What the cerveau isolé preparation tells us nowadays about sleep-wake mechanisms?

Proceedings of the Second Curing Coma Campaign NIH Symposium: Challenging the Future of Research for Coma and Disorders of Consciousness

This proceedings article presents actionable research targets on the basis of the presentations and discussions at the 2nd Curing Coma National Institutes of Health (NIH) symposium held from May 3 to May 5, 2021. Here, we summarize the background, research priorities, panel discussions, and deliverables discussed during the symposium across six major domains related to disorders of consciousness. The six domains include (1) Biology of Coma, (2) Coma Database, (3) Neuroprognostication, (4) Care of Comatose Patients, (5) Early Clinical Trials, and (6) Long-term Recovery. Following the 1st Curing Coma NIH virtual symposium held on September 9 to September 10, 2020, six workgroups, each consisting of field experts in respective domains, were formed and tasked with identifying gaps and developing key priorities and deliverables to advance the mission of the Curing Coma Campaign. The highly interactive and inspiring presentations and panel discussions during the 3-day virtual NIH symposium identified several action items for the Curing Coma Campaign mission, which we summarize in this article.

Age-related effect of ritanserin on the sleep-waking phases in rats

The age-related effect of the specific 5-hydroxytryptamine-2A/2C (5-HT(2A/2C)) antagonist ritanserin at two doses 0.63 mg/kg and 2.5 mg/kg) on six sleep-waking phases in young, middle-aged, and old male Wistar rats was electroencephalographically (EEG) examined. Only in the young and middle-aged rats, ritanserin enhanced slow wave sleep and reduced wakefulness in a dose-dependent manner. Ritanserin suppressed paradoxical sleep, such that this effect did not depend on the age. Although the effect of ritanserin on slow wave sleep was significantly smaller in the old compared to the young and the middle-aged rats, ritanserin produced an apparent sleep-improving effect in the old age group.

Sleep-waking cycle in chronic rat preparations with brain stem transected at the caudopontine level

The brain stem of rats was transected at the middle of the nucleus reticularis pontis caudalis. The preparations were maintained 2-9 days, and their EEG activity and behavior were studied. Maintained EEG activity and EEG arousal to visual and olfactory stimuli indicated the presence of sleep-waking cycle. Three stages were identified. Two of them corresponded to waking with hippocampal theta rhythm and to slow wave sleep in intact rats. The third stage (absent in intact rats) was characterized by slow waves and spindles of low amplitude in the cortex and low frequency theta rhythm, and it was considered as "drowsiness." Waking without theta rhythm, paradoxical sleep, and its forerunner intermediate stage were never found. Paroxystic-like EEG episodes were frequently observed. Thus, although present, the sleep-waking cycle is severely impaired in the caudopontine rats. The impairment is similar to that found previously in rats transected at the intercollicular or pretrigeminal level. The preparations were able to crawl abortively and to swallow liquid. Their respiratory rhythm was normal, but the heart rate increased. Thus, the caudal part of the preparations showed remarkable ability in controlling motor and vegetative functions.

Aberrant transients in the EEG of epileptic rats: a spectral analytical approach

Aberrant transients in the cortical electroencephalogram of rats of the epileptic WAG/Rij strain were studied by means of spectral analysis. The EEG of rats of this strain contains, besides normal sleep spindles, high-voltage spiky phenomena, epileptic spike-wave discharges, and deviant intermediate stage. Spectral analysis of these transient phenomena shows that some features, like their peak frequency, are alike, but that they differ in other spectral characteristics, as in the first harmonic of the peak frequency and in the domain of the high frequencies. The results provide arguments for the view that spike-wave discharges might be considered as unique aberrant phenomena, presumably related but dissimilar to the high-voltage spiky phenomena and intermediate stage. Next to this, spectral analysis was used to study the intraphenomenal dynamics of spike-wave discharges. The peak frequency was found to decrease monotonously from about 10 Hz at the beginning of the spike-wave discharge to about 8 Hz at the end. Other spike-wave discharge frequency bands showed an intraphenomenal increase followed by a decrease. These time-variant EEG dynamics in spike-wave discharges might correlate with the cognitive disturbances during absence seizures in man.

Positive transfer of audiogenic kindling to electrical hippocampal kindling in rats

Audiogenic seizures in genetically susceptible rodents are provoked by intense acoustic stimulations which result in a tonic seizure associated with a short flattening of the EEG. These seizures have been shown to involve primarily brainstem structures. Daily exposure to sound for 30-40 days produced a permanent change in the evoked seizure with development of facial myoclonias, rearing and falling, or of tonic-clonic seizures accompanied by high amplitude cortical spike-and-wave discharges. Kindled audiogenic seizures appear similar to seizures kindled from amygdala or hippocampus, suggesting that repeated auditory stimulations cause a progressive propagation of the epileptic discharge toward limbic structures. To verify this hypothesis, the behavioral and EEG development of electrical hippocampal kindling has been studied in 7 non epileptic controls (NE), 8 acoustic susceptible (AS), and 8 audiogenic kindled rats (KAS). The behavioral and EEG development of the electrical hippocampal kindling was similar in the AS and the NE rats. However, 2 animals in the AS group but no controls exhibited behavioral running and bouncing during the course of hippocampal kindling. In the KAS group, the hippocampal kindling was clearly facilitated as compared to NE and AS: behavioral stage greater than or equal to 5 was reached in a mean of 4 stimulations in KAS versus 30 and 22 stimulations respectively in NE and AS groups. This positive transfer phenomenon suggests that during kindling of audiogenic seizures, epileptic discharge spreads from the brainstem to the forebrain and progressively involves the hippocampus.

Study of the 5-HT2 antagonist ritanserin on sleep-walking cycle in the rat

Ritanserin, a 5-HT2 receptor antagonist, was injected intraperitoneally to rats at light onset. It was found that 0.63 mg/kg decreased waking, increased the slow waves characteristic of the first stage of sleep, and decreased paradoxical sleep (PS) during the first four hours. Active waking was further decreased and slow wave stage increased during the following four hours. The number of synchronized and paradoxical sleep phases decreased whereas their duration increased during the first four hours. Ritanserin at 2.5 mg/kg decreased active waking and PS, whereas quite waking and slow wave stage were increased during the first four hours. Quiet waking was increased during the following four hours. It is concluded that serotonin acting on 5 HT2 receptors is actively involved in sleep-waking regulation.

The intermediate stage of sleep in mice

Seven mice of Balb/C strain were implanted with electrodes to perform sleep-waking recordings. In 100% of the cases, the mice showed, prior to paradoxical sleep, the intermediate stage of sleep characterized by high-amplitude cortical spindles interspersed with slow waves and low-frequency theta rhythm in the dorsal hippocampus. Consequently, the intermediate stage which seems to correspond to a transient functional isolated forebrain does exist in the rat, cat and mouse. in the rat, cat and mouse.

Hippocampal and cortical EEG activity in rats with transected hypothalamus

The brain was transected in eight rats: the transection passed through the posterior pole of the superior colliculi and ended down at midhypothalamic level. The EEG activity in the dorsal hippocampus and cortex showed continuously slow, high amplitude waves. Thus the posterior hypothalamus is critical for the previously described hippocampal theta rhythm found in rats transected at the posthypothalamic level.

Genetically epileptic rats show a pronounced intermediate stage of sleep

Rats of the genetically epileptic WAG/Rij strain show a more long-lasting intermediate stage of sleep compared to rats of the Wistar strain. Therefore the WAG/Rij strain provides a privileged model for studying this stage of sleep. On the other hand, the percentage of paradoxical sleep in WAG/Rij rats is lower than in Wistar rats, for the reason that the intermediate stage in WAG/Rij rats is less frequently followed by paradoxical sleep and more frequently by slow wave sleep and especially by arousals. It is speculated that the epileptic rats encounter a greater difficulty in entering into paradoxical sleep.

Forebrain afferents to the cat posterior hypothalamus: a double labeling study

Using a double immunostaining technique with cholera toxin (CT) as a retrograde tracer, we examined the cells of origin and the histochemical nature of afferents to the cat posterior hypothalamus. After injection in the tuberomamillary nucleus, a number of CT-labeled cells were observed in: medial preoptic area, nuclei of the septum and the stria terminalis, amygdaloid complex, anterior hypothalamic, ventromedial hypothalamic and premamillary nuclei. CT injections in the lateral hypothalamic area gave an additional heavy labeling of neurons in: lateral preoptic area, nuclei of the diagonal band of Broca, substantia innominata, and nucleus accumbens. The posterior hypothalamus receives: 1) cholinergic inputs from the septum, the lateral preoptic area and the nuclei of the diagonal band of Broca; 2) dopaminergic afferents from A11, A13, and A14 groups; 3) histaminergic afferents from the posterior hypothalamus; and 4) peptidergic afferents such as methionin-enkephalin, galanin and neurotensin, substance P and corticotropin-releasing factor from the medial preoptic area, the nucleus of the stria terminalis and/or the posterior hypothalamic structures.

Hippocampal theta activity in the acute precollicular rat

In eleven acute precollicular rats, cortical and hippocampal EEG activity was recorded. Hippocampal theta activity of low frequency (mean 4.5 c/sec) was found in nine rats and in four occupied above 50% of the recording time. In contrast, in the cortex the synchronized EEG activity dominated. The electrical stimulation of the posterior hypothalamus induced the theta rhythm, or increased its frequency. The large amounts of theta activity in some rats suggests that the forebrain theta pacemakers, partly modulated by the posterior hypothalamus, are released from brain stem inhibitory influences.