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Braca S, Miele A, Stornaiuolo A, Cretella G, De Simone R, Russo CV. Are anti-calcitonin gene-related peptide monoclonal antibodies effective in treating migraine aura? A pilot prospective observational cohort study. Neurol Sci 2024; 45:1655-1660. [PMID: 38091211 DOI: 10.1007/s10072-023-07241-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 11/28/2023] [Indexed: 03/16/2024]
Abstract
BACKGROUND About 15% to one third of migraineurs experience aura symptoms. Aura is a reversible focal neurological phenomenon involving visual, sensory, speech, and motor symptoms that usually precede migraine pain. Monoclonal antibodies against calcitonin-related peptide (anti- CGRP mAbs) are effective in preventing chronic and episodic migraine, but little is known about their effectiveness on specifically preventing migraine with aura. METHODS This is a pilot prospective observational cohort study, aiming at evaluating the effectiveness and safety of Erenumab, Fremanezumab or Galcanezumab for the treatment of migraine aura. We enrolled 14 patients at the Headache Centre of University Federico II of Naples. Duration of follow-up was 12 months. We assessed mean monthly days with aura symptoms, with or without subsequent headache, as well as mean monthly days with headache and mean monthly MIDAS score, by reviewing standardized paper patient headache diaries every three months. RESULTS A significant decrease in mean monthly aura days was observed throughout the observation period (median baseline: 13, interquartile range: 4-16; after 12 months: 1, interquartile range: 0-3, p < 0.001). We observed a statistically significant decrease in mean monthly headache days as well (median baseline 21, interquartile range: 16-30; after 12 months: 5, interquartile range: 4-7, p < 0.001). During the 12-month treatment period, none of the 14 patients reported mild or serious adverse events. CONCLUSION Our findings suggest that anti-CGRP mAbs are highly effective in migraine with aura, both in reducing mean monthly aura days and mean monthly days with headache.
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Affiliation(s)
- Simone Braca
- Department of Neurological Sciences, Reproductive and Odontostomatological Sciences, University Federico II, Naples, Italy
| | - Angelo Miele
- Department of Neurological Sciences, Reproductive and Odontostomatological Sciences, University Federico II, Naples, Italy
| | - Antonio Stornaiuolo
- Department of Neurological Sciences, Reproductive and Odontostomatological Sciences, University Federico II, Naples, Italy
| | - Gennaro Cretella
- Department of Neurological Sciences, Reproductive and Odontostomatological Sciences, University Federico II, Naples, Italy
| | - Roberto De Simone
- Department of Neurological Sciences, Reproductive and Odontostomatological Sciences, University Federico II, Naples, Italy
| | - Cinzia Valeria Russo
- Department of Neurological Sciences, Reproductive and Odontostomatological Sciences, University Federico II, Naples, Italy.
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2
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Xiao C, Sun Y, Huang H, Yue X, Song Z, David T, Xu S. Cellular communication among smooth muscle cells: The role of membrane potential via connexins. J Theor Biol 2024; 576:111627. [PMID: 37977477 DOI: 10.1016/j.jtbi.2023.111627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 09/16/2023] [Accepted: 09/25/2023] [Indexed: 11/19/2023]
Abstract
Communication via action potentials among neurons has been extensively studied. However, effective communication without action potentials is ubiquitous in biological systems, yet it has received much less attention in comparison. Multi-cellular communication among smooth muscles is crucial for regulating blood flow, for example. Understanding the mechanism of this non-action potential communication is critical in many cases, like synchronization of cellular activity, under normal and pathological conditions. In this paper, we employ a multi-scale asymptotic method to derive a macroscopic homogenized bidomain model from the microscopic electro-neutral (EN) model. This is achieved by considering different diffusion coefficients and incorporating nonlinear interface conditions. Subsequently, the homogenized macroscopic model is used to investigate communication in multi-cellular tissues. Our computational simulations reveal that the membrane potential of syncytia, formed by interconnected cells via connexins, plays a crucial role in propagating oscillations from one region to another, providing an effective means for fast cellular communication. Statement of Significance: In this study, we investigated cellular communication and ion transport in vascular smooth muscle cells, shedding light on their mechanisms under normal and abnormal conditions. Our research highlights the potential of mathematical models in understanding complex biological systems. We developed effective macroscale electro-neutral bi-domain ion transport models and examined their behavior in response to different stimuli. Our findings revealed the crucial role of connexinmediated membrane potential changes and demonstrated the effectiveness of cellular communication through syncytium membranes. Despite some limitations, our study provides valuable insights into these processes and emphasizes the importance of mathematical modeling in unraveling the complexities of cellular communication and ion transport.
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Affiliation(s)
- Chun Xiao
- School of Mathematics and Statistics, Lingnan Normal University, Zhanjiang, 524048, China.
| | - Yishui Sun
- Department of Applied Mathematics and Theoretical Physics, University of Cambridge, Cambridge CB3 0WA, United Kingdom.
| | - Huaxiong Huang
- Research Center for Mathematics, Advanced Institute of Natural Sciences, Beijing Normal University, Zhuhai, Guangdong, 519088, China; Guangdong Provincial Key Laboratory of Interdisciplinary Research and Application for Data Science, BNU-HKBU United International College, Zhuhai, Guangdong, 519088, China; Laboratory of Mathematics and Complex Systems, MOE, Beijing Normal University, 100875, Beijing, China; Department of Mathematics and Statistics York University, Toronto, ON, M3J 1P3, Canada.
| | - Xingye Yue
- School of Mathematical Sciences, Soochow University, Suzhou 215006, China.
| | - Zilong Song
- Math and Statistics Department, Utah State University, Old Main Hill, Logan , UT 84322, USA.
| | - Tim David
- Department of Mechanical Engineering, College of Engineering, University of Canterbury, Private Bag 4800, Christchurch, 8041, New Zealand.
| | - Shixin Xu
- Zu Chongzhi Center for Mathematics and Computational Sciences (CMCS), Duke Kunshan University, Kunshan, 215316, China.
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3
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McPherson JI, Nazir MSZ, Willer BS, Leddy JJ, Haider MN. Does Physiologic Post-Concussion Disorder Cause Persistent Post-Traumatic Headache? Curr Pain Headache Rep 2023; 27:793-799. [PMID: 37831366 DOI: 10.1007/s11916-023-01176-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/27/2023] [Indexed: 10/14/2023]
Abstract
PURPOSE OF REVIEW One system classifies patients with symptoms after concussion into physiologic, vestibulo-ocular, cervicogenic, and mood/cognition post-concussion disorders (PCD) based upon the preponderance of specific symptoms and physical impairments. This review discusses physiologic PCD and its potential relationship to the development of persistent post-traumatic headaches (PPTH). RECENT FINDINGS Headache is the most reported symptom after a concussion. Headaches in physiologic PCD are suspected to be due to abnormal cellular metabolism, subclinical neuroinflammation, and dysfunction of the autonomic nervous system (ANS). These abnormalities have been linked to the development of migraine-like and neuralgia-related PPTH. Physiologic PCD is a potential cause of PPTH after a concussion. Future research should focus on how to prevent PPTH in patients with physiologic PCD.
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Affiliation(s)
- Jacob I McPherson
- Department of Rehabilitation Science, School of Public Health and Health Professions, State University of New York at Buffalo, 534 Kimball Tower, Buffalo, NY, 14214, USA.
| | - Muhammad S Z Nazir
- Concussion Management Clinic and Research Center, UBMD Orthopedics and Sports Medicine, State University of New York at Buffalo, Buffalo, NY, 14214, USA
| | - Barry S Willer
- Department of Psychiatry, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY, 14215, USA
| | - John J Leddy
- Department of Orthopedics, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY, 14215, USA
| | - Mohammad N Haider
- Department of Orthopedics, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY, 14215, USA
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4
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Staehr C, Aalkjaer C, Matchkov V. The vascular Na,K-ATPase: clinical implications in stroke, migraine, and hypertension. Clin Sci (Lond) 2023; 137:1595-1618. [PMID: 37877226 PMCID: PMC10600256 DOI: 10.1042/cs20220796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 10/05/2023] [Accepted: 10/09/2023] [Indexed: 10/26/2023]
Abstract
In the vascular wall, the Na,K-ATPase plays an important role in the control of arterial tone. Through cSrc signaling, it contributes to the modulation of Ca2+ sensitivity in vascular smooth muscle cells. This review focuses on the potential implication of Na,K-ATPase-dependent intracellular signaling pathways in severe vascular disorders; ischemic stroke, familial migraine, and arterial hypertension. We propose similarity in the detrimental Na,K-ATPase-dependent signaling seen in these pathological conditions. The review includes a retrospective proteomics analysis investigating temporal changes after ischemic stroke. The analysis revealed that the expression of Na,K-ATPase α isoforms is down-regulated in the days and weeks following reperfusion, while downstream Na,K-ATPase-dependent cSrc kinase is up-regulated. These results are important since previous studies have linked the Na,K-ATPase-dependent cSrc signaling to futile recanalization and vasospasm after stroke. The review also explores a link between the Na,K-ATPase and migraine with aura, as reduced expression or pharmacological inhibition of the Na,K-ATPase leads to cSrc kinase signaling up-regulation and cerebral hypoperfusion. The review discusses the role of an endogenous cardiotonic steroid-like compound, ouabain, which binds to the Na,K-ATPase and initiates the intracellular cSrc signaling, in the pathophysiology of arterial hypertension. Currently, our understanding of the precise control mechanisms governing the Na,K-ATPase/cSrc kinase regulation in the vascular wall is limited. Understanding the role of vascular Na,K-ATPase signaling is essential for developing targeted treatments for cerebrovascular disorders and hypertension, as the Na,K-ATPase is implicated in the pathogenesis of these conditions and may contribute to their comorbidity.
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Affiliation(s)
- Christian Staehr
- Department of Biomedicine, Aarhus University, Høegh-Guldbergsgade 10, 8000 Aarhus, Denmark
- Department of Renal Medicine, Aarhus University Hospital, Palle Juul-Jensens Boulevard 35, Aarhus, Denmark
| | - Christian Aalkjaer
- Department of Biomedicine, Aarhus University, Høegh-Guldbergsgade 10, 8000 Aarhus, Denmark
- Danish Cardiovascular Academy, Høegh-Guldbergsgade 10, 8000 Aarhus, Denmark
| | - Vladimir V. Matchkov
- Department of Biomedicine, Aarhus University, Høegh-Guldbergsgade 10, 8000 Aarhus, Denmark
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Bastany ZJR, Askari S, Gorji A, Dumont GA. Detection of spreading depression features from the scalp of epileptic patients. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2023; 2023:1-4. [PMID: 38082623 DOI: 10.1109/embc40787.2023.10341160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
Spreading depression (SD), a pathological cortical negative DC potential, is caused by an elevation of potassium ions in the extracellular space. This leads to a transient relocation of ions within neurons and a slow spread through brain tissue. Our previous research established a correlation between scalp SD and seizures in patients with intractable epilepsy using our novel electroencephalography (EEG). In this study, we enhanced our EEG system by incorporating a Near-infrared spectroscopy (NIRS) module for multi-modal EEG-NIRS measurements. The aim is to provide an investigation into the defining characteristics and methods for detecting SD.Clinical Relevance-: The detection of SD serves as a novel biomarker for epilepsy, capable of forewarning seizures within a time range from 10 secs to 30 min. This detection plays a crucial role in predicting and preventing seizures and providing diagnostic information for drug-resistant epilepsy patients.
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Kentar M, Ramirez-Cuapio FL, Gutiérrez-Herrera MA, Sanchez-Porras R, Díaz-Peregrino R, Holzwarth N, Maier-Hein L, Woitzik J, Santos E. Mild hypothermia reduces spreading depolarizations and infarct size in a swine model. J Cereb Blood Flow Metab 2023; 43:999-1009. [PMID: 36722153 PMCID: PMC10196741 DOI: 10.1177/0271678x231154604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 12/06/2022] [Accepted: 12/15/2022] [Indexed: 02/02/2023]
Abstract
Spreading depolarizations (SDs) have been linked to infarct volume expansion following ischemic stroke. Therapeutic hypothermia provides a neuroprotective effect after ischemic stroke. This study aimed to evaluate the effect of hypothermia on the propagation of SDs and infarct volume in an ischemic swine model. Through left orbital exenteration, middle cerebral arteries were surgically occluded (MCAo) in 16 swine. Extensive craniotomy and durotomy were performed. Six hypothermic and five normothermic animals were included in the analysis. An intracranial temperature probe was placed right frontal subdural. One hour after ischemic onset, mild hypothermia was induced and eighteen hours of electrocorticographic (ECoG) and intrinsic optical signal (IOS) recordings were acquired. Postmortem, 4 mm-thick slices were stained with 2,3,5-triphenyltetrazolium chloride to estimate the infarct volume. Compared to normothermia (36.4 ± 0.4°C), hypothermia (32.3 ± 0.2°C) significantly reduced the frequency and expansion of SDs (ECoG: 3.5 ± 2.1, 73.2 ± 5.2% vs. 1.0 ± 0.7, 41.9 ± 21.8%; IOS 3.9 ± 0.4, 87.6 ± 12.0% vs. 1.4 ± 0.7, 67.7 ± 8.3%, respectively). Further, infarct volume among hypothermic animals (23.2 ± 1.8% vs. 32.4 ± 2.5%) was significantly reduced. Therapeutic hypothermia reduces infarct volume and the frequency and expansion of SDs following cerebral ischemia.
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Affiliation(s)
- Modar Kentar
- Department of Neurosurgery,
University of Heidelberg, Heidelberg, Germany
| | | | | | - Renan Sanchez-Porras
- Department of Neurosurgery,
Evangelisches Krankenhaus Oldenburg, Carl von Ossietzky University of Oldenburg,
Oldenburg, Germany
| | | | - Niklas Holzwarth
- Division of Intelligent Medical
Systems, German Cancer Research Center, Heidelberg, Germany
| | - Lena Maier-Hein
- Division of Intelligent Medical
Systems, German Cancer Research Center, Heidelberg, Germany
| | - Johannes Woitzik
- Department of Neurosurgery,
Evangelisches Krankenhaus Oldenburg, Carl von Ossietzky University of Oldenburg,
Oldenburg, Germany
| | - Edgar Santos
- Department of Neurosurgery,
University of Heidelberg, Heidelberg, Germany
- Department of Neurosurgery,
Evangelisches Krankenhaus Oldenburg, Carl von Ossietzky University of Oldenburg,
Oldenburg, Germany
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7
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Bastany ZJR, Askari S, Dumont GA, Kellinghaus C, Askari B, Gharagozli K, Gorji A. Concurrent recordings of slow DC-potentials and epileptiform discharges: novel EEG amplifier and signal processing techniques. J Neurosci Methods 2023:109894. [PMID: 37245651 DOI: 10.1016/j.jneumeth.2023.109894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 05/15/2023] [Accepted: 05/19/2023] [Indexed: 05/30/2023]
Abstract
Ionic currents within the brain generate voltage oscillations consist of slow and rapid fluctuations. These bioelectrical activities include ultra-low frequency electroencephalograms (DC-EEG, frequency less than 0.1Hz) and conventional clinical electroencephalograms (AC-EEG, 0.5 to 70Hz). Although AC-EEG is commonly used for diagnosing epilepsy, recent studies indicate that DC-EEG is an essential frequency component of EEG and can provide valuable information for analyzing epileptiform discharges. During conventional EEG recordings, DC-EEG is censored by applying high-pass filtering to i) obliterate slow-wave artifacts, ii) eliminate the bioelectrodes' half-cell potential asymmetrical changes in ultralow-low frequency, and iii) prevent instrument saturation. Spreading depression (SD), which is the most prolonged fluctuation in DC-EEG, may be associated with epileptiform discharges. However, recording of SD signals from the scalp's surface can be challenging due to the filtering effect and non-neuronal slow shift potentials. In this study, we describe a novel technique to extend the frequency bandwidth of surface EEG to record SD signals. The method includes novel instrumentation, appropriate bioelectrodes, and efficient signal-processing techniques. To evaluate the accuracy of our approach, we performed a simultaneous surface recording of DC- and AC-EEG from epileptic patients during long-term video EEG monitoring, which provide a promising tool for diagnosis of epilepsy. DATA AVAILABILITY STATEMENT: The data presented in this study are available on request.
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Affiliation(s)
- Zoya J R Bastany
- Electrical and Computer Engineering Department, The University of British Columbia, Vancouver, Canada; BC Children's Hospital Research Institute, Vancouver, Canada
| | - Shahbaz Askari
- Electrical and Computer Engineering Department, The University of British Columbia, Vancouver, Canada; BC Children's Hospital Research Institute, Vancouver, Canada
| | - Guy A Dumont
- Electrical and Computer Engineering Department, The University of British Columbia, Vancouver, Canada; BC Children's Hospital Research Institute, Vancouver, Canada
| | | | - Baran Askari
- Shefa Neuroscience Research Center, Khatam Alanbia Hospital, Tehran, Iran
| | - Kurosh Gharagozli
- Epilepsy Research Center, Loghman hospital, Department of Neurology, Shahid Beheshti University of Medical Science, Tehran, Iran
| | - Ali Gorji
- Electrical and Computer Engineering Department, The University of British Columbia, Vancouver, Canada; Neuroscience Research Center, Mashhad University of Medical Sciences, Mashhad, Iran; Department of Neurosurgery, Westfälische Wilhelms-Universität Münster, Germany; Epilepsy Research Center, Westfälische Wilhelms-Universität Münster, Germany.
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Bauer J, Devinsky O, Rothermel M, Koch H. Autonomic dysfunction in epilepsy mouse models with implications for SUDEP research. Front Neurol 2023; 13:1040648. [PMID: 36686527 PMCID: PMC9853197 DOI: 10.3389/fneur.2022.1040648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 12/12/2022] [Indexed: 01/09/2023] Open
Abstract
Epilepsy has a high prevalence and can severely impair quality of life and increase the risk of premature death. Sudden unexpected death in epilepsy (SUDEP) is the leading cause of death in drug-resistant epilepsy and most often results from respiratory and cardiac impairments due to brainstem dysfunction. Epileptic activity can spread widely, influencing neuronal activity in regions outside the epileptic network. The brainstem controls cardiorespiratory activity and arousal and reciprocally connects to cortical, diencephalic, and spinal cord areas. Epileptic activity can propagate trans-synaptically or via spreading depression (SD) to alter brainstem functions and cause cardiorespiratory dysfunction. The mechanisms by which seizures propagate to or otherwise impair brainstem function and trigger the cascading effects that cause SUDEP are poorly understood. We review insights from mouse models combined with new techniques to understand the pathophysiology of epilepsy and SUDEP. These techniques include in vivo, ex vivo, invasive and non-invasive methods in anesthetized and awake mice. Optogenetics combined with electrophysiological and optical manipulation and recording methods offer unique opportunities to study neuronal mechanisms under normal conditions, during and after non-fatal seizures, and in SUDEP. These combined approaches can advance our understanding of brainstem pathophysiology associated with seizures and SUDEP and may suggest strategies to prevent SUDEP.
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Affiliation(s)
- Jennifer Bauer
- Department of Epileptology and Neurology, RWTH Aachen University, Aachen, Germany,Institute for Physiology and Cell Biology, University of Veterinary Medicine Hannover, Foundation, Hannover, Germany
| | - Orrin Devinsky
- Departments of Neurology, Neurosurgery and Psychiatry, NYU Langone School of Medicine, New York, NY, United States
| | - Markus Rothermel
- Institute for Physiology and Cell Biology, University of Veterinary Medicine Hannover, Foundation, Hannover, Germany
| | - Henner Koch
- Department of Epileptology and Neurology, RWTH Aachen University, Aachen, Germany,*Correspondence: Henner Koch ✉
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Mulkey DK, Milla BM. Perspectives on the basis of seizure-induced respiratory dysfunction. Front Neural Circuits 2022; 16:1033756. [PMID: 36605420 PMCID: PMC9807672 DOI: 10.3389/fncir.2022.1033756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 11/28/2022] [Indexed: 12/24/2022] Open
Abstract
Epilepsy is an umbrella term used to define a wide variety of seizure disorders and sudden unexpected death in epilepsy (SUDEP) is the leading cause of death in epilepsy. Although some SUDEP risk factors have been identified, it remains largely unpredictable, and underlying mechanisms remain poorly understood. Most seizures start in the cortex, but the high mortality rate associated with certain types of epilepsy indicates brainstem involvement. Therefore, to help understand SUDEP we discuss mechanisms by which seizure activity propagates to the brainstem. Specifically, we highlight clinical and pre-clinical evidence suggesting how seizure activation of: (i) descending inhibitory drive or (ii) spreading depolarization might contribute to brainstem dysfunction. Furthermore, since epilepsy is a highly heterogenous disorder, we also considered factors expected to favor or oppose mechanisms of seizure propagation. We also consider whether epilepsy-associated genetic variants directly impact brainstem function. Because respiratory failure is a leading cause of SUDEP, our discussion of brainstem dysfunction focuses on respiratory control.
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Affiliation(s)
- Daniel K. Mulkey
- Department of Physiology and Neurobiology, University of Connecticut, Storrs, CT, United States
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Russo M, De Rosa MA, Calisi D, Consoli S, Evangelista G, Dono F, Santilli M, Granzotto A, Onofrj M, Sensi SL. Migraine Pharmacological Treatment and Cognitive Impairment: Risks and Benefits. Int J Mol Sci 2022; 23:ijms231911418. [PMID: 36232720 PMCID: PMC9569564 DOI: 10.3390/ijms231911418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 09/19/2022] [Accepted: 09/20/2022] [Indexed: 11/23/2022] Open
Abstract
Migraine is a common neurological disorder impairing the quality of life of patients. The condition requires, as an acute or prophylactic line of intervention, the frequent use of drugs acting on the central nervous system (CNS). The long-term impact of these medications on cognition and neurodegeneration has never been consistently assessed. The paper reviews pharmacological migraine treatments and discusses their biological and clinical effects on the CNS. The different anti-migraine drugs show distinct profiles concerning neurodegeneration and the risk of cognitive deficits. These features should be carefully evaluated when prescribing a pharmacological treatment as many migraineurs are of scholar or working age and their performances may be affected by drug misuse. Thus, a reconsideration of therapy guidelines is warranted. Furthermore, since conflicting results have emerged in the relationship between migraine and dementia, future studies must consider present and past pharmacological regimens as potential confounding factors.
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Affiliation(s)
- Mirella Russo
- Department of Neurosciences, Imaging and Clinical Sciences, “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy
- CAST—Center for Advanced Studies and Technology, “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy
| | - Matteo A. De Rosa
- Department of Neurosciences, Imaging and Clinical Sciences, “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy
| | - Dario Calisi
- Department of Neurosciences, Imaging and Clinical Sciences, “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy
| | - Stefano Consoli
- Department of Neurosciences, Imaging and Clinical Sciences, “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy
| | - Giacomo Evangelista
- Department of Neurosciences, Imaging and Clinical Sciences, “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy
| | - Fedele Dono
- Department of Neurosciences, Imaging and Clinical Sciences, “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy
- CAST—Center for Advanced Studies and Technology, “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy
| | - Matteo Santilli
- Department of Neurosciences, Imaging and Clinical Sciences, “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy
| | - Alberto Granzotto
- Department of Neurosciences, Imaging and Clinical Sciences, “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy
- CAST—Center for Advanced Studies and Technology, “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy
| | - Marco Onofrj
- Department of Neurosciences, Imaging and Clinical Sciences, “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy
- CAST—Center for Advanced Studies and Technology, “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy
| | - Stefano L. Sensi
- Department of Neurosciences, Imaging and Clinical Sciences, “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy
- CAST—Center for Advanced Studies and Technology, “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy
- Institute for Mind Impairments and Neurological Disorders-iMIND, University of California, Irvine, Irvine, CA 92697, USA
- ITAB—Institute of Advanced Biomedical Technology, “G. d’Annunzio” University of Chieti-Pescara, 66100 Chieti, Italy
- Correspondence:
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11
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Granelli R, Alessandri I, Gkoupidenis P, Vassalini I, Kovács-Vajna ZM, Blom PWM, Torricelli F. High-Performance Bioelectronic Circuits Integrated on Biodegradable and Compostable Substrates with Fully Printed Mask-Less Organic Electrochemical Transistors. SMALL (WEINHEIM AN DER BERGSTRASSE, GERMANY) 2022; 18:e2108077. [PMID: 35642950 DOI: 10.1002/smll.202108077] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 03/31/2022] [Indexed: 06/15/2023]
Abstract
Organic electrochemical transistors (OECTs) rely on volumetric ion-modulation of the electronic current to provide low-voltage operation, large signal amplification, enhanced sensing capabilities, and seamless integration with biology. The majority of current OECT technologies require multistep photolithographic microfabrication methods on glass or plastic substrates, which do not provide an ideal path toward ultralow cost ubiquitous and sustainable electronics and bioelectronics. At the same time, the development of advanced bioelectronic circuits combining bio-detection, amplification, and local processing functionalities urgently demand for OECT technology platforms with a monolithic integration of high-performance iontronic circuits and sensors. Here, fully printed mask-less OECTs fabricated on thin-film biodegradable and compostable substrates are proposed. The dispensing and capillary printing methods are used for depositing both high- and low-viscosity OECT materials. Fully printed OECT unipolar inverter circuits with a gain normalized to the supply voltage as high as 136.6 V-1 , and current-driven sensors for ion detection and real-time monitoring with a sensitivity of up to 506 mV dec-1 , are integrated on biodegradable and compostable substrates. These universal building blocks with the top-performance ever reported demonstrate the effectiveness of the proposed approach and can open opportunities for next-generation high-performance sustainable bioelectronics.
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Affiliation(s)
- Roberto Granelli
- Department of Information Engineering, University of Brescia, via Branze 38, Brescia, 25123, Italy
| | - Ivano Alessandri
- Department of Information Engineering, University of Brescia, via Branze 38, Brescia, 25123, Italy
| | | | - Irene Vassalini
- Department of Information Engineering, University of Brescia, via Branze 38, Brescia, 25123, Italy
| | - Zsolt M Kovács-Vajna
- Department of Information Engineering, University of Brescia, via Branze 38, Brescia, 25123, Italy
| | - Paul W M Blom
- Max Planck Institute for Polymer Research, Ackermannweg 10, 55128, Mainz, Germany
| | - Fabrizio Torricelli
- Department of Information Engineering, University of Brescia, via Branze 38, Brescia, 25123, Italy
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12
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GABA A Receptor-Stabilizing Protein Ubqln1 Affects Hyperexcitability and Epileptogenesis after Traumatic Brain Injury and in a Model of In Vitro Epilepsy in Mice. Int J Mol Sci 2022; 23:ijms23073902. [PMID: 35409261 PMCID: PMC8999075 DOI: 10.3390/ijms23073902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 03/23/2022] [Accepted: 03/30/2022] [Indexed: 11/16/2022] Open
Abstract
Posttraumatic epilepsy (PTE) is a major public health concern and strongly contributes to human epilepsy cases worldwide. However, an effective treatment and prevention remains a matter of intense research. The present study provides new insights into the gamma aminobutyric acid A (GABAA)-stabilizing protein ubiquilin-1 (ubqln1) and its regulation in mouse models of traumatic brain injury (TBI) and in vitro epilepsy. We performed label-free quantification on isolated cortical GABAergic interneurons from GAD67-GFP mice that received unilateral TBI and discovered reduced expression of ubqln1 24 h post-TBI. To investigate the link between this regulation and the development of epileptiform activity, we further studied ubqln1 expression in hippocampal and cortical slices. Epileptiform events were evoked pharmacologically in acute brain slices by administration of picrotoxin (PTX, 50 μM) and kainic acid (KA, 500 nM) and recorded in the hippocampal CA1 subfield using Multi-electrode Arrays (MEA). Interestingly, quantitative Western blots revealed significant decreases in ubqln1 expression 1–7 h after seizure induction that could be restored by application of the non-selective monoamine oxidase inhibitor nialamide (NM, 10 μM). In picrotoxin-dependent dose–response relationships, NM administration alleviated the frequency and peak amplitude of seizure-like events (SLEs). These findings indicate a role of the monoamine transmitter systems and ubqln1 for cortical network activity during posttraumatic epileptogenesis.
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13
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Validating a Computational Framework for Ionic Electrodiffusion with Cortical Spreading Depression as a Case Study. eNeuro 2022; 9:ENEURO.0408-21.2022. [PMID: 35365505 PMCID: PMC9045477 DOI: 10.1523/eneuro.0408-21.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 02/21/2022] [Accepted: 03/12/2022] [Indexed: 11/21/2022] Open
Abstract
Cortical spreading depression (CSD) is a wave of pronounced depolarization of brain tissue accompanied by substantial shifts in ionic concentrations and cellular swelling. Here, we validate a computational framework for modeling electrical potentials, ionic movement, and cellular swelling in brain tissue during CSD. We consider different model variations representing wild-type (WT) or knock-out/knock-down mice and systematically compare the numerical results with reports from a selection of experimental studies. We find that the data for several CSD hallmarks obtained computationally, including wave propagation speed, direct current shift duration, peak in extracellular K+ concentration as well as a pronounced shrinkage of extracellular space (ECS) are well in line with what has previously been observed experimentally. Further, we assess how key model parameters including cellular diffusivity, structural ratios, membrane water and/or K+ permeabilities affect the set of CSD characteristics.
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14
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Mathew AA, Panonnummal R. Cortical spreading depression: culprits and mechanisms. Exp Brain Res 2022; 240:733-749. [DOI: 10.1007/s00221-022-06307-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 01/06/2022] [Indexed: 02/14/2023]
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15
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Larner A. Transient global amnesia: model, mechanism, hypothesis. Cortex 2022; 149:137-147. [DOI: 10.1016/j.cortex.2022.01.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Revised: 11/13/2021] [Accepted: 01/19/2022] [Indexed: 01/03/2023]
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16
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Larner A. Migralepsy explained … perhaps‽. ADVANCES IN CLINICAL NEUROSCIENCE & REHABILITATION 2021. [DOI: 10.47795/ytqd4039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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17
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Malchow RP, Tchernookova BK, Choi JIV, Smith PJS, Kramer RH, Kreitzer MA. Review and Hypothesis: A Potential Common Link Between Glial Cells, Calcium Changes, Modulation of Synaptic Transmission, Spreading Depression, Migraine, and Epilepsy-H . Front Cell Neurosci 2021; 15:693095. [PMID: 34539347 PMCID: PMC8446203 DOI: 10.3389/fncel.2021.693095] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 06/25/2021] [Indexed: 01/03/2023] Open
Abstract
There is significant evidence to support the notion that glial cells can modulate the strength of synaptic connections between nerve cells, and it has further been suggested that alterations in intracellular calcium are likely to play a key role in this process. However, the molecular mechanism(s) by which glial cells modulate neuronal signaling remains contentiously debated. Recent experiments have suggested that alterations in extracellular H+ efflux initiated by extracellular ATP may play a key role in the modulation of synaptic strength by radial glial cells in the retina and astrocytes throughout the brain. ATP-elicited alterations in H+ flux from radial glial cells were first detected from Müller cells enzymatically dissociated from the retina of tiger salamander using self-referencing H+-selective microelectrodes. The ATP-elicited alteration in H+ efflux was further found to be highly evolutionarily conserved, extending to Müller cells isolated from species as diverse as lamprey, skate, rat, mouse, monkey and human. More recently, self-referencing H+-selective electrodes have been used to detect ATP-elicited alterations in H+ efflux around individual mammalian astrocytes from the cortex and hippocampus. Tied to increases in intracellular calcium, these ATP-induced extracellular acidifications are well-positioned to be key mediators of synaptic modulation. In this article, we examine the evidence supporting H+ as a key modulator of neurotransmission, review data showing that extracellular ATP elicits an increase in H+ efflux from glial cells, and describe the potential signal transduction pathways involved in glial cell-mediated H+ efflux. We then examine the potential role that extracellular H+ released by glia might play in regulating synaptic transmission within the vertebrate retina, and then expand the focus to discuss potential roles in spreading depression, migraine, epilepsy, and alterations in brain rhythms, and suggest that alterations in extracellular H+ may be a unifying feature linking these disparate phenomena.
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Affiliation(s)
- Robert Paul Malchow
- Department of Biological Sciences, University of Illinois at Chicago, Chicago, IL, United States
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, IL, United States
| | - Boriana K. Tchernookova
- Department of Biological Sciences, University of Illinois at Chicago, Chicago, IL, United States
| | - Ji-in Vivien Choi
- Department of Biological Sciences, University of Illinois at Chicago, Chicago, IL, United States
- Stritch School of Medicine, Loyola University, Maywood, IL, United States
| | - Peter J. S. Smith
- Institute for Life Sciences, University of Southampton, Highfield Campus, Southampton, United Kingdom
- Bell Center, Marine Biological Laboratory, Woods Hole, MA, United States
| | - Richard H. Kramer
- Department of Molecular and Cell Biology, University of California, Berkeley, Berkeley, CA, United States
| | - Matthew A. Kreitzer
- Department of Biology, Indiana Wesleyan University, Marion, IN, United States
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18
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Dodd WS, Laurent D, Dumont AS, Hasan DM, Jabbour PM, Starke RM, Hosaka K, Polifka AJ, Hoh BL, Chalouhi N. Pathophysiology of Delayed Cerebral Ischemia After Subarachnoid Hemorrhage: A Review. J Am Heart Assoc 2021; 10:e021845. [PMID: 34325514 PMCID: PMC8475656 DOI: 10.1161/jaha.121.021845] [Citation(s) in RCA: 92] [Impact Index Per Article: 30.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 06/09/2021] [Indexed: 01/23/2023]
Abstract
Delayed cerebral ischemia is a major predictor of poor outcomes in patients who suffer subarachnoid hemorrhage. Treatment options are limited and often ineffective despite many years of investigation and clinical trials. Modern advances in basic science have produced a much more complex, multifactorial framework in which delayed cerebral ischemia is better understood and novel treatments can be developed. Leveraging this knowledge to improve outcomes, however, depends on a holistic understanding of the disease process. We conducted a review of the literature to analyze the current state of investigation into delayed cerebral ischemia with emphasis on the major themes that have emerged over the past decades. Specifically, we discuss microcirculatory dysfunction, glymphatic impairment, inflammation, and neuroelectric disruption as pathological factors in addition to the canonical focus on cerebral vasospasm. This review intends to give clinicians and researchers a summary of the foundations of delayed cerebral ischemia pathophysiology while also underscoring the interactions and interdependencies between pathological factors. Through this overview, we also highlight the advances in translational studies and potential future therapeutic opportunities.
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Affiliation(s)
- William S. Dodd
- Department of NeurosurgeryCollege of MedicineUniversity of FloridaGainesvilleFL
| | - Dimitri Laurent
- Department of NeurosurgeryCollege of MedicineUniversity of FloridaGainesvilleFL
| | - Aaron S. Dumont
- Department of Neurological SurgerySchool of MedicineTulane UniversityNew OrleansLA
| | - David M. Hasan
- Department of NeurosurgeryCarver College of MedicineUniversity of IowaIowa CityIA
| | - Pascal M. Jabbour
- Department of Neurological SurgerySidney Kimmel Medical CollegeThomas Jefferson UniversityPhiladelphiaPA
| | - Robert M. Starke
- Department of Neurological SurgeryMiller School of MedicineUniversity of MiamiFL
| | - Koji Hosaka
- Department of NeurosurgeryCollege of MedicineUniversity of FloridaGainesvilleFL
| | - Adam J. Polifka
- Department of NeurosurgeryCollege of MedicineUniversity of FloridaGainesvilleFL
| | - Brian L. Hoh
- Department of NeurosurgeryCollege of MedicineUniversity of FloridaGainesvilleFL
| | - Nohra Chalouhi
- Department of NeurosurgeryCollege of MedicineUniversity of FloridaGainesvilleFL
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19
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Song JL, Kim JA, Struck AF, Zhang R, Westover MB. A model of metabolic supply-demand mismatch leading to secondary brain injury. J Neurophysiol 2021; 126:653-667. [PMID: 34232754 DOI: 10.1152/jn.00674.2020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Secondary brain injury (SBI) is defined as new or worsening injury to the brain after an initial neurologic insult, such as hemorrhage, trauma, ischemic stroke, or infection. It is a common and potentially preventable complication following many types of primary brain injury (PBI). However, mechanistic details about how PBI leads to additional brain injury and evolves into SBI are poorly characterized. In this work, we propose a mechanistic model for the metabolic supply demand mismatch hypothesis (MSDMH) of SBI. Our model, based on the Hodgkin-Huxley model, supplemented with additional dynamics for extracellular potassium, oxygen concentration, and excitotoxity, provides a high-level unified explanation for why patients with acute brain injury frequently develop SBI. We investigate how decreased oxygen, increased extracellular potassium, excitotoxicity, and seizures can induce SBI and suggest three underlying paths for how events following PBI may lead to SBI. The proposed model also helps explain several important empirical observations, including the common association of acute brain injury with seizures, the association of seizures with tissue hypoxia and so on. In contrast to current practices which assume that ischemia plays the predominant role in SBI, our model suggests that metabolic crisis involved in SBI can also be nonischemic. Our findings offer a more comprehensive understanding of the complex interrelationship among potassium, oxygen, excitotoxicity, seizures, and SBI.NEW & NOTEWORTHY We present a novel mechanistic model for the metabolic supply demand mismatch hypothesis (MSDMH), which attempts to explain why patients with acute brain injury frequently develop seizure activity and secondary brain injury (SBI). Specifically, we investigate how decreased oxygen, increased extracellular potassium, excitotoxicity, seizures, all common sequalae of primary brain injury (PBI), can induce SBI and suggest three underlying paths for how events following PBI may lead to SBI.
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Affiliation(s)
- Jiang-Ling Song
- The Medical Big Data Research Center, Northwest University, Xi'an, China.,Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Jennifer A Kim
- Department of Neurology, Yale New Haven Hospital, New Haven, Connecticut
| | - Aaron F Struck
- Departments of Neurology, University of Wisconsin-Madison, Madison, Wisconsin.,William S Middleton Veterans Administration Hospital, Madison, Wisconsin
| | - Rui Zhang
- The Medical Big Data Research Center, Northwest University, Xi'an, China
| | - M Brandon Westover
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
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20
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Simpson HD, Johnson E, Britton J, Braksick S. Alternating hemiparesis in the context of hemolytic uremic syndrome and COVID-19 positivity. Epilepsy Behav Rep 2021; 16:100468. [PMID: 34250459 PMCID: PMC8256673 DOI: 10.1016/j.ebr.2021.100468] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 06/29/2021] [Accepted: 06/30/2021] [Indexed: 11/24/2022] Open
Abstract
Hemiparesis has been reported in hemolytic uremic syndrome (HUS), however electrophysiological findings associated with this syndrome have not been well-characterized, and alternating hemiparesis presentations have not been reported. We present detailed electrophysiological and clinical findings in a case of alternating hemiparesis corresponding to alternating focal contralateral delta slowing on prolonged EEG monitoring in a case of HUS with COVID-19 positivity. A 24-year-old woman was admitted with bloody diarrhea, acute kidney injury, and focal seizures initially presumed due to Escherichia coli 0157:H7 Shiga-like toxin-related hemolytic uremic syndrome (ST-HUS). After admission, the patient tested positive for COVID-19. Continuous EEG monitoring revealed diffuse polymorphic delta slowing. Around 24 hours into the admission, the delta slowing became focal in the right hemisphere and was associated with a left hemiparesis. Around three days later, the clinical and EEG pattern reversed, showing left hemisphere slowing and an associated right hemiparesis. Additionally, 14 Hz positive spikes were observed throughout the recording period. Neuroimaging, including CT and MRI, was negative for acute ischemia throughout. The patient subsequently recovered over several days with no residual neurologic abnormalities.
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Affiliation(s)
| | - Erica Johnson
- Division of Critical Care and Hospital Neurology, Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | | | - Sherri Braksick
- Division of Critical Care and Hospital Neurology, Department of Neurology, Mayo Clinic, Rochester, MN, USA
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21
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Zimmerman B, Rypma B, Gratton G, Fabiani M. Age-related changes in cerebrovascular health and their effects on neural function and cognition: A comprehensive review. Psychophysiology 2021; 58:e13796. [PMID: 33728712 PMCID: PMC8244108 DOI: 10.1111/psyp.13796] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 01/11/2021] [Accepted: 02/08/2021] [Indexed: 12/11/2022]
Abstract
The process of aging includes changes in cellular biology that affect local interactions between cells and their environments and eventually propagate to systemic levels. In the brain, where neurons critically depend on an efficient and dynamic supply of oxygen and glucose, age-related changes in the complex interaction between the brain parenchyma and the cerebrovasculature have effects on health and functioning that negatively impact cognition and play a role in pathology. Thus, cerebrovascular health is considered one of the main mechanisms by which a healthy lifestyle, such as habitual cardiorespiratory exercise and a healthful diet, could lead to improved cognitive outcomes with aging. This review aims at detailing how the physiology of the cerebral vascular system changes with age and how these changes lead to differential trajectories of cognitive maintenance or decline. This provides a framework for generating specific mechanistic hypotheses about the efficacy of proposed interventions and lifestyle covariates that contribute to enhanced cognitive well-being. Finally, we discuss the methodological implications of age-related changes in the cerebral vasculature for human cognitive neuroscience research and propose directions for future experiments aimed at investigating age-related changes in the relationship between physiology and cognitive mechanisms.
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Affiliation(s)
- Benjamin Zimmerman
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Bart Rypma
- School of Behavioral and Brain Sciences, University of Texas at Dallas, Richardson, TX, USA
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Gabriele Gratton
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL, USA
- Department of Psychology, University of Illinois at Urbana-Champaign, Champaign, IL, USA
- Neuroscience Program, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Monica Fabiani
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL, USA
- Department of Psychology, University of Illinois at Urbana-Champaign, Champaign, IL, USA
- Neuroscience Program, University of Illinois at Urbana-Champaign, Champaign, IL, USA
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22
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Choi JIV, Tchernookova BK, Kumar W, Kiedrowski L, Goeke C, Guizzetti M, Larson J, Kreitzer MA, Malchow RP. Extracellular ATP-Induced Alterations in Extracellular H + Fluxes From Cultured Cortical and Hippocampal Astrocytes. Front Cell Neurosci 2021; 15:640217. [PMID: 33994945 PMCID: PMC8120152 DOI: 10.3389/fncel.2021.640217] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 03/19/2021] [Indexed: 12/18/2022] Open
Abstract
Small alterations in the level of extracellular H+ can profoundly alter neuronal activity throughout the nervous system. In this study, self-referencing H+-selective microelectrodes were used to examine extracellular H+ fluxes from individual astrocytes. Activation of astrocytes cultured from mouse hippocampus and rat cortex with extracellular ATP produced a pronounced increase in extracellular H+ flux. The ATP-elicited increase in H+ flux appeared to be independent of bicarbonate transport, as ATP increased H+ flux regardless of whether the primary extracellular pH buffer was 26 mM bicarbonate or 1 mM HEPES, and persisted when atmospheric levels of CO2 were replaced by oxygen. Adenosine failed to elicit any change in extracellular H+ fluxes, and ATP-mediated increases in H+ flux were inhibited by the P2 inhibitors suramin and PPADS suggesting direct activation of ATP receptors. Extracellular ATP also induced an intracellular rise in calcium in cultured astrocytes, and ATP-induced rises in both calcium and H+ efflux were significantly attenuated when calcium re-loading into the endoplasmic reticulum was inhibited by thapsigargin. Replacement of extracellular sodium with choline did not significantly reduce the size of the ATP-induced increases in H+ flux, and the increases in H+ flux were not significantly affected by addition of EIPA, suggesting little involvement of Na+/H+ exchangers in ATP-elicited increases in H+ flux. Given the high sensitivity of voltage-sensitive calcium channels on neurons to small changes in levels of free H+, we hypothesize that the ATP-mediated extrusion of H+ from astrocytes may play a key role in regulating signaling at synapses within the nervous system.
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Affiliation(s)
- Ji-In Vivien Choi
- Department of Biological Sciences, University of Illinois at Chicago, Chicago, IL, United States.,Stritch School of Medicine, Loyola University, Maywood, IL, United States
| | - Boriana K Tchernookova
- Department of Biological Sciences, University of Illinois at Chicago, Chicago, IL, United States
| | - Wasan Kumar
- Department of Biological Sciences, University of Illinois at Chicago, Chicago, IL, United States
| | - Lech Kiedrowski
- Department of Biological Sciences, University of Illinois at Chicago, Chicago, IL, United States.,Spot Cells LLC, Chicago, IL, United States
| | - Calla Goeke
- VA Portland Health Care System, Portland, OR, United States.,Department of Behavioral Neuroscience, Oregon Health & Science University, Portland, OR, United States
| | - Marina Guizzetti
- VA Portland Health Care System, Portland, OR, United States.,Department of Behavioral Neuroscience, Oregon Health & Science University, Portland, OR, United States
| | - John Larson
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, United States
| | - Matthew A Kreitzer
- Department of Biology, Indiana Wesleyan University, Marion, IN, United States
| | - Robert Paul Malchow
- Department of Biological Sciences, University of Illinois at Chicago, Chicago, IL, United States.,Department Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, IL, United States
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23
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Charbonnier G, Desilles JP, Escalard S, Maier B, Ciccio G, Smajda S, Fahed R, Delvoye F, Redjem H, Blanc R, Piotin M, Mazighi M. Timing and Spectrum of Neurological Complications After Flow Diverter Implantation for Intracranial Aneurysms. Front Neurol 2021; 12:590383. [PMID: 33959085 PMCID: PMC8093792 DOI: 10.3389/fneur.2021.590383] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Accepted: 03/17/2021] [Indexed: 11/17/2022] Open
Abstract
Background and Purpose: The aim of this study was to characterize neurological complications after flow diverter (FD) treatment on a long follow-up cohort and identify predictive factors associated with these complications. Methods: This study was conducted on a monocentric cohort of patients treated for intracranial aneurysms by FD. Results: Between September 2008 and July 2018, 413 patients were treated for 514 aneurysms: 18% of the patients presented with at least one neurological complication during a median follow-up of 446 days (IQR 186–1,210). Sixty-one patients presented with ischemic complications, 13 with hemorrhagic ones and 10 with compressive processes. Among 89 neurological complications 64.5% were peri-operative (occurring within the 30 days following the procedure) and 35.5% were delayed after 1 month. Conclusions: Overall, neurological complications after FD implantation were overrepresented by cerebrovascular ischemic events occurring during the peri-operative period, but also in a delayed manner after 1 year. Long-term follow-up is relevant after aneurysm intervention using FD.
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Affiliation(s)
| | | | - Simon Escalard
- Interventional Neuroradiology, Rothschild Foundation Hospital, Paris, France
| | - Benjamin Maier
- Interventional Neuroradiology, Rothschild Foundation Hospital, Paris, France
| | - Gabriele Ciccio
- Interventional Neuroradiology, Rothschild Foundation Hospital, Paris, France
| | - Stanislas Smajda
- Interventional Neuroradiology, Rothschild Foundation Hospital, Paris, France
| | - Robert Fahed
- Interventional Neuroradiology, Rothschild Foundation Hospital, Paris, France
| | - François Delvoye
- Interventional Neuroradiology, Rothschild Foundation Hospital, Paris, France
| | - Hocine Redjem
- Interventional Neuroradiology, Rothschild Foundation Hospital, Paris, France
| | - Raphaël Blanc
- Interventional Neuroradiology, Rothschild Foundation Hospital, Paris, France
| | - Michel Piotin
- Interventional Neuroradiology, Rothschild Foundation Hospital, Paris, France
| | - Mikael Mazighi
- Interventional Neuroradiology, Rothschild Foundation Hospital, Paris, France
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24
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Abstract
OBJECTIVES To discuss headache secondary to cerebrovascular disease. BACKGROUND Headache is an important symptom in cerebrovascular diseases. In some conditions, headache is the leading symptom. Migraine is associated with an increased risk of stroke. METHODS The authors undertook a literature search for the terms "headache" and "cerebrovascular diseases". RESULTS We report studies on headache in subarachnoidal hemorrhage, intracerebral hemorrhage, ischemic stroke, TIA, basilar artery thrombosis, cervical artery dissection, cerebellar stroke, arteritis and cerebral sinus venous thrombosis. In addition, we discuss migraine and stroke and thunderclap headache. CONCLUSIONS Headache is a leading symptom in many cerebrovascular diseases. Headache in combination with focal neurological deficits requires immediate diagnosis and treatment.
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Affiliation(s)
- John F Rothrock
- Department of Neurology, George Washington University School of Medicine, MFA Building, Department of Neurology, Washington, DC, USA
| | - Hans-Christoph Diener
- Institute for Medical Informatics, Biometry and Epidemiology, Medical Faculty of the University Duisburg-Essen, Essen, Germany
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25
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AlKhaja M, Alhowity I, Alotaibi F, Khoja A, Alsumaili M, Alsulami A, Baz S, AlKhateeb M, Abalkhail T. Lateralization value of peri-ictal headache in drug-resistant focal epilepsy. Epilepsy Behav 2021; 116:107712. [PMID: 33460988 DOI: 10.1016/j.yebeh.2020.107712] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 12/13/2020] [Accepted: 12/14/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To examine the lateralizing value of unilateral peri-ictal and interictal headaches in patients with drug-resistant focal epilepsy (DRFE). METHODS Four-hundred consecutive patients undergoing presurgical evaluation for DRFE were interviewed. Patients with headache were broadly divided into two groups: peri-ictal and interictal headache. The lateralizing value of unilateral headache was compared in each group between three diagnoses: temporal lobe epilepsy (TLE), extratemporal lobe epilepsy (ETLE), and temporal-plus epilepsy (TEMP+ epilepsy). RESULTS Out of 400 patients, 169 (42.25%) had headaches. Peri-ictal headaches were experienced in 106 patients (26.5%) and interictal headaches were experienced in 63 (15.75%). In the peri-ictal group, unilateral headaches were present in 48 out of 60 patients (80%) with TLE; they were ipsilateral to the seizure focus in 45 out of 48 patients (93.75%). Unilateral headaches in patients with ETLE were present in 20 out of 31 patients (64.5%) and were ipsilateral to the seizure focus in 14 out of 20 patients (70%). In patients with TEMP + epilepsy, unilateral peri-ictal headaches were present in 9 out of 15 patients (60%); they were ipsilateral to the seizure focus in all 9 patients (100%). In the interictal headache group, unilateral headaches were ipsilateral the seizure focus in 9 out of 10 patients (90%) with TLE and 5 out of 6 patients (83.3%) with ETLE. None of the TEMP + epilepsy patients had a unilateral interictal headache. CONCLUSION Headache is a frequently encountered symptom in patients with DRFE. When occurring in a unilateral fashion, it has a high lateralizing value in temporal and extratemporal lobe epilepsies. This has been demonstrated to be true for both peri-ictal and interictal headaches. In the vast majority of patients with DRFE, unilateral headache occurs ipsilateral to the seizure focus.
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Affiliation(s)
- Mohamed AlKhaja
- Department of Internal Medicine, King Hamad University Hospital, Busaiteen, Bahrain; Department of Neurosciences, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
| | - Ibrahim Alhowity
- Department of Neurosciences, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Fawaz Alotaibi
- Department of Neurosciences, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Abeer Khoja
- Department of Neurosciences, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia; Department of Medicine, King Abdulaziz University Hospital, Jeddah, Saudi Arabia.
| | - Mohammad Alsumaili
- Department of Neurosciences, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Ashwaq Alsulami
- Department of Neurosciences, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Salah Baz
- Department of Neurosciences, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
| | - Mashael AlKhateeb
- Department of Neurosciences, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
| | - Tariq Abalkhail
- Department of Neurosciences, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
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26
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ROCK inhibition reduces morphological and functional damage to rod synapses after retinal injury. Sci Rep 2021; 11:692. [PMID: 33436892 PMCID: PMC7804129 DOI: 10.1038/s41598-020-80267-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 12/16/2020] [Indexed: 01/29/2023] Open
Abstract
Retinal detachment (RD) causes damage, including disjunction, of the rod photoreceptor-bipolar synapse, which disrupts vision and may contribute to the poor visual recovery observed after retinal reattachment surgery. We created a model of iatrogenic RD in adult female pigs to study damage to the rod-bipolar synapse after injury and the ability of a highly specific Rho-kinase (ROCK) inhibitor to preserve synaptic structure and function. This model mimics procedures used in humans when viral vectors or cells are injected subretinally for treatment of retinal disease. Synaptic disjunction by retraction of rod spherules, quantified by image analysis of confocal sections, was present 2 h after detachment and remained 2 days later even though the retina had spontaneously reattached by then. Moreover, spherule retraction occurred in attached retina 1-2 cms from detached retina. Synaptic damage was significantly reduced by ROCK inhibition in detached retina whether injected subretinally or intravitreally. Dark-adapted full-field electroretinograms were recorded in reattached retinas to assess rod-specific function. Reduction in synaptic injury correlated with increases in rod-driven responses in drug-treated eyes. Thus, ROCK inhibition helps prevent synaptic damage and improves functional outcomes after retinal injury and may be a useful adjunctive treatment in iatrogenic RD and other retinal degenerative diseases.
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Sharma HS, Sahib S, Tian ZR, Muresanu DF, Nozari A, Castellani RJ, Lafuente JV, Wiklund L, Sharma A. Protein kinase inhibitors in traumatic brain injury and repair: New roles of nanomedicine. PROGRESS IN BRAIN RESEARCH 2020; 258:233-283. [PMID: 33223036 DOI: 10.1016/bs.pbr.2020.09.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Traumatic brain injury (TBI) causes physical injury to the cell membranes of neurons, glial and axons causing the release of several neurochemicals including glutamate and cytokines altering cell-signaling pathways. Upregulation of mitogen associated protein kinase (MAPK) and extracellular signal-regulated kinase (ERK) occurs that is largely responsible for cell death. The pharmacological blockade of these pathways results in cell survival. In this review role of several protein kinase inhibitors on TBI induced oxidative stress, blood-brain barrier breakdown, brain edema formation, and resulting brain pathology is discussed in the light of current literature.
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Affiliation(s)
- Hari Shanker Sharma
- International Experimental Central Nervous System Injury & Repair (IECNSIR), Department of Surgical Sciences, Anesthesiology & Intensive Care Medicine, Uppsala University Hospital, Uppsala University, Uppsala, Sweden.
| | - Seaab Sahib
- Department of Chemistry & Biochemistry, University of Arkansas, Fayetteville, AR, United States
| | - Z Ryan Tian
- Department of Chemistry & Biochemistry, University of Arkansas, Fayetteville, AR, United States
| | - Dafin F Muresanu
- Department of Clinical Neurosciences, University of Medicine & Pharmacy, Cluj-Napoca, Romania; "RoNeuro" Institute for Neurological Research and Diagnostic, Cluj-Napoca, Romania
| | - Ala Nozari
- Anesthesiology & Intensive Care, Massachusetts General Hospital, Boston, MA, United States
| | - Rudy J Castellani
- Department of Pathology, University of Maryland, Baltimore, MD, United States
| | - José Vicente Lafuente
- LaNCE, Department of Neuroscience, University of the Basque Country (UPV/EHU), Leioa, Bilbao, Spain
| | - Lars Wiklund
- International Experimental Central Nervous System Injury & Repair (IECNSIR), Department of Surgical Sciences, Anesthesiology & Intensive Care Medicine, Uppsala University Hospital, Uppsala University, Uppsala, Sweden
| | - Aruna Sharma
- International Experimental Central Nervous System Injury & Repair (IECNSIR), Department of Surgical Sciences, Anesthesiology & Intensive Care Medicine, Uppsala University Hospital, Uppsala University, Uppsala, Sweden
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Wanchoo S, Khazanehdari S, Patel A, Lin A, Rebeiz T, DeMatteo C, Ullman J, Ledoux D. Ketamine for empiric treatment of cortical spreading depolarization after subdural hematoma evacuation. Clin Neurol Neurosurg 2020; 200:106318. [PMID: 33268191 DOI: 10.1016/j.clineuro.2020.106318] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Revised: 10/10/2020] [Accepted: 10/13/2020] [Indexed: 01/18/2023]
Abstract
BACKGROUND It is widely known that some patients surgically treated for subdural hematoma (SDH) experience neurologic deficits not clearly explained by the acute brain injury or known sequelae like seizures. There is increasing evidence that cortical spreading depolarization (CSD) may be the cause. A recent article demonstrated that CSD occurred at a rate of 15 % and was associated with neurological deterioration in a subset of patients following chronic subdural hematoma evacuation. Furthermore, CSD can lead to ischemia leading to worsening neurologic deficits. CSD is usually detected on electrocorticography (ECoG) and needs cortical strip electrode placement with equipment and expertise that may not be readily available. CASE DESCRIPTION We report three cases of patients with subdural hematoma (SDH) not undergoing ECoG in whom CSD was suspected to be the cause of their neurologic deficits post evacuation. Extensive workup including neuroimaging and electroencephalography (EEG) were inconclusive. Patients were subsequently treated with ketamine infusion and had resultant neurological recovery. CONCLUSIONS Ketamine infusion can help reverse neurologic deficits in patients with SDH in whom the deficits are not explained by neuroimaging or electrographic seizure. CSD is a known phenomenon that can result in neurological injury and must remain in the differential diagnosis of such patients. Though only limited cases are discussed (n = 3), this small case series provides the basis for conducting clinical trials evaluating the efficacy of ketamine in improving functional outcome in brain-injured patients demonstrating evidence of CSD.
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Affiliation(s)
- Sheshali Wanchoo
- Department of Neurosurgery, Northwell Health, Manhasset, NY 11030, USA
| | | | - Arpan Patel
- Department of Neurology, Northwell Health, Manhasset, NY 11030, USA
| | - Amanda Lin
- Department of Pharmacy, Northwell Health, Manhasset, NY 11030, USA
| | - Tania Rebeiz
- Department of Neurosurgery, Northwell Health, Manhasset, NY 11030, USA
| | - Celine DeMatteo
- Department of Neurosurgery, Northwell Health, Manhasset, NY 11030, USA
| | - Jamie Ullman
- Department of Neurosurgery, Northwell Health, Manhasset, NY 11030, USA
| | - David Ledoux
- Department of Neurosurgery, Northwell Health, Manhasset, NY 11030, USA.
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Dolati S, Rikhtegar R, Mehdizadeh A, Yousefi M. The Role of Magnesium in Pathophysiology and Migraine Treatment. Biol Trace Elem Res 2020; 196:375-383. [PMID: 31691193 DOI: 10.1007/s12011-019-01931-z] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Accepted: 10/14/2019] [Indexed: 01/03/2023]
Abstract
Migraine is one of the most common recurrent types of headache and is the seventh cause of disability. This neurological disorder is characterized by having pain in head and other various symptoms such as nausea, emesis, photophobia, phonophobia, and sometimes visual sensory disorders. Magnesium (Mg) is a necessary ion for human body and has a crucial role in health and life maintenance. One of the main roles of Mg is to conserve neurons electric potential. Therefore, magnesium deficiency can cause neurological complications. Migraine is usually related to low amounts of Mg in serum and cerebrospinal fluid (CSF). Deficits in magnesium have significant role in the pathogenesis of migraine. Mg has been extensively used in migraine prophylaxis and treatment. This review summarizes the role of Mg in migraine pathogenesis and the potential utilizations of Mg in the prevention and treatment of migraine with the emphasis on transdermal magnesium delivery.
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Affiliation(s)
- Sanam Dolati
- Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
- Stem Cell Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Student's Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Reza Rikhtegar
- Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Amir Mehdizadeh
- Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mehdi Yousefi
- Stem Cell Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
- Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
- Department of Immunology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
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Romele P, Gkoupidenis P, Koutsouras DA, Lieberth K, Kovács-Vajna ZM, Blom PWM, Torricelli F. Multiscale real time and high sensitivity ion detection with complementary organic electrochemical transistors amplifier. Nat Commun 2020; 11:3743. [PMID: 32719350 PMCID: PMC7385487 DOI: 10.1038/s41467-020-17547-0] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Accepted: 06/22/2020] [Indexed: 02/07/2023] Open
Abstract
Ions are ubiquitous biological regulators playing a key role for vital processes in animals and plants. The combined detection of ion concentration and real-time monitoring of small variations with respect to the resting conditions is a multiscale functionality providing important information on health states. This multiscale functionality is still an open challenge for current ion sensing approaches. Here we show multiscale real-time and high-sensitivity ion detection with complementary organic electrochemical transistors amplifiers. The ion-sensing amplifier integrates in the same device both selective ion-to-electron transduction and local signal amplification demonstrating a sensitivity larger than 2300 mV V-1 dec-1, which overcomes the fundamental limit. It provides both ion detection over a range of five orders of magnitude and real-time monitoring of variations two orders of magnitude lower than the detected concentration, viz. multiscale ion detection. The approach is generally applicable to several transistor technologies and opens opportunities for multifunctional enhanced bioelectronics.
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Affiliation(s)
- Paolo Romele
- University of Brescia, Department of Information Engineering, via Branze 38, 25123, Brescia, Italy
| | | | | | - Katharina Lieberth
- Max Planck Institute for Polymer Research, Ackermannweg 10, 55128, Mainz, Germany
| | - Zsolt M Kovács-Vajna
- University of Brescia, Department of Information Engineering, via Branze 38, 25123, Brescia, Italy
| | - Paul W M Blom
- Max Planck Institute for Polymer Research, Ackermannweg 10, 55128, Mainz, Germany
| | - Fabrizio Torricelli
- University of Brescia, Department of Information Engineering, via Branze 38, 25123, Brescia, Italy.
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Effect of Nortriptyline on Spreading Depolarization. ARCHIVES OF NEUROSCIENCE 2020. [DOI: 10.5812/ans.102102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Spreading depolarization is associated with the extension of lesion size and complications in some important neurological diseases such as stroke, epilepsy, migraine, and traumatic brain injury. Objectives: This study aimed to reveal some molecular aspects of spreading depolarization and suggesting new therapeutic targets for its control by changing the function of different astrocytic and neuronal ion channels. Methods: The effects of nortriptyline on spreading depolarization in cortical and hippocampal tissues and on the electrophysiological properties of CA1 hippocampal pyramidal neurons were assessed by extra- and intracellular recording, following washing rat brain slices by the drug. Results: Nortriptyline made a significant increase in the amplitude of spreading depolarization in cortical and hippocampal tissues relative to control but did not change the duration significantly in each of the tissues. No significant difference was found in the effects of spreading depolarization on the electrophysiological properties of the CA1 pyramidal neurons between nortriptyline and control groups. Conclusions: The stimulating effect of nortriptyline on spreading depolarization is probably related to the augmentation of extracellular potassium collection in the cortex and hippocampus due to inhibition of astrocytic potassium scavenging function. This change can make more neurons prone to depolarization and increase the overall amplitude of spreading depolarization waves. Further studies should assess the effect of enhancing the clearance function of astrocyte-specific inwardly rectifying potassium channels, Kir4.1, or preventing other factors contributing to spreading depolarization on control of the process.
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Peek AL, Rebbeck T, Puts NAJ, Watson J, Aguila MER, Leaver AM. Brain GABA and glutamate levels across pain conditions: A systematic literature review and meta-analysis of 1H-MRS studies using the MRS-Q quality assessment tool. Neuroimage 2020; 210:116532. [DOI: 10.1016/j.neuroimage.2020.116532] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 12/06/2019] [Accepted: 01/08/2020] [Indexed: 12/24/2022] Open
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Capo-Rangel G, Gerardo-Giorda L, Somersalo E, Calvetti D. Metabolism plays a central role in the cortical spreading depression: Evidence from a mathematical model. J Theor Biol 2020; 486:110093. [PMID: 31778711 DOI: 10.1016/j.jtbi.2019.110093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 10/28/2019] [Accepted: 11/23/2019] [Indexed: 11/24/2022]
Abstract
The slow propagating waves of strong depolarization of neural cells characterizing cortical spreading depression, or depolarization, (SD) are known to break cerebral homeostasis and induce significant hemodynamic and electro-metabolic alterations. Mathematical models of cortical spreading depression found in the literature tend to focus on the changes occurring at the electrophysiological level rather than on the ensuing metabolic changes. In this paper, we propose a novel mathematical model which is able to simulate the coupled electrophysiology and metabolism dynamics of SD events, including the swelling of neurons and astrocytes and the concomitant shrinkage of extracellular space. The simulations show that the metabolic coupling leads to spontaneous repetitions of the SD events, which the electrophysiological model alone is not capable to produce. The model predictions, which corroborate experimental findings from the literature, show a strong disruption in metabolism accompanying each wave of spreading depression in the form of a sharp decrease of glucose and oxygen concentrations, with a simultaneous increase in lactate concentration which, in turn, delays the clearing of excess potassium in extracellular space. Our model suggests that the depletion of glucose and oxygen concentration is more pronounced in astrocyte than neuron, in line with the partitioning of the energetic cost of potassium clearing. The model suggests that the repeated SD events are electro-metabolic oscillations that cannot be explained by the electrophysiology alone. The model highlights the crucial role of astrocytes in cleaning the excess potassium flooding extracellular space during a spreading depression event: further, if the ratio of glial/neuron density increases, the frequency of cortical SD events decreases, and the peak potassium concentration in extracellular space is lower than with equal volume fractions.
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Affiliation(s)
| | | | - E Somersalo
- Basque Center for Applied Mathematics, Spain
| | - D Calvetti
- Department of Mathematics, Applied Mathematics and Statistics, Case Western Reserve University, Ohio.
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Alstadhaug KB, Andreou AP. Caffeine and Primary (Migraine) Headaches-Friend or Foe? Front Neurol 2019; 10:1275. [PMID: 31849829 PMCID: PMC6901704 DOI: 10.3389/fneur.2019.01275] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Accepted: 11/18/2019] [Indexed: 12/19/2022] Open
Abstract
Background: The actions of caffeine as an antagonist of adenosine receptors have been extensively studied, and there is no doubt that both daily and sporadic dietary consumption of caffeine has substantial biological effects on the nervous system. Caffeine influences headaches, the migraine syndrome in particular, but how is unclear. Materials and Methods: This is a narrative review based on selected articles from an extensive literature search. The aim of this study is to elucidate and discuss how caffeine may affect the migraine syndrome and discuss the potential pathophysiological pathways involved. Results: Whether caffeine has any significant analgesic and/or prophylactic effect in migraine remains elusive. Neither is it clear whether caffeine withdrawal is an important trigger for migraine. However, withdrawal after chronic exposure of caffeine may cause migraine-like headache and a syndrome similar to that experienced in the prodromal phase of migraine. Sensory hypersensitivity however, does not seem to be a part of the caffeine withdrawal syndrome. Whether it is among migraineurs is unknown. From a modern viewpoint, the traditional vascular explanation of the withdrawal headache is too simplistic and partly not conceivable. Peripheral mechanisms can hardly explain prodromal symptoms and non-headache withdrawal symptoms. Several lines of evidence point at the hypothalamus as a locus where pivotal actions take place. Conclusion: In general, chronic consumption of caffeine seems to increase the burden of migraine, but a protective effect as an acute treatment or in severely affected patients cannot be excluded. Future clinical trials should explore the relationship between caffeine withdrawal and migraine, and investigate the effects of long-term elimination.
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Affiliation(s)
- Karl B. Alstadhaug
- Nordland Hospital Trust, Bodø, Norway
- Institute of Clinical Medicine, The Arctic University of Norway, Tromsø, Norway
| | - Anna P. Andreou
- Headache Research, Wolfson CARD, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
- The Headache Centre, Guy's and St Thomas', NHS Foundation Trust, London, United Kingdom
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35
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Dolgorukova A, Osipchuk AV, Murzina AA, Sokolov AY. The Influence of Metoclopramide on Trigeminovascular Nociception: Possible Anti-migraine Mechanism of Action. Neuroscience 2019; 425:123-133. [PMID: 31785356 DOI: 10.1016/j.neuroscience.2019.11.026] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2019] [Revised: 11/05/2019] [Accepted: 11/15/2019] [Indexed: 12/20/2022]
Abstract
Metoclopramide is widely used as an abortive migraine therapy due to the advantage of having not only antiemetic, but also analgesic properties. Despite the proven clinical efficacy of metoclopramide in acute migraine, the mechanism of its anti-cephalalgic action has not been entirely elucidated. Taking into account the key role of the trigeminovascular system activation in migraine pathophysiology, we aimed to investigate metoclopramide effects on the excitability of central trigeminovascular neurons and neurogenic dural vasodilation using valid electrophysiological and neurovascular models of trigeminovascular nociception. Extracellular recordings of the activity of second-order dura-sensitive neurons were made in the trigeminocervical complex (TCC) of 16 anaesthetised rats. Cumulative metoclopramide infusion (three steps in 30 min intervals, 5 mg/kg i.v. per step, n = 8) significantly and dose-dependently suppressed both ongoing firing of the TCC neurons and their responses to dural electrical stimulation, maximally to 30%[0-49%] (median[Q1-Q3]) and 4%[0-30%] of the initial level, respectively (both p = 0.001, compared to saline (n = 8)). By contrast, the neurogenic dural vasodilation studied in a separate group of 12 rats was not significantly affected by cumulative infusion of metoclopramide (5 mg/kg i.v. per step, n = 6) compared to both baseline values and the vehicle group (n = 6) (all p > 0.05). These results provide evidence that metoclopramide is unable to affect the peripheral response to trigeminovascular activation, but it does suppress the central response, which is highly predictive of anti-migraine action. Thus, here we show the neurophysiological mechanism underlying the therapeutic efficacy of metoclopramide in migraine.
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Affiliation(s)
- Antonina Dolgorukova
- Department of Neuropharmacology, Valdman Institute of Pharmacology, Pavlov First Saint Petersburg State Medical University, L'va Tolstogo str. 6-8, 197022 Saint Petersburg, Russia.
| | - Anastasiia V Osipchuk
- Department of Neuropharmacology, Valdman Institute of Pharmacology, Pavlov First Saint Petersburg State Medical University, L'va Tolstogo str. 6-8, 197022 Saint Petersburg, Russia
| | - Anna A Murzina
- Department of Neuropharmacology, Valdman Institute of Pharmacology, Pavlov First Saint Petersburg State Medical University, L'va Tolstogo str. 6-8, 197022 Saint Petersburg, Russia
| | - Alexey Y Sokolov
- Department of Neuropharmacology, Valdman Institute of Pharmacology, Pavlov First Saint Petersburg State Medical University, L'va Tolstogo str. 6-8, 197022 Saint Petersburg, Russia; Laboratory of Cortico-Visceral Physiology, Pavlov Institute of Physiology of the Russian Academy of Sciences, Nab. Makarova 6, 199034 Saint Petersburg, Russia
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36
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Li R, Buchanan GF. Scurrying to Understand Sudden Expected Death in Epilepsy: Insights From Animal Models. Epilepsy Curr 2019; 19:390-396. [PMID: 31526023 PMCID: PMC6891182 DOI: 10.1177/1535759719874787] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Sudden unexpected death in epilepsy (SUDEP) is the leading cause of death in patients with refractory epilepsy, accounting for up to 17% of deaths in patients with epilepsy. The pathophysiology of SUDEP has remained unclear, largely because it is unpredictable and commonly unwitnessed. This poses a great challenge to studies in patients. Recently, there has been an increase in animal studies to try to better understand the pathophysiology of SUDEP. In this current review, we focus on developments through seizure-induced death models and the preventative strategies they may reveal.
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Affiliation(s)
- Rui Li
- Department of Neurology, Carver College of Medicine, University of Iowa, IA, USA
- Iowa Neuroscience Institute, Carver College of Medicine, University of Iowa, IA, USA
| | - Gordon F. Buchanan
- Department of Neurology, Carver College of Medicine, University of Iowa, IA, USA
- Iowa Neuroscience Institute, Carver College of Medicine, University of Iowa, IA, USA
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37
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Affiliation(s)
- Vinod Kumar Gupta
- Physician, Migraine-Headache Institute, Gupta Medical Clinic, S-407, Greater Kailash Part Two, New Delhi 110048, India
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38
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Salma Z, Hanen HK, Salma S, Olfa H, Nouha F, Mariem D, Chokri M. Headaches and their relationships to epileptic seizures. Epilepsy Behav 2019; 90:233-237. [PMID: 30583857 DOI: 10.1016/j.yebeh.2018.11.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2018] [Revised: 11/03/2018] [Accepted: 11/15/2018] [Indexed: 01/03/2023]
Abstract
PURPOSE The frequent association between headache and epilepsy has been increasingly studied in recent years. Through this study, we attempted to study possible temporal associations between epileptic seizures and headaches. We also tried to describe clinical aspects of headache in our patients with epilepsy. PATIENTS AND METHODS We included patients with epilepsy and patients without epilepsy who presented for a first neurologic episode suggestive of epileptic seizure or unusual headache. These patients were invited to answer a standardized questionnaire screening for headache characteristics. Patients with epilepsy were asked for further data about their epilepsy. Electroencephalogram (EEG) was performed in all patients. Brain Magnetic resonance imaging MRI was reserved for patients in whom we suspected a structural lesion. RESULTS Overall, we included 47 patients with a mean age of about 39 ± 15 years (19 to 68 years old) and a female predominance (Sex Ratio: SR = 1.47). Most frequently, our patients documented periictal headache (Peri-IH) (85.1%) including respectively ictal headache (IH: 31.9%); postictal headache (Post-IH: 21.3%), and preictal headache (Pre-IH: 4.3%). Less frequently, our patients noted interictal headache (Inter-IH: 31.9%). Interestingly, these subgroups exhibited different headache patterns with predominantly unclassified-type headache (U-TH) in patients with IH (72.7%), tension-type headache (T-TH) in patients with Post-IH (73.3%), and migraine-type headache (M-TH) in patients with Inter-IH (60%). CONCLUSIONS Our results suggest that patients with epilepsy could exhibit different headache types. The clinical pattern of headache seemed to be linked to the time of seizure onset.
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Affiliation(s)
- Zouari Salma
- Department of Neurology, Habib Bourguiba University Hospital, 3029 Sfax, Tunisia; Neuroscience Laboratory "LR-12-SP-19", Habib Bourguiba University Hospital, 3029 Sfax, Tunisia.
| | - Haj Kacem Hanen
- Department of Neurology, Habib Bourguiba University Hospital, 3029 Sfax, Tunisia; Neuroscience Laboratory "LR-12-SP-19", Habib Bourguiba University Hospital, 3029 Sfax, Tunisia
| | - Sakka Salma
- Department of Neurology, Habib Bourguiba University Hospital, 3029 Sfax, Tunisia; Neuroscience Laboratory "LR-12-SP-19", Habib Bourguiba University Hospital, 3029 Sfax, Tunisia
| | - Hdiji Olfa
- Department of Neurology, Habib Bourguiba University Hospital, 3029 Sfax, Tunisia; Neuroscience Laboratory "LR-12-SP-19", Habib Bourguiba University Hospital, 3029 Sfax, Tunisia
| | - Farhat Nouha
- Department of Neurology, Habib Bourguiba University Hospital, 3029 Sfax, Tunisia; Neuroscience Laboratory "LR-12-SP-19", Habib Bourguiba University Hospital, 3029 Sfax, Tunisia
| | - Damak Mariem
- Department of Neurology, Habib Bourguiba University Hospital, 3029 Sfax, Tunisia; Neuroscience Laboratory "LR-12-SP-19", Habib Bourguiba University Hospital, 3029 Sfax, Tunisia; Clinical Investigation Center "CIC", Habib Bourguiba University Hospital, 3029 Sfax, Tunisia
| | - Mhiri Chokri
- Department of Neurology, Habib Bourguiba University Hospital, 3029 Sfax, Tunisia; Neuroscience Laboratory "LR-12-SP-19", Habib Bourguiba University Hospital, 3029 Sfax, Tunisia; Clinical Investigation Center "CIC", Habib Bourguiba University Hospital, 3029 Sfax, Tunisia
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Newton AJH, McDougal RA, Hines ML, Lytton WW. Using NEURON for Reaction-Diffusion Modeling of Extracellular Dynamics. Front Neuroinform 2018; 12:41. [PMID: 30042670 PMCID: PMC6049079 DOI: 10.3389/fninf.2018.00041] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2018] [Accepted: 06/12/2018] [Indexed: 11/13/2022] Open
Abstract
Development of credible clinically-relevant brain simulations has been slowed due to a focus on electrophysiology in computational neuroscience, neglecting the multiscale whole-tissue modeling approach used for simulation in most other organ systems. We have now begun to extend the NEURON simulation platform in this direction by adding extracellular modeling. The extracellular medium of neural tissue is an active medium of neuromodulators, ions, inflammatory cells, oxygen, NO and other gases, with additional physiological, pharmacological and pathological agents. These extracellular agents influence, and are influenced by, cellular electrophysiology, and cellular chemophysiology-the complex internal cellular milieu of second-messenger signaling and cascades. NEURON's extracellular reaction-diffusion is supported by an intuitive Python-based where/who/what command sequence, derived from that used for intracellular reaction diffusion, to support coarse-grained macroscopic extracellular models. This simulation specification separates the expression of the conceptual model and parameters from the underlying numerical methods. In the volume-averaging approach used, the macroscopic model of tissue is characterized by free volume fraction-the proportion of space in which species are able to diffuse, and tortuosity-the average increase in path length due to obstacles. These tissue characteristics can be defined within particular spatial regions, enabling the modeler to account for regional differences, due either to intrinsic organization, particularly gray vs. white matter, or to pathology such as edema. We illustrate simulation development using spreading depression, a pathological phenomenon thought to play roles in migraine, epilepsy and stroke. Simulation results were verified against analytic results and against the extracellular portion of the simulation run under FiPy. The creation of this NEURON interface provides a pathway for interoperability that can be used to automatically export this class of models into complex intracellular/extracellular simulations and future cross-simulator standardization.
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Affiliation(s)
- Adam J. H. Newton
- Department of Neuroscience, Yale University, New Haven, CT, United States
- SUNY Downstate Medical Center, The State University of New York, New York, NY, United States
| | - Robert A. McDougal
- Department of Neuroscience, Yale University, New Haven, CT, United States
- Center for Medical Informatics, Yale University, New Haven, CT, United States
| | - Michael L. Hines
- Department of Neuroscience, Yale University, New Haven, CT, United States
| | - William W. Lytton
- SUNY Downstate Medical Center, The State University of New York, New York, NY, United States
- Neurology, Kings County Hospital Center, Brooklyn, NY, United States
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