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Bahr-Hosseini M, Saver JL. Mechanisms of action of acute and subacute sphenopalatine ganglion stimulation for ischemic stroke. Int J Stroke 2020; 15:839-848. [PMID: 32326842 DOI: 10.1177/1747493020920739] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
BACKGROUND Sphenopalatine ganglion stimulation (SPG-Stim) for ischemic stroke, starting 8-24 h after onset and continuing through five days in a pooled analysis of two recent, randomized, sham-controlled trials, improved outcome of acute ischemic stroke patients with confirmed cortical involvement. As a neuromodulatory therapy, SPG-Stim differs substantially from existing pharmacologic (lytic and antiplatelets) and device (endovascular thrombectomy) acute ischemic stroke treatments. AIM Focused review of SPG anatomy, physiology, and neurovascular and neurobiologic mechanisms of action mediating benefit of SPG-Stim in acute ischemic stroke. SUMMARY OF REVIEW Located posterior to the maxillary sinus, the SPG is the main source of parasympathetic innervation to the anterior circulation. Preclinical and human studies delineate four distinct mechanisms of action by which the SPG-Stim may confer benefit in acute ischemic stroke: (1) collateral vasodilation and enhanced cerebral blood flow, mediated by release of neurotransmitters with vasodilatory effects, nitric oxide, and acetylcholine, (2) stimulation frequency- and intensity-dependent stabilization of the blood-brain barrier, reducing edema (3) direct acute neuroprotection from activation of the central cholinergic system with resulting anti-inflammatory, anti-apoptotic, and anti-excitatory effects; and (4) neuroplasticity enhancement from enhanced central cholinergic and adrenergic neuromodulation of cortical networks and nitrous oxide release stimulating neurogenesis. CONCLUSION The benefit of SPG-Stim in acute ischemic stroke is likely conferred not only by potent collateral augmentation, but also blood-barrier stabilization, direct neuroprotection, and neuroplasticity enhancement. Further studies clarifying the relative contribution of these mechanisms and the stimulation protocols that maximize each may help optimize SPG-Stim as a therapy for acute ischemic stroke.
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Affiliation(s)
- Mersedeh Bahr-Hosseini
- Department of Neurology and Comprehensive Stroke Center, David Geffen School of Medicine at 8783UCLA, Los Angeles, CA, USA
| | - Jeffrey L Saver
- Department of Neurology and Comprehensive Stroke Center, David Geffen School of Medicine at 8783UCLA, Los Angeles, CA, USA
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Integrity of Cerebellar Fastigial Nucleus Intrinsic Neurons Is Critical for the Global Ischemic Preconditioning. Brain Sci 2017; 7:brainsci7100121. [PMID: 28934119 PMCID: PMC5664048 DOI: 10.3390/brainsci7100121] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Revised: 09/15/2017] [Accepted: 09/18/2017] [Indexed: 01/25/2023] Open
Abstract
Excitation of intrinsic neurons of cerebellar fastigial nucleus (FN) renders brain tolerant to local and global ischemia. This effect reaches a maximum 72 h after the stimulation and lasts over 10 days. Comparable neuroprotection is observed following sublethal global brain ischemia, a phenomenon known as preconditioning. We hypothesized that FN may participate in the mechanisms of ischemic preconditioning as a part of the intrinsic neuroprotective mechanism. To explore potential significance of FN neurons in brain ischemic tolerance we lesioned intrinsic FN neurons with excitotoxin ibotenic acid five days before exposure to 20 min four-vessel occlusion (4-VO) global ischemia while analyzing neuronal damage in Cornu Ammoni area 1 (CA1) hippocampal area one week later. In FN-lesioned animals, loss of CA1 cells was higher by 22% compared to control (phosphate buffered saline (PBS)-injected) animals. Moreover, lesion of FN neurons increased morbidity following global ischemia by 50%. Ablation of FN neurons also reversed salvaging effects of five-minute ischemic preconditioning on CA1 neurons and morbidity, while ablation of cerebellar dentate nucleus neurons did not change effect of ischemic preconditioning. We conclude that FN is an important part of intrinsic neuroprotective system, which participates in ischemic preconditioning and may participate in naturally occurring neuroprotection, such as "diving response".
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The Effect of Pre-Condition Cerebella Fastigial Nucleus Electrical Stimulation within and beyond the Time Window of Thrombolytic on Ischemic Stroke in the Rats. PLoS One 2015; 10:e0128447. [PMID: 26016630 PMCID: PMC4446308 DOI: 10.1371/journal.pone.0128447] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Accepted: 04/27/2015] [Indexed: 11/19/2022] Open
Abstract
Objective To investigate the effect of neurogenic neuroprotection conferred by cerebellar fastigial nucleus stimulation (FNS) and the role of PPARγ- mediated inflammation in a rat model of cerebral ischemia reperfusion. Methods After a continuous 1 hour fastigial nucleus electric stimulation, the male Sprague Dawley (SD) rats were given middle cerebral artery occlusion (MCAO) for 1, 3, 6, 9, 12 and 15 hours undergoing reperfusion with intravenous recombinant tissue plasminogen activator (rt-PA), while the control group received without FNS. After 72h of reperfusion, the neurological deficits, infarct volume and brain edema were evaluated. The brain tissue in ischemic penumbra was determined the myeloperoxidase (MPO) activity by a spectrophotometer and expression of PPARγ was measured by Rt-PCR and Western blotting. Results Our findings showed that FNS group had significantly reduced infarct volume and brain edema, and improved neurological deficits compared with the control group, especially in 6h and 9h reperfusion subgroups(p<0.05). The expression levels of PPARγ increased gradually and the peak may be before and after 9h reperfusion, the 3h, 6h, 9h, 12h and 15h reperfusion subgroups were higher than each control group(p<0.05). The MPO activity of 6h, 12h and 15h reperfusion subgroups were higher than each control group(p<0.05). Conclusions The neuroprotective effects of FNS have been shown to prolong the therapeutic window in cerebral ischemia/reperfusion, which might be related to the PPARγ mediated-inflammation in penumbral region.
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Cetas JS, McFarlane R, Kronfeld K, Smitasin P, Liu JJ, Raskin JS. Brainstem Opioidergic System Is Involved in Early Response to Experimental SAH. Transl Stroke Res 2014; 6:140-7. [DOI: 10.1007/s12975-014-0378-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2014] [Revised: 10/22/2014] [Accepted: 11/13/2014] [Indexed: 01/21/2023]
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Deer TR, Krames E, Mekhail N, Pope J, Leong M, Stanton-Hicks M, Golovac S, Kapural L, Alo K, Anderson J, Foreman RD, Caraway D, Narouze S, Linderoth B, Buvanendran A, Feler C, Poree L, Lynch P, McJunkin T, Swing T, Staats P, Liem L, Williams K. The Appropriate Use of Neurostimulation: New and Evolving Neurostimulation Therapies and Applicable Treatment for Chronic Pain and Selected Disease States. Neuromodulation 2014; 17:599-615; discussion 615. [DOI: 10.1111/ner.12204] [Citation(s) in RCA: 81] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2013] [Revised: 01/14/2014] [Accepted: 02/07/2014] [Indexed: 12/20/2022]
Affiliation(s)
| | | | - Nagy Mekhail
- University of Kentucky-Lexington; Lexington KY USA
| | - Jason Pope
- Center for Pain Relief; Charleston WV USA
| | | | | | | | - Leo Kapural
- Carolinas Pain Institute at Brookstown; Wake Forest Baptist Health; Winston-Salem NC USA
| | - Ken Alo
- The Methodist Hospital Research Institute; Houston TX USA
- Monterey Technical Institute; Monterey Mexico
| | | | - Robert D. Foreman
- University of Oklahoma Health Sciences Center, College of Medicine; Oklahoma City OK USA
| | - David Caraway
- Center for Pain Relief, Tri-State, LLC; Huntington WV USA
| | - Samer Narouze
- Anesthesiology and Pain Medicine, Neurological Surgery; Summa Western Reserve Hospital; Cuyahoga Falls OH USA
| | - Bengt Linderoth
- Functional Neurosurgery and Applied Neuroscience Research Unit, Karolinska Institute; Karolinska University Hospital; Stockholm Sweden
| | | | - Claudio Feler
- University of Tennessee; Memphis TN USA
- Valley View Hospital; Glenwood Springs CO USA
| | - Lawrence Poree
- University of California at San Francisco; San Francisco CA USA
- Pain Clinic of Monterey Bay; Aptos CA
| | - Paul Lynch
- Arizona Pain Specialists; Scottsdale AZ USA
| | | | - Ted Swing
- Arizona Pain Specialists; Scottsdale AZ USA
| | - Peter Staats
- Premier Pain Management Centers; Shrewsbury NJ USA
- Johns Hopkins University; Baltimore MD USA
| | - Liong Liem
- St. Antonius Hospital; Nieuwegein The Netherlands
| | - Kayode Williams
- Johns Hopkins School of Medicine and Carey Business School; Baltimore MD USA
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Abstract
The last decade has seen a growing interest in adjuvant treatments that synergistically influence mechanisms underlying rehabilitation of paretic upper limb in stroke. One such approach is invasive neurostimulation of spared cortices at the periphery of a lesion. Studies in animals have shown that during training of paretic limb, adjuvant stimulation targeting the peri-infarct circuitry enhances mechanisms of its reorganization, generating functional advantage. Success of early animal studies and clinical reports, however, failed to translate to a phase III clinical trial. As lesions in humans are diffuse, unlike many animal models, peri-infarct circuitry may not be a feasible, or consistent target across most. Instead, alternate mechanisms, such as changing transcallosal inhibition between hemispheres, or reorganization of other viable regions in motor control, may hold greater potential. Here, we review comprehensive mechanisms of clinical recovery and factors that govern which mechanism(s) become operative when. We suggest novel approaches that take into account a patient's initial clinical-functional state, and findings from neuroimaging and neurophysiology to guide to their most suitable mechanism for ideal targeting. Further, we suggest new localization schemes, and bypass strategies that indirectly target peri-lesional circuitry, and methods that serve to counter technical and theoretical challenge in identifying and stimulating such targets at the periphery of infarcts in humans. Last, we describe how stimulation may modulate mechanisms differentially across varying phases of recovery- a temporal effect that may explain missed advantage in clinical trials and help plan for the next stage. With information presented here, future trials would effectively be able to target patient's specific mechanism(s) with invasive (or noninvasive) neurostimulation for the greatest, most consistent benefit.
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Affiliation(s)
- Ela B Plow
- Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic Foundation, 9500 Euclid Ave, ND20, Cleveland, OH, 44195, USA,
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Wang J, Dong WW, Zhang WH, Zheng J, Wang X. Electrical stimulation of cerebellar fastigial nucleus: mechanism of neuroprotection and prospects for clinical application against cerebral ischemia. CNS Neurosci Ther 2014; 20:710-6. [PMID: 24930936 DOI: 10.1111/cns.12288] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2014] [Revised: 04/28/2014] [Accepted: 05/01/2014] [Indexed: 12/18/2022] Open
Abstract
For around two decades, electrical fastigial nucleus stimulation (FNS) has been demonstrated to induce neuroprotection involving multiple mechanisms. In this review, we summarize the protective effects of FNS against cerebral ischemia through the inhibition of electrical activity around the lesion, excitotoxic damage on neurons, and brain inflammatory response, as well as apoptosis. Moreover, FNS has been reported to promote nerve tissue repair, reconstruction, and neurological rehabilitation and improve stroke-related complications including poststroke cognitive dysfunction, depression, and abnormal heart rate variability. We thus further discuss the potential of FNS for clinical applications. Given the absence of any risk of inducing sublethal damage, FNS may offer a new approach to preconditioned neuroprotection against cerebral ischemia.
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Affiliation(s)
- Jian Wang
- Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Department of Neurology, The Second People's Hospital of Chengdu, Chengdu, Sichuan, China
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Fastigial Nucleus Electrostimulation Reduces the Expression of Repulsive Guidance Molecule, Improves Axonal Growth Following Focal Cerebral Ischemia. Neurochem Res 2012; 37:1906-14. [DOI: 10.1007/s11064-012-0809-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2012] [Revised: 04/29/2012] [Accepted: 05/26/2012] [Indexed: 02/04/2023]
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Abstract
Abstract
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Ay I, Sorensen AG, Ay H. Vagus nerve stimulation reduces infarct size in rat focal cerebral ischemia: an unlikely role for cerebral blood flow. Brain Res 2011; 1392:110-5. [PMID: 21458427 DOI: 10.1016/j.brainres.2011.03.060] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2010] [Revised: 03/22/2011] [Accepted: 03/23/2011] [Indexed: 01/30/2023]
Abstract
We sought to investigate the effect of cervical vagus nerve stimulation (VNS) on cerebral blood flow (CBF), infarct volume, and clinical outcome in a model of middle cerebral artery occlusion in rats. Electrical stimulation of the right and left vagus nerves was initiated 30min after the induction of the right-sided ischemia and lasted for 1h. Infarct size measurement revealed that the volume of ischemic damage was 41-45% smaller in animals receiving stimulation as compared with control animals. Both the right and left VNS caused subtle reduction in CBF during each 30-s stimulation period that quickly returned back to the baseline level at the end of each stimulation cycle. There was no significant effect of VNS on CBF during the entire 1-h stimulation period. The effect of VNS on tissue outcome was associated with better neurological outcome at both 1- and 3-day time points after the induction of ischemia. These findings suggest that VNS-induced protection against acute ischemic brain injury is not primarily mediated by changes in CBF, stimulation of both the right and left nerve have comparable effects, and VNS is effective after ipsilateral and contralateral focal ischemia.
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Affiliation(s)
- Ilknur Ay
- MGH/MIT/HMS A. A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital-East, 149 13th Street, Charlestown, MA O2129, USA.
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Pre- and post-conditioning treatment with an ultra-low dose of Δ9-tetrahydrocannabinol (THC) protects against pentylenetetrazole (PTZ)-induced cognitive damage. Behav Brain Res 2011; 220:194-201. [PMID: 21315768 DOI: 10.1016/j.bbr.2011.02.005] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2010] [Revised: 02/01/2011] [Accepted: 02/02/2011] [Indexed: 12/15/2022]
Abstract
Preconditioning, a phenomenon where a minor noxious stimulus protects from a subsequent more severe insult, and post-conditioning, where the protective intervention is applied following the insult, offer new insight into the neuronal mechanism(s) of neuroprotection and may provide new strategies for the prevention and treatment of brain damage. We have previously reported that a single administration of an extremely low dose of Δ(9)-tetrahydrocannabinol (THC; the psychoactive ingredient of marijuana) to mice induced minor long-lasting cognitive deficits. In the present study we examined the possibility that such a low dose of THC will protect the mice from more severe cognitive deficits induced by the epileptogenic drug pentylenetetrazole (PTZ). THC (0.002 mg/kg, a dose that is 3-4 orders of magnitude lower than the doses that induce the conventional effects of THC) was administered 1-7 days before, or 1-3 days after the injection of PTZ (60 mg/kg). The consequences of this treatment were studied 3-7 weeks later by various behavioral tests that evaluated different aspects of memory and learning. We found that a single administration of THC either before or after PTZ abolished the PTZ-induced long-lasting cognitive deficits. Biochemical studies indicated a concomitant reduction in phosphorylated-ERK (extracellular signal-regulated kinase) in the cerebella of mice 7 weeks following the injection of THC. Our results suggest that a pre- or post-conditioning treatment with extremely low doses of THC, several days before or after brain injury, may provide safe and effective long-term neuroprotection.
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Davis MF, Lay CC, Chen-Bee CH, Frostig RD. Amount but not pattern of protective sensory stimulation alters recovery after permanent middle cerebral artery occlusion. Stroke 2011; 42:792-8. [PMID: 21317269 DOI: 10.1161/strokeaha.110.607135] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND AND PURPOSE Using a rodent model of ischemia (permanent middle cerebral artery occlusion), our laboratory previously demonstrated that 4.27 minutes of patterned single-whisker stimulation delivered over 120 minutes can fully protect from impending damage when initiated within 2 hours of permanent middle cerebral artery occlusion ("early"). When initiated 3 hours postpermanent middle cerebral artery occlusion ("late"), stimulation resulted in irreversible damage. Here we investigate the effect of altering pattern, distribution, or amount of stimulation in this model. METHODS We assessed the cortex using functional imaging and histological analysis with altered stimulation treatment protocols. In 2 groups of animals we administered the same number of whisker deflections but in a random rather than patterned fashion distributed either over 120 minutes or condensed into 10 minutes postpermanent middle cerebral artery occlusion. We also tested increased (full-whisker array versus single-whisker) stimulation. RESULTS Early random whisker stimulation (condensed or dispersed) resulted in protection equivalent to early patterned stimulation. Early full-whisker array patterned stimulation also resulted in complete protection but promoted faster recovery. Late full-whisker array patterned stimulation, however, resulted in loss of evoked function and infarct volumes larger than those sustained by single-whisker counterparts. CONCLUSIONS When induced early on after ischemic insult, stimulus-evoked cortical activity, irrespective of the parameters of peripheral stimulation that induced it, seems to be the important variable for neuroprotection.
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Affiliation(s)
- Melissa F Davis
- University of California-Irvine, 2205 McGaugh Hall, Ring Road, Department of Neurobiology & Behavior, UCI, Irvine CA 92697, USA
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Nöthen C, Sandu N, Prabhakar H, Filis A, Arasho BD, Buchfelder M, Schaller BJ. Trigemino-cardiac reflex and antecedent transient ischemic attacks. Expert Rev Cardiovasc Ther 2010; 8:509-12. [PMID: 20397825 DOI: 10.1586/erc.10.19] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVES The trigemino-cardiac reflex (TCR) is a brainstem reflex that has gained enormous interest in recent years and was initially described by Schaller and coworkers as a centrally inducible reflex during skull-base surgery. In the meantime, parts of its functional consequences have been described. Here, we present a study that gives special reference to preventive factors of the TCR and investigates the hypothesis linking preceding transient ischemic attacks (TIAs) to the occurrence of TCR. METHODS We retrospectively reviewed 338 consecutive patients with the histological diagnosis of a pituitary adenoma, who were operated on from 2000 to 2006 in the Neurosurgery department of the University of Gottingen in Germany. Depending on the occurrence of intraoperative TCR, patients were divided into TCR and non-TCR groups. In 19 of these patients (6%), we found the intraoperative occurrence of the TCR. The patient characteristics between the two subgroups were comparable. RESULTS There was a statistically significant difference between the subgroups of precedent TIA (TCR: 11% vs non-TCR: 4%) versus nonprecedent TIA (TCR: 89% vs non-TCR: 96%) regarding the intraoperative occurrence of the TCR (chi(2): p < 0.01). CONCLUSION A precedent TIA less than 6 weeks before operation represents a significant risk factor for subsequent intraoperative occurrence of the TCR. Our data may indicate, for the first time, the existence of an oxygen-conserving reflex not only in animals but also in humans. Its neuroprotective effect in the context of the TCR is discussed.
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Affiliation(s)
- Christoph Nöthen
- Neurosurgical Department, University Hospitals Erlangen, Germany
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Wei Y, Zhang R. Preventive Effect of Fastigial Nucleus on Oxidative Damage in Rats Undergoing Acute Myocardial Infarction. ACTA ACUST UNITED AC 2008. [DOI: 10.1248/jhs.54.330] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Yidong Wei
- Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University
| | - Runfeng Zhang
- Heart, Lung and Blood Vessel Center, Tongji University
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Jeon HY, Joung KW, Choi JM, Kim YK, Shin JW, Leem JG, Han SM. The Effects of Superior Cervical Sympathetic Ganglion Block on the Acute Phase Injury and Long Term Protection against Focal Cerebral Ischemia/Reperfusion Injury in Rats. Korean J Pain 2008. [DOI: 10.3344/kjp.2008.21.2.119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Hae Young Jeon
- Department of Anesthesiology and Pain Medicine, University of Ulsan College of Medicine, Seoul, Korea
| | - Kyoung Woon Joung
- Department of Anesthesiology and Pain Medicine, University of Ulsan College of Medicine, Seoul, Korea
| | - Jae Moon Choi
- Department of Anesthesiology and Pain Medicine, University of Ulsan College of Medicine, Seoul, Korea
| | - Yoo Kyung Kim
- Department of Anesthesiology and Pain Medicine, University of Ulsan College of Medicine, Seoul, Korea
| | - Jin Woo Shin
- Department of Anesthesiology and Pain Medicine, University of Ulsan College of Medicine, Seoul, Korea
| | - Jeong Gill Leem
- Department of Anesthesiology and Pain Medicine, University of Ulsan College of Medicine, Seoul, Korea
| | - Sung Min Han
- Department of Anesthesiology and Pain Medicine, University of Ulsan College of Medicine, Seoul, Korea
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Kim HH, Leem JG, Shin JW, Shim JY, Lee DM. Superior Cervical Sympathetic Ganglion Block may not Influence Early Brain Damage Induced by Permanent Focal Cerebral Ischemia in Rats. Korean J Pain 2008. [DOI: 10.3344/kjp.2008.21.1.33] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Hyun Hae Kim
- Department of Anesthesiology and Pain Medicine, Asan Medical Center, Ulsan Univercity College of Medicine, Seoul, Korea
| | - Jeong Gill Leem
- Department of Anesthesiology and Pain Medicine, Asan Medical Center, Ulsan Univercity College of Medicine, Seoul, Korea
| | - Jin Woo Shin
- Department of Anesthesiology and Pain Medicine, Asan Medical Center, Ulsan Univercity College of Medicine, Seoul, Korea
| | - Ji Yeon Shim
- Department of Anesthesiology and Pain Medicine, Asan Medical Center, Ulsan Univercity College of Medicine, Seoul, Korea
| | - Dong Myung Lee
- Department of Anesthesiology and Pain Medicine, Asan Medical Center, Ulsan Univercity College of Medicine, Seoul, Korea
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Wang S, Wu DC, Ding MP, Li Q, Zhuge ZB, Zhang SH, Chen Z. Low-frequency stimulation of cerebellar fastigial nucleus inhibits amygdaloid kindling acquisition in Sprague–Dawley rats. Neurobiol Dis 2008; 29:52-8. [PMID: 17904855 DOI: 10.1016/j.nbd.2007.07.027] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2007] [Revised: 07/22/2007] [Accepted: 07/29/2007] [Indexed: 01/25/2023] Open
Abstract
Low-frequency stimulation (LFS) of the kindling focus or the piriform cortex inhibits kindling epileptogenesis, but whether LFS of brain targets outside the limbic system has anticonvulsive actions remain unknown. The current study was designed to investigate the effect of LFS of the cerebellar fastigial nucleus (FN) on seizure progression induced by amygdaloid kindling. Stimulation at 1 Hz (15-min train of 0.1-ms pulses, 100 muA), but not at 3 Hz, in the ipsilateral FN immediately after the daily kindling stimulus (1-s train of 1-ms pulses at 60 Hz and 100-300 muA) significantly inhibited the seizure stage and afterdischarge duration in kindling acquisition. Neither 1 Hz nor 3 Hz stimulation of the contralateral FH had any significant effect. It is interesting that delaying delivery (immediately after the cessation of afterdischarge) of LFS in the ipsilateral FN accelerated the rate of kindling acquisition compared to controls. Our study suggests that LFS of targets outside the limbic system, such as the FN, may have a significant anti-epileptogenic action, and the effects of LFS depend on the frequency and timing of stimulation.
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Affiliation(s)
- Shuang Wang
- Department of Pharmacology, Institute of Neuroscience, School of Medicine, Zhejiang University, Hangzhou, 310058 China
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Eulitz D, Prüss H, Derst C, Veh RW. Heterogeneous Distribution of Kir3 Potassium Channel Proteins Within Dopaminergic Neurons in the Mesencephalon of the Rat Brain. Cell Mol Neurobiol 2007; 27:285-302. [PMID: 17235695 DOI: 10.1007/s10571-006-9118-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2006] [Accepted: 09/06/2006] [Indexed: 11/25/2022]
Abstract
1. Dopaminergic neurons in the substantia nigra pars compacta (SNc) and the ventral tegmental area (VTA) of the ventral mesencephalon play an important role in the regulation of the parallel basal ganglia loops.2. We have raised affinity-purified polyclonal rabbit antibodies specific for all four members of the Kir3 family of inwardly rectifying potassium channels (Kir3.1-Kir3.4) to investigate the distribution of the channel proteins in the dopaminergic neurons of the rat mesencephalon at light and electron microscopic level. In addition, immunocytochemical double labeling with tyrosine hydroxylase (TH), a marker of dopaminergic neurons, were performed.3. All Kir3 channels were present in this region. However, the individual proteins showed differential cellular and subcellular distributions.4. Kir3.1 immunoreactivity was found in SNc fibers and some neurons of the substantia nigra pars reticulata (SNr). Few Kir3.3-positive neurons were found in the SNc. However, a strong Kir3.3 signal was identified in the SNr neuropil. Weak Kir3.4 staining was detected in neuronal somata as well as in dendritic fibers of both parts of the SN.5. In the VTA, Kir3.1, Kir3.3, and Kir3.4 showed only weak staining of neuropil structures. The distribution of the Kir3.2 channel protein was especially striking with strong labeling in the SNc and in the lateral but not central VTA.6. Our results suggest that the heterogeneously distributed Kir3.2 channel proteins could help to discriminate the dopaminergic neurons of VTA and SNc.
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Affiliation(s)
- Dirk Eulitz
- Centrum für Anatomie, Institut für Integrative Neuroanatomie, Charité-Universitätsmedizin Berlin, Philippstrasse 12, D-10115 Berlin, Germany
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Burnett MG, Shimazu T, Szabados T, Muramatsu H, Detre JA, Greenberg JH. Electrical forepaw stimulation during reversible forebrain ischemia decreases infarct volume. Stroke 2006; 37:1327-31. [PMID: 16556880 DOI: 10.1161/01.str.0000217305.82123.d8] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
BACKGROUND AND PURPOSE Functional stimulation is accompanied by increases in regional cerebral blood flow which exceed metabolic demands under normal circumstances, but it is unknown whether functional stimulation is beneficial or detrimental in the setting of acute ischemia. The aim of this study was to determine the effect of forepaw stimulation during temporary focal ischemia on neurological and tissue outcome in a rat model of reversible focal forebrain ischemia. METHODS Sprague-Dawley rats were prepared for temporary occlusion of the right middle cerebral artery (MCA) using the filament model. Cerebral blood flow in the MCA territory was continuously monitored with a laser-Doppler flowmeter. Subdermal electrodes were inserted into the dorsal forepaw to stimulate either the forepaw ipsilateral or contralateral to the occlusion starting 1 minute into ischemia and continuing throughout the ischemic period. A neurological evaluation was undertaken after 24 hours of reperfusion, and animals were then euthanized and brain slices stained with 2,3,5-triphenyltetrazolium chloride. Cortical and striatal damage was measured separately. RESULTS The cortical and striatal infarct volumes were both significantly reduced in the contralateral stimulated group compared with the ipsilateral stimulated group (48% total reduction). There were no statistically significant differences in the neurobehavioral scores between the 2 groups, or in the laser-Doppler flow measurements from the MCA core. CONCLUSIONS Functional stimulation of ischemic tissue may decrease tissue damage and improve outcome from stroke. Although the precise mechanism of this effect remains to be determined, functional stimulation could readily be translated to clinical practice.
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Affiliation(s)
- Mark G Burnett
- Department of Neurology, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
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Jensen EC, Bennet L, Hunter CJ, Power GC, Gunn AJ. Post-hypoxic hypoperfusion is associated with suppression of cerebral metabolism and increased tissue oxygenation in near-term fetal sheep. J Physiol 2006; 572:131-9. [PMID: 16484307 PMCID: PMC1779646 DOI: 10.1113/jphysiol.2005.100768] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Secondary cerebral hypoperfusion is common following perinatal hypoxia-ischaemia. However, it remains unclear whether this represents a true failure to provide sufficient oxygen and nutrients to tissues, or whether it is simply a consequence of reduced cerebral metabolic demand. We therefore examined the hypothesis that cerebral oxygenation would be reduced during hypoperfusion after severe asphyxia, and further, that the greater neural injury associated with blockade of the adenosine A(1) receptor during the insult would be associated with greater hypoperfusion and deoxygenation. Sixteen near-term fetal sheep received either vehicle or 8-cyclopentyl-1,3-dipropylxanthine (DPCPX) for 1 h, followed by 10 min of severe asphyxia induced by complete occlusion of the umbilical cord. Infusions were discontinued at the end of the occlusion and data were analysed for the following 8 h. A transient, secondary fall in carotid artery blood flow and laser Doppler flow was seen from approximately 1-4 h after occlusion (P < 0.001), with no significant differences between vehicle and DPCPX. Changes in laser Doppler blood flow were highly correlated with carotid blood flow (r(2)= 0.81, P < 0.001). Cortical metabolism was suppressed, reaching a nadir 1 h after occlusion and then resolving. Cortical tissue P(O(2)) was significantly increased at 1, 2 and 3 h after occlusion compared to baseline, and inversely correlated with carotid blood flow (r(2)= 0.69, P < 0.001). In conclusion, contrary to our initial hypothesis, delayed posthypoxic hypoperfusion was associated with suppression of cerebral metabolism and increased tissue P(O(2)), and was not significantly affected by preceding adenosine A1 blockade. These data suggest that posthypoxic hypoperfusion is actively mediated and reflects suppressed cerebral metabolism.
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Affiliation(s)
- E C Jensen
- Department of Physiology, Faculty of Medical and Health Sciences, University of Auckland, Private Bag 92019, Auckland, New Zealand
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Zhou P, Qian L, Zhou T, Iadecola C. Mitochondria are involved in the neurogenic neuroprotection conferred by stimulation of cerebellar fastigial nucleus. J Neurochem 2005; 95:221-9. [PMID: 16181426 DOI: 10.1111/j.1471-4159.2005.03358.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Activation of neural pathways originating in the cerebellar fastigial nucleus (FN) protects the brain from the deleterious effects of cerebral ischemia and excitotoxicity, a phenomenon termed central neurogenic neuroprotection. The neuroprotection is, in part, mediated by suppression of apoptosis. We sought to determine whether FN stimulation exerts its anti-apoptotic effect through mitochondrial mechanisms. Mitochondria were isolated from the cerebral cortex of rats in which the FN was stimulated for 1 h (100 microA; 1 s on/1 s off), 72 h earlier. Stimulation of the dentate nucleus (DN), a brain region that does not confer neuroprotection, served as control. Mitochondria isolated from FN-stimulated rats exhibited a marked increase in their ability to sequester Ca2+ and an increased resistance to Ca2+-induced membrane depolarization and depression in respiration. FN stimulation also leads to reduction in the release in cytochrome c, induced either by Ca2+ or the mitochondrial toxin mastoparan. Furthermore, in brain slices, FN stimulation reduced the staurosporine-induced insertion of the pro-apoptotic protein Bax into the mitochondria, a critical step in the mitochondrial mechanisms of apoptosis. Collectively, these results provide evidence that FN stimulation protects the mitochondria from dysfunction induced by Ca2+ loading, and inhibits mitochondrial pathways initiating apoptosis. These mitochondrial mechanisms are likely to play a role in the neuroprotection exerted by FN stimulation.
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Affiliation(s)
- Ping Zhou
- Division of Neurobiology, Weill Medical College of Cornell University, New York, NY 10021, USA.
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