Introduction to focus issue: rhythms and dynamic transitions in neurological disease: modeling, computation, and experiment

A Pragmatic Review on Spinal Cord Stimulation Therapy for Parkinson's Disease Gait Related Disorders: Gaps and Controversies

BACKGROUND

Parkinson's Disease (PD) is a progressive neurological disorder that results in potentially debilitating mobility deficits. Recently, spinal cord stimulation (SCS) has been proposed as a novel therapy for PD gait disorders. The highest levels of evidence remain limited for SCS.

OBJECTIVES

In this systematic review and narrative synthesis, the literature was searched using combinations of key phrases indicating spinal cord stimulation and PD.

METHODS

We included pre-clinical studies and all published clinical trials, case reports, conference abstracts as well as protocols for ongoing clinical trials. Additionally, we included trials of SCS applied to atypical parkinsonism.

RESULTS

A total of 45 human studies and trials met the inclusion criteria. Based on the narrative synthesis, a number of knowledge gaps and future avenues of potential research were identified. This review demonstrated that evidence for SCS is currently not sufficient to recommend it as an evidence-based therapy for PD related gait disorders. There remain challenges and significant barriers to widespread implementation, including issues regarding patient selection, effective outcome selection, stimulation location and mode, and in programming parameter optimization. Results of early randomized controlled trials are currently pending. SCS is prone to placebo, lessebo and nocebo as well as blinding effects which may impact interpretation of outcomes, particularly when studies are underpowered.

CONCLUSION

Therapies such as SCS may build on current evidence and be shown to improve specific gait features in PD. Early negative trials should be interpreted with caution, as more evidence will be required to develop effective methodologies in order to drive clinical outcomes.

Bifurcation analysis of motoneuronal excitability mechanisms under normal and ALS conditions

Introduction

Bifurcation analysis allows the examination of steady-state, non-linear dynamics of neurons and their effects on cell firing, yet its usage in neuroscience is limited to single-compartment models of highly reduced states. This is primarily due to the difficulty in developing high-fidelity neuronal models with 3D anatomy and multiple ion channels in XPPAUT, the primary bifurcation analysis software in neuroscience.

Methods

To facilitate bifurcation analysis of high-fidelity neuronal models under normal and disease conditions, we developed a multi-compartment model of a spinal motoneuron (MN) in XPPAUT and verified its firing accuracy against its original experimental data and against an anatomically detailed cell model that incorporates known MN non-linear firing mechanisms. We used the new model in XPPAUT to study the effects of somatic and dendritic ion channels on the MN bifurcation diagram under normal conditions and after amyotrophic lateral sclerosis (ALS) cellular changes.

Results

Our results show that somatic small-conductance Ca2+-activated K (SK) channels and dendritic L-type Ca2+ channels have the strongest effects on the bifurcation diagram of MNs under normal conditions. Specifically, somatic SK channels extend the limit cycles and generate a subcritical Hopf bifurcation node in the V-I bifurcation diagram of the MN to replace a supercritical node Hopf node, whereas L-type Ca2+ channels shift the limit cycles to negative currents. In ALS, our results show that dendritic enlargement has opposing effects on MN excitability, has a greater overall impact than somatic enlargement, and dendritic overbranching offsets the dendritic enlargement hyperexcitability effects.

Discussion

Together, the new multi-compartment model developed in XPPAUT facilitates studying neuronal excitability in health and disease using bifurcation analysis.

Alternating activity patterns and a chimeralike state in a network of globally coupled excitable Morris-Lecar neurons

Spatiotemporal chaos collapses to either a rest state or a propagating pulse in a ring network of diffusively coupled, excitable Morris-Lecar neurons. Adding global varying synaptic coupling to the ring network reveals complex transient behavior. Spatiotemporal chaos collapses into a transient pulse that reinitiates spatiotemporal chaos to allow sequential pattern switching until a collapse to the rest state. A domain of irregular neuron activity coexists with a domain of inactive neurons forming a transient chimeralike state. Transient spatial localization of the chimeralike state is observed for stronger synapses.

Transient chaos and associated system-intrinsic switching of spacetime patterns in two synaptically coupled layers of Morris-Lecar neurons

Spatiotemporal chaos collapses to either a rest state or a propagating pulse solution in a single layer of diffusively coupled, excitable Morris-Lecar neurons. Weak synaptic coupling of two such layers reveals system intrinsic switching of spatiotemporal activity patterns within and between the layers at irregular times. Within a layer, switching sequences include spatiotemporal chaos, erratic and regular pulse propagation, spontaneous network wide neuron activity, and rest state. A momentary substantial reduction in neuron activity in one layer can reinitiate transient spatiotemporal chaos in the other layer, which can induce a swap of spatiotemporal chaos with a pulse state between the layers. Presynaptic input maximizes the distance between propagating pulses, in contrast to pulse merging in the absence of synapses.

Frequency-domain order parameters for the burst and spike synchronization transitions of bursting neurons

We are interested in characterization of synchronization transitions of bursting neurons in the frequency domain. Instantaneous population firing rate (IPFR) [Formula: see text], which is directly obtained from the raster plot of neural spikes, is often used as a realistic collective quantity describing population activities in both the computational and the experimental neuroscience. For the case of spiking neurons, a realistic time-domain order parameter, based on [Formula: see text], was introduced in our recent work to characterize the spike synchronization transition. Unlike the case of spiking neurons, the IPFR [Formula: see text] of bursting neurons exhibits population behaviors with both the slow bursting and the fast spiking timescales. For our aim, we decompose the IPFR [Formula: see text] into the instantaneous population bursting rate [Formula: see text] (describing the bursting behavior) and the instantaneous population spike rate [Formula: see text] (describing the spiking behavior) via frequency filtering, and extend the realistic order parameter to the case of bursting neurons. Thus, we develop the frequency-domain bursting and spiking order parameters which are just the bursting and spiking "coherence factors" [Formula: see text] and [Formula: see text] of the bursting and spiking peaks in the power spectral densities of [Formula: see text] and [Formula: see text] (i.e., "signal to noise" ratio of the spectral peak height and its relative width). Through calculation of [Formula: see text] and [Formula: see text], we obtain the bursting and spiking thresholds beyond which the burst and spike synchronizations break up, respectively. Consequently, it is shown in explicit examples that the frequency-domain bursting and spiking order parameters may be usefully used for characterization of the bursting and the spiking transitions, respectively.

Subthreshold amplitude and phase resonance in models of quadratic type: nonlinear effects generated by the interplay of resonant and amplifying currents

We investigate the biophysical and dynamic mechanisms of generation of subthreshold amplitude and phase resonance in response to sinusoidal input currents in two-dimensional models of quadratic type. These models feature a parabolic voltage nullcline and a linear nullcline for the recovery gating variable, capturing the interplay of the so-called resonant currents (e.g., hyperpolarization-activated mixed-cation inward and slow potassium) and amplifying currents (e.g., persistent sodium) in biophysically realistic parameter regimes. These currents underlie the generation of resonance in medial entorhinal cortex layer II stellate cells and CA1 pyramidal cells. We show that quadratic models exhibit nonlinear amplifications of the voltage response to sinusoidal inputs in the resonant frequency band. These are expressed as an increase in the impedance profile as the input amplitude increases. They are stronger for values positive than negative to resting potential and are accompanied by a shift in the phase profile, a decrease in the resonant and phase-resonant frequencies, and an increase in the sharpness of the voltage response. These effects are more prominent for smaller values of ∊ (larger levels of the time scale separation between the voltage and the resonant gating variable) and for values of the resting potential closer to threshold for spike generation. All other parameter fixed, as ∊ increases the voltage response becomes "more linear"; i.e., the nonlinearities are present, but "ignored". In addition, the nonlinear effects are strongly modulated by the curvature of the parabolic voltage nullcline (partially reflecting the effects of the amplifying current) and the slope of the resonant current activation curve. Following the effects of changes in the biophysical conductances of realistic conductance-based models through the parameters of the quadratic model, we characterize the qualitatively different effects that resonant and amplifying currents have on the nonlinear properties of the voltage response. We identify different classes of resonant currents, represented by h- and slow potassium, according to whether they enhance (h-) or attenuate (slow potassium) the nonlinear effects. Finally, we use dynamical systems tools to investigate the dynamic mechanisms of generation of resonance and phase-resonance. We show that the nonlinear effects on the voltage response (e.g., amplification of the voltage response in the resonant frequency band and shifts in the resonant and phase-resonant frequencies) result from the ability of limit cycle trajectories to follow the unstable (right) branch of the voltage nullcline for a significant amount of time. This is a canard-related mechanism that has been shown to underlie the generation of intrinsic subthreshold oscillations in quadratic type models such as medial entorhinal cortex stellate cells. Overall, our results highlight the complexity of the voltage response to oscillatory inputs in nonlinear models and the roles that resonant and amplifying currents have in shaping these responses.

Impact of weak excitatory synapses on chaotic transients in a diffusively coupled Morris-Lecar neuronal network

Spatiotemporal chaos collapses to either a rest state or a propagating pulse solution in a ring network of diffusively coupled, excitable Morris-Lecar neurons. Weak excitatory synapses can increase the Lyapunov exponent, expedite the collapse, and promote the collapse to the rest state rather than the pulse state. A single traveling pulse solution may no longer be asymptotic for certain combinations of network topology and (weak) coupling strengths, and initiate spatiotemporal chaos. Multiple pulses can cause chaos initiation due to diffusive and synaptic pulse-pulse interaction. In the presence of chaos initiation, intermittent spatiotemporal chaos exists until typically a collapse to the rest state.