balloon content (1.0 mL) was much lower in group A than in group B (10.3 ± 3.3 vs 18.3 ± 5.5, P < 0.05), although no difference was found to the higher balloon content (1.5 and 2.0 mL). Immunoreactive area and OD of 5-HT- and c-fos-positive neurons and fibers in group A were significantly higher than those in group B (5-HT immunoreactive area, 146.5 ± 15.1 vs 109.3 ± 18.5; 5-HT OD, 45826 ± 2563.2 vs 29358 ± 8965.5; c-fos immunoreactive area, 125.4 ± 23.3 vs 88.7 ± 23.2; c-fos OD, 46258 ± 4642 vs 33238 ± 4587; all P < 0.05).

CONCLUSION: The model of C-IBS has a decreased visceral sensitivity to rectal balloon distention. The increased expression of 5-HT and c-fos in the spinal dorsal horn is probably involved in the process.