Transcranial ultrasound neuromodulation facilitates isoflurane-induced general anesthesia recovery and improves cognition in mice

Red light-induced localized release of carbon monoxide for alleviating postoperative cognitive dysfunction

Inflammation within the central nervous system (CNS), which may be triggered by surgical trauma, has been implicated as a significant factor contributing to postoperative cognitive dysfunction (POCD). The relationship between mitigating inflammation at peripheral surgical sites and its potential to attenuate the CNS inflammatory response, thereby easing POCD symptoms, remains uncertain. Notably, carbon monoxide (CO), a gasotransmitter, exhibits pronounced anti-inflammatory effects. Herein, we have developed carbon monoxide-releasing micelles (CORMs), a nanoparticle that safely and locally liberates CO upon exposure to 650 nm light irradiation. In a POCD mouse model, treatment with CORMs activated by light (CORMs + hv) markedly reduced the concentrations of interleukin (IL)-6, IL-1β, and tumor necrosis factor-alpha (TNF-α) in both the peripheral blood and the hippocampus, alongside a decrease in ionized calcium-binding adapter molecule 1 in the hippocampal CA1 region. Furthermore, CORMs + hv treatment diminished Evans blue extravasation, augmented the expression of tight junction proteins zonula occludens-1 and occludin, enhanced neurocognitive functions, and fostered fracture healing. Bioinformatics analysis and experimental validation has identified Htr1b and Trhr as potential key regulators in the neuroactive ligand-receptor interaction signaling pathway implicated in POCD. This work offers new perspectives on the mechanisms driving POCD and avenues for therapeutic intervention.

Label free, capillary-scale blood flow mapping in vivo reveals that low intensity focused ultrasound evokes persistent dilation in cortical microvasculature

Non-invasive, low intensity focused ultrasound (FUS) is an emerging neuromodulation technique that offers the potential for precision, personalized therapy. An increasing body of research has identified mechanosensitive ion channels that can be modulated by FUS and support acute electrical activity in neurons. However, neuromodulatory effects that persist from hours to days have also been reported. The brain's ability to provide targeted blood flow to electrically active regions involve a multitude of non-neuronal cell types and signaling pathways in the cerebral vasculature; an open question is whether persistent effects can be attributed, at least partly, to vascular mechanisms. Using a novel in vivo optical approach, we found that microvascular responses, unlike larger vessels which prior investigations have explored, exhibit persistent dilation following sonication without the use of microbubbles. This finding and approach offers a heretofore unseen aspect of the effects of FUS in vivo and indicate that concurrent changes in neurovascular function may partially underly persistent neuromodulatory effects.

Rosiglitazone Promotes Oligodendrocyte Development and Myelin Formation of Repeated Neonatal Sevoflurane Exposure via PPARγ Signaling

Sevoflurane is one of the most commonly used general anesthetics for children and infants. Recent research indicates that repeated exposure to sevoflurane in neonates induces cognitive and fine motor deficits. Peroxisome proliferator-activated receptor-γ (PPARγ) agonists have garnered significant attention as potential therapies for a variety of neurological conditions. In this research, we evaluated whether pretreatment with rosiglitazone in neonatal mice could address myelination defects, cognitive impairment, and fine motor dysfunction via PPARγ. The mice were exposed to 3% sevoflurane for 2 h on postnatal days 6-8 (P6-P8). Behavioral tests were conducted from P29 to P34. Additionally, we evaluated morphological and functional changes related to myelin. Our results showed that rosiglitazone pretreatment significantly ameliorated the cognitive and fine motor impairments of repeated neonatal sevoflurane exposure. In addition, rosiglitazone pretreatment promoted oligodendrocyte precursor cells (OPCs) differentiation and myelination. This suggests that rosiglitazone may be used in clinical settings to enhance the security of neonatal sevoflurane exposure. Furthermore, PPARγ and fatty acid synthase (FASN) may be mediators for rosiglitazone, which alleviates myelination defects, cognitive impairment, and fine motor dysfunction.

Myelin modulates the process of isoflurane anesthesia through the regulation of neural activity

AIMS

The mechanism underlying the reversible unconsciousness induced by general anesthetics (GA) remains unclear. Recent studies revealed the critical roles of myelin and oligodendrocytes (OLs) in higher functions of the brain. However, it is unknown whether myelin actively participates in the regulation of GA. The aim of this study is to investigate the roles and possible mechanisms of myelin in the regulation of consciousness alterations induced by isoflurane anesthesia.

METHODS

First, demyelination models for the entire brain and specific neural nuclei were established to investigate the potential role of myelination in the regulation of GA, as well as its possible regional specificity. c-Fos staining was then performed on the demyelinated nuclei to verify the impact of myelin loss on neuronal activity. Finally, the activity of neurons during isoflurane anesthesia in demyelinated mice was recorded by optical fiber photometric calcium signal. The related behavioral indicators and EEG were recorded and analyzed.

RESULTS

A prolonged emergence time was observed from isoflurane anesthesia in demyelinated mice, which suggested the involvement of myelin in regulating GA. The demyelination in distinct nuclei by LPC further clarified the region-specific roles of isoflurane anesthesia regulation by myelin. The effect of demyelination on isoflurane anesthesia in the certain nucleus was consistent with that in neurons towards isoflurane anesthesia. Finally, we found that the mechanism of myelin in the modulation of isoflurane anesthesia is possibly through the regulation of neuronal activity.

CONCLUSIONS

In brief, myelin in the distinct neural nucleus plays an essential role in regulating the process of isoflurane anesthesia. The possible mechanism of myelin in the regulation of isoflurane anesthesia is neuronal activity modification by myelin integrity during GA. Our findings enhanced the comprehension of myelin function, and offered a fresh perspective for investigating the neural mechanisms of GA.

Neurobiological basis of emergence from anesthesia

The suppression of consciousness by anesthetics and the emergence of the brain from anesthesia are complex and elusive processes. Anesthetics may exert their inhibitory effects by binding to specific protein targets or through membrane-mediated targets, disrupting neural activity and the integrity and function of neural circuits responsible for signal transmission and conscious perception/subjective experience. Emergence from anesthesia was generally thought to depend on the elimination of the anesthetic from the body. Recently, studies have suggested that emergence from anesthesia is a dynamic and active process that can be partially controlled and is independent of the specific molecular targets of anesthetics. This article summarizes the fundamentals of anesthetics' actions in the brain and the mechanisms of emergence from anesthesia that have been recently revealed in animal studies.

An efficient method for transcranial ultrasound focus correction based on the coupling of boundary integrals and finite elements

Transcranial focused ultrasound is a novel technique for the noninvasive treatment of brain diseases. The success of the treatment greatly depends on achieving precise and efficient intraoperative focus. However, compensating for aberrated ultrasound waves caused by the skull through numerical simulation-based phase corrections is a challenging task due to the significant computational burden involved in solving the acoustic wave equation. In this article, we propose a promising strategy using the coupling of the boundary integral equation method (BIEM) and the finite element method (FEM) to overcome the above limitation. Specifically, we adopt the BIEM to obtain the Robin-to-Dirichlet maps on the boundaries of the skull and then couple the maps to the FEM matrices via a dual interpolation technique, resulting in a computational domain including only the skull. Three simulation experiments were conducted to evaluate the effectiveness of the proposed method, including a convergence test and two skull-induced aberration corrections in 2D and 3D ultrasound. The results show that the method's convergence is guaranteed as the element size decreases, leading to a decrease in pressure error. The computation times for simulating a 500 kHz ultrasound field on a regular desktop computer were found to be 0.47 ± 0.01 s in the 2D case and 43.72 ± 1.49 s in the 3D case, provided that lower-upper decomposition (approximately 13 s in 2D and 2.5 h in 3D) was implemented in advance. We also demonstrated that more accurate transcranial focusing can be achieved by phase correction compared to the noncorrected results (with errors of 1.02 mm vs. 6.45 mm in 2D and 0.28 mm vs. 3.07 mm in 3D). The proposed strategy is valuable for enabling online ultrasound simulations during treatment, facilitating real-time adjustments and interventions.

Correction of a transcranial acoustic field using a transient ultrasound field visualization technique

Ultrasound, due to its noninvasive nature, has the potential to enhance or suppress neural activity, making it highly promising for regulating intractable brain disorders. Precise ultrasound stimulation is crucial for improving the efficiency of neural modulation and studying its mechanisms. However, the presence of the skull can cause distortion in the ultrasound field, thereby affecting the accuracy of stimulation. Existing correction methods primarily rely on magnetic resonance guidance and numerical simulation. Due to the large size and high cost, the MR-guided transcranial ultrasound is difficult to be widely applied in small animals. The numerical simulation usually requires further validation and optimization before application, and the most effective method is to visualize the excited ultrasound field. However, the ultrasound field correction methods based on acoustic field visualization are still lacking. Therefore, a shadowgraph-based transient ultrasonic field visualization system is developed, and an ex vivo transcranial ultrasound field correction is performed. By visualizing the ultrasound field with or without a rat skull and then calculating the time difference of each element's ultrasound wavefront, the parameters for ultrasound field correction can be achieved. The experimental results show that this method can improve both the shape and the size of the focal spot, as well as enhance the acoustic pressure at the focus. Overall, the results demonstrate that the ultrasonic field visualization technology can effectively improve the transcranial ultrasound focusing effect and provide a new tool for achieving precise ultrasonic neural modulation.