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McNamara IN, Wellman SM, Li L, Eles JR, Savya S, Sohal HS, Angle MR, Kozai TDY. Electrode sharpness and insertion speed reduce tissue damage near high-density penetrating arrays. J Neural Eng 2024; 21:026030. [PMID: 38518365 DOI: 10.1088/1741-2552/ad36e1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 03/22/2024] [Indexed: 03/24/2024]
Abstract
Objective. Over the past decade, neural electrodes have played a crucial role in bridging biological tissues with electronic and robotic devices. This study focuses on evaluating the optimal tip profile and insertion speed for effectively implanting Paradromics' high-density fine microwire arrays (FμA) prototypes into the primary visual cortex (V1) of mice and rats, addressing the challenges associated with the 'bed-of-nails' effect and tissue dimpling.Approach. Tissue response was assessed by investigating the impact of electrodes on the blood-brain barrier (BBB) and cellular damage, with a specific emphasis on tailored insertion strategies to minimize tissue disruption during electrode implantation.Main results.Electro-sharpened arrays demonstrated a marked reduction in cellular damage within 50μm of the electrode tip compared to blunt and angled arrays. Histological analysis revealed that slow insertion speeds led to greater BBB compromise than fast and pneumatic methods. Successful single-unit recordings validated the efficacy of the optimized electro-sharpened arrays in capturing neural activity.Significance.These findings underscore the critical role of tailored insertion strategies in minimizing tissue damage during electrode implantation, highlighting the suitability of electro-sharpened arrays for long-term implant applications. This research contributes to a deeper understanding of the complexities associated with high-channel-count microelectrode array implantation, emphasizing the importance of meticulous assessment and optimization of key parameters for effective integration and minimal tissue disruption. By elucidating the interplay between insertion parameters and tissue response, our study lays a strong foundation for the development of advanced implantable devices with a reduction in reactive gliosis and improved performance in neural recording applications.
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Affiliation(s)
- Ingrid N McNamara
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, United States of America
| | - Steven M Wellman
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, United States of America
| | - Lehong Li
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, United States of America
| | - James R Eles
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, United States of America
| | - Sajishnu Savya
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, United States of America
| | | | | | - Takashi D Y Kozai
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, United States of America
- Center of the Basis of Neural Cognition, Pittsburgh, PA, United States of America
- McGowan Institute of Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA, United States of America
- NeuroTech Center, University of Pittsburgh Brain Institute, Pittsburgh, PA, United States of America
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Boergens KM, Tadić A, Hopper MS, McNamara I, Fell D, Sahasrabuddhe K, Kong Y, Straka M, Sohal HS, Angle MR. Laser ablation of the pia mater for insertion of high-density microelectrode arrays in a translational sheep model. J Neural Eng 2021; 18. [PMID: 34038875 DOI: 10.1088/1741-2552/ac0585] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Accepted: 05/26/2021] [Indexed: 01/03/2023]
Abstract
Objective. The safe insertion of high density intracortical electrode arrays has been a long-standing practical challenge for neural interface engineering and applications such as brain-computer interfaces (BCIs). However, the pia mater can be difficult to penetrate and causes deformation of underlying cortical tissue during insertion of high-density intracortical arrays. This can lead to neuron damage or failed insertions. The development of a method to ease insertion through the pia mater would represent a significant step toward inserting high density intracortical arrays.Approach. Here we describe a surgical procedure, inspired by laser corneal ablation, that can be used in translational models to thin the pia mater.Main results. We demonstrate that controlled pia removal with laser ablation over a small area of cortex allows for microelectrode arrays to be inserted into the cortex with less force, thus reducing deformation of underlying tissue during placement of the microelectrodes. This procedure allows for insertion of high-density electrode arrays and subsequent acute recordings of spiking neuron activity in sheep cortex. We also show histological and electrophysiological evidence that laser removal of the pia does not acutely affect neuronal viability in the region.Significance. Laser ablation of the pia reduces insertion forces of high-density arrays with minimal to no acute damage to cortical neurons. This approach suggests a promising new path for clinical BCI with high-density microelectrode arrays.
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Affiliation(s)
| | | | | | | | - Devin Fell
- Paradromics, Inc., Austin, TX, United States of America
| | | | - Yifan Kong
- Paradromics, Inc., Austin, TX, United States of America
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Sahasrabuddhe K, Khan AA, Singh AP, Stern TM, Ng Y, Tadić A, Orel P, LaReau C, Pouzzner D, Nishimura K, Boergens KM, Shivakumar S, Hopper MS, Kerr B, Hanna MES, Edgington RJ, McNamara I, Fell D, Gao P, Babaie-Fishani A, Veijalainen S, Klekachev AV, Stuckey AM, Luyssaert B, Kozai TDY, Xie C, Gilja V, Dierickx B, Kong Y, Straka M, Sohal HS, Angle MR. The Argo: a high channel count recording system for neural recording in vivo. J Neural Eng 2021; 18:015002. [PMID: 33624614 PMCID: PMC8607496 DOI: 10.1088/1741-2552/abd0ce] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Decoding neural activity has been limited by the lack of tools available to record from large numbers of neurons across multiple cortical regions simultaneously with high temporal fidelity. To this end, we developed the Argo system to record cortical neural activity at high data rates. APPROACH Here we demonstrate a massively parallel neural recording system based on platinum-iridium microwire electrode arrays bonded to a CMOS voltage amplifier array. The Argo system is the highest channel count in vivo neural recording system, supporting simultaneous recording from 65 536 channels, sampled at 32 kHz and 12-bit resolution. This system was designed for cortical recordings, compatible with both penetrating and surface microelectrodes. MAIN RESULTS We validated this system through initial bench testing to determine specific gain and noise characteristics of bonded microwires, followed by in-vivo experiments in both rat and sheep cortex. We recorded spiking activity from 791 neurons in rats and surface local field potential activity from over 30 000 channels in sheep. SIGNIFICANCE These are the largest channel count microwire-based recordings in both rat and sheep. While currently adapted for head-fixed recording, the microwire-CMOS architecture is well suited for clinical translation. Thus, this demonstration helps pave the way for a future high data rate intracortical implant.
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Affiliation(s)
| | - Aamir A Khan
- Paradromics, Inc, Austin, TX, United States of America
| | | | - Tyler M Stern
- Paradromics, Inc, Austin, TX, United States of America
| | - Yeena Ng
- Paradromics, Inc, Austin, TX, United States of America
| | | | - Peter Orel
- Paradromics, Inc, Austin, TX, United States of America
| | - Chris LaReau
- Paradromics, Inc, Austin, TX, United States of America
| | | | | | | | | | | | - Bryan Kerr
- Paradromics, Inc, Austin, TX, United States of America
| | | | | | | | - Devin Fell
- Paradromics, Inc, Austin, TX, United States of America
| | - Peng Gao
- Caeleste CVBA, Mechelen, Belgium
| | | | | | | | | | | | - Takashi D Y Kozai
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, United States of America
- Center for the Neural Basis of Cognition, University of Pittsburgh, Pittsburgh, PA, United States of America
- McGowan Institute of Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA, United States of America
- Center for Neuroscience, University of Pittsburgh, Pittsburgh, PA, United States of America
- NeuroTech Center, University of Pittsburgh Brain Institute, Pittsburgh, PA, United States of America
| | - Chong Xie
- Department of Electrical and Computer Engineering, Rice University, Houston, TX, United States of America
- Department of Bioengineering, Rice University, Houston, TX, United States of America
- NeuroEngineering Initiative, Rice University, Houston, TX, United States of America
| | - Vikash Gilja
- Department of Electrical and Computer Engineering, University of California, San Diego, La Jolla, CA, United States of America
| | | | - Yifan Kong
- Paradromics, Inc, Austin, TX, United States of America
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Kollo M, Racz R, Hanna ME, Obaid A, Angle MR, Wray W, Kong Y, Müller J, Hierlemann A, Melosh NA, Schaefer AT. CHIME: CMOS-Hosted in vivo Microelectrodes for Massively Scalable Neuronal Recordings. Front Neurosci 2020; 14:834. [PMID: 32848584 PMCID: PMC7432274 DOI: 10.3389/fnins.2020.00834] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Accepted: 07/16/2020] [Indexed: 01/20/2023] Open
Abstract
Mammalian brains consist of 10s of millions to 100s of billions of neurons operating at millisecond time scales, of which current recording techniques only capture a tiny fraction. Recording techniques capable of sampling neural activity at high spatiotemporal resolution have been difficult to scale. The most intensively studied mammalian neuronal networks, such as the neocortex, show a layered architecture, where the optimal recording technology samples densely over large areas. However, the need for application-specific designs as well as the mismatch between the three-dimensional architecture of the brain and largely two-dimensional microfabrication techniques profoundly limits both neurophysiological research and neural prosthetics. Here, we discuss a novel strategy for scalable neuronal recording by combining bundles of glass-ensheathed microwires with large-scale amplifier arrays derived from high-density CMOS in vitro MEA systems or high-speed infrared cameras. High signal-to-noise ratio (<25 μV RMS noise floor, SNR up to 25) is achieved due to the high conductivity of core metals in glass-ensheathed microwires allowing for ultrathin metal cores (down to <1 μm) and negligible stray capacitance. Multi-step electrochemical modification of the tip enables ultra-low access impedance with minimal geometric area, which is largely independent of the core diameter. We show that the microwire size can be reduced to virtually eliminate damage to the blood-brain-barrier upon insertion and we demonstrate that microwire arrays can stably record single-unit activity. Combining microwire bundles and CMOS arrays allows for a highly scalable neuronal recording approach, linking the progress in electrical neuronal recordings to the rapid progress in silicon microfabrication. The modular design of the system allows for custom arrangement of recording sites. Our approach of employing bundles of minimally invasive, highly insulated and functionalized microwires to extend a two-dimensional CMOS architecture into the 3rd dimension can be translated to other CMOS arrays, such as electrical stimulation devices.
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Affiliation(s)
- Mihaly Kollo
- Neurophysiology of Behaviour Laboratory, Francis Crick Institute, London, United Kingdom
- Department of Neuroscience, Physiology and Pharmacology, University College London, London, United Kingdom
| | - Romeo Racz
- Neurophysiology of Behaviour Laboratory, Francis Crick Institute, London, United Kingdom
| | - Mina-Elraheb Hanna
- Department of Materials Science and Engineering, Stanford University, Stanford, CA, United States
- Paradromics, Inc., Austin, TX, United States
| | - Abdulmalik Obaid
- Department of Materials Science and Engineering, Stanford University, Stanford, CA, United States
| | | | - William Wray
- Neurophysiology of Behaviour Laboratory, Francis Crick Institute, London, United Kingdom
| | - Yifan Kong
- Paradromics, Inc., Austin, TX, United States
| | - Jan Müller
- ETH Zürich, Department of Biosystems Science and Engineering, Basel, Switzerland
- MaxWell Biosystems AG, Zurich, Switzerland
| | - Andreas Hierlemann
- ETH Zürich, Department of Biosystems Science and Engineering, Basel, Switzerland
| | - Nicholas A. Melosh
- Department of Materials Science and Engineering, Stanford University, Stanford, CA, United States
| | - Andreas T. Schaefer
- Neurophysiology of Behaviour Laboratory, Francis Crick Institute, London, United Kingdom
- Department of Neuroscience, Physiology and Pharmacology, University College London, London, United Kingdom
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Obaid A, Hanna ME, Wu YW, Kollo M, Racz R, Angle MR, Müller J, Brackbill N, Wray W, Franke F, Chichilnisky EJ, Hierlemann A, Ding JB, Schaefer AT, Melosh NA. Massively parallel microwire arrays integrated with CMOS chips for neural recording. Sci Adv 2020; 6:eaay2789. [PMID: 32219158 PMCID: PMC7083623 DOI: 10.1126/sciadv.aay2789] [Citation(s) in RCA: 73] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Accepted: 12/26/2019] [Indexed: 05/21/2023]
Abstract
Multi-channel electrical recordings of neural activity in the brain is an increasingly powerful method revealing new aspects of neural communication, computation, and prosthetics. However, while planar silicon-based CMOS devices in conventional electronics scale rapidly, neural interface devices have not kept pace. Here, we present a new strategy to interface silicon-based chips with three-dimensional microwire arrays, providing the link between rapidly-developing electronics and high density neural interfaces. The system consists of a bundle of microwires mated to large-scale microelectrode arrays, such as camera chips. This system has excellent recording performance, demonstrated via single unit and local-field potential recordings in isolated retina and in the motor cortex or striatum of awake moving mice. The modular design enables a variety of microwire types and sizes to be integrated with different types of pixel arrays, connecting the rapid progress of commercial multiplexing, digitisation and data acquisition hardware together with a three-dimensional neural interface.
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Affiliation(s)
- Abdulmalik Obaid
- Department of Materials Science and Engineering, Stanford University, Stanford, CA, USA
| | - Mina-Elraheb Hanna
- Department of Materials Science and Engineering, Stanford University, Stanford, CA, USA
- Paradromics Inc., Austin, TX, USA
| | - Yu-Wei Wu
- Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA, USA
| | - Mihaly Kollo
- Neurophysiology of Behaviour Laboratory, Francis Crick Institute, London, UK
- Department of Neuroscience, Physiology and Pharmacology, University College London, London, UK
| | - Romeo Racz
- Neurophysiology of Behaviour Laboratory, Francis Crick Institute, London, UK
| | | | - Jan Müller
- Department of Biosystems Science and Engineering, ETH Zurich, Basel, Switzerland
| | - Nora Brackbill
- Department of Physics, Stanford University, Stanford, CA, USA
| | - William Wray
- Neurophysiology of Behaviour Laboratory, Francis Crick Institute, London, UK
| | - Felix Franke
- Department of Biosystems Science and Engineering, ETH Zurich, Basel, Switzerland
| | - E. J. Chichilnisky
- Departments of Neurosurgery and Ophthalmology, Stanford University, Stanford, CA, USA
| | - Andreas Hierlemann
- Department of Biosystems Science and Engineering, ETH Zurich, Basel, Switzerland
| | - Jun B. Ding
- Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA, USA
| | - Andreas T. Schaefer
- Neurophysiology of Behaviour Laboratory, Francis Crick Institute, London, UK
- Department of Neuroscience, Physiology and Pharmacology, University College London, London, UK
| | - Nicholas A. Melosh
- Department of Materials Science and Engineering, Stanford University, Stanford, CA, USA
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6
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Angle MR, Wang A, Thomas A, Schaefer AT, Melosh NA. Penetration of cell membranes and synthetic lipid bilayers by nanoprobes. Biophys J 2015; 107:2091-100. [PMID: 25418094 DOI: 10.1016/j.bpj.2014.09.023] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Revised: 08/08/2014] [Accepted: 09/16/2014] [Indexed: 11/28/2022] Open
Abstract
Nanoscale devices have been proposed as tools for measuring and controlling intracellular activity by providing electrical and/or chemical access to the cytosol. Unfortunately, nanostructures with diameters of 50-500 nm do not readily penetrate the cell membrane, and rationally optimizing nanoprobes for cell penetration requires real-time characterization methods that are capable of following the process of membrane penetration with nanometer resolution. Although extensive work has examined the rupture of supported synthetic lipid bilayers, little is known about the applicability of these model systems to living cell membranes with complex lipid compositions, cytoskeletal attachment, and membrane proteins. Here, we describe atomic force microscopy (AFM) membrane penetration experiments in two parallel systems: live HEK293 cells and stacks of synthetic lipid bilayers. By using the same probes in both systems, we were able to clearly identify membrane penetration in synthetic bilayers and compare these events with putative membrane penetration events in cells. We examined membrane penetration forces for three tip geometries and 18 chemical modifications of the probe surface, and in all cases the median forces required to penetrate cellular and synthetic lipid bilayers with nanoprobes were greater than 1 nN. The penetration force was sensitive to the probe's sharpness, but not its surface chemistry, and the force did not depend on cell surface or cytoskeletal properties, with cells and lipid stacks yielding similar forces. This systematic assessment of penetration under various mechanical and chemical conditions provides insights into nanoprobe-cell interactions and informs the design of future intracellular nanoprobes.
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Affiliation(s)
- Matthew R Angle
- Department of Materials Science and Engineering, Stanford University, Stanford, California
| | - Andrew Wang
- Department of Materials Science and Engineering, Stanford University, Stanford, California
| | - Aman Thomas
- Department of Materials Science and Engineering, Stanford University, Stanford, California
| | - Andreas T Schaefer
- Department of Materials Science and Engineering, Stanford University, Stanford, California
| | - Nicholas A Melosh
- Department of Materials Science and Engineering, Stanford University, Stanford, California.
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7
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Abstract
Neuroscience would be revolutionized by a technique to measure intracellular electrical potentials that would not disrupt cellular physiology and could be massively parallelized. Though such a technology does not yet exist, the technical hurdles for fabricating minimally disruptive, solid-state electrical probes have arguably been overcome in the field of nanotechnology. Nanoscale devices can be patterned with features on the same length scale as biological components, and several groups have demonstrated that nanoscale electrical probes can measure the transmembrane potential of electrogenic cells. Developing these nascent technologies into robust intracellular recording tools will now require a better understanding of device-cell interactions, especially the membrane-inorganic interface. Here we review the state-of-the art in nanobioelectronics, emphasizing the characterization and design of stable interfaces between nanoscale devices and cells.
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Affiliation(s)
- Matthew R Angle
- Department of Materials Science and Engineering, Stanford University, CA, USA
| | - Bianxiao Cui
- Department of Chemistry, Stanford University, CA, USA
| | - Nicholas A Melosh
- Department of Materials Science and Engineering, Stanford University, CA, USA; Stanford Institute for Materials and Energy Sciences, SLAC National Accelerator Laboratory, Menlo Park, CA, USA.
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8
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Abstract
Direct access into cells' interiors is essential for biomolecular delivery, gene transfection, and electrical recordings yet is challenging due to the cell membrane barrier. Recently, molecular delivery using vertical nanowires (NWs) has been demonstrated for introducing biomolecules into a large number of cells in parallel. However, the microscopic understanding of how and when the nanowires penetrate cell membranes is still lacking, and the degree to which actual membrane penetration occurs is controversial. Here we present results from a mechanical continuum model of elastic cell membrane penetration through two mechanisms, namely through "impaling" as cells land onto a bed of nanowires, and through "adhesion-mediated" penetration, which occurs as cells spread on the substrate and generate adhesion force. Our results reveal that penetration is much more effective through the adhesion mechanism, with NW geometry and cell stiffness being critically important. Stiffer cells have higher penetration efficiency, but are more sensitive to NW geometry. These results provide a guide to designing nanowires for applications in cell membrane penetration.
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Affiliation(s)
- Xi Xie
- Department of Materials Science and Engineering, Stanford University , Stanford, California 94305, United States
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9
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Abstract
Direct electrical recording of the neuronal transmembrane potential has been crucial to our understanding of the biophysical mechanisms subserving neuronal computation. Existing intracellular recording techniques, however, limit the accuracy and duration of such measurements by changing intracellular biochemistry and/or by damaging the plasma membrane. Here we demonstrate that nanoengineered electrodes can be used to record neuronal transmembrane potentials in brain tissue without causing these physiological perturbations. Using focused ion beam milling, we have fabricated Solid-Conductor Intracellular NanoElectrodes (SCINEs), from conventional tungsten microelectrodes. SCINEs have tips that are <300 nm in diameter for several micrometers, but can be easily handled and can be inserted into brain tissue. Performing simultaneous whole-cell patch recordings, we show that SCINEs can record action potentials (APs) as well as slower, subthreshold neuronal potentials without altering cellular properties. These results show a key role for nanotechnology in the development of new electrical recording techniques in neuroscience.
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Affiliation(s)
- Matthew R. Angle
- Behavioural Neurophysiology, Max Planck Institute for Medical Research, Heidelberg, Germany
| | - Andreas T. Schaefer
- Behavioural Neurophysiology, Max Planck Institute for Medical Research, Heidelberg, Germany
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Abstract
BACKGROUND Cerebral arteriolar tone is modulated in response to changes in transmural pressure and luminal flow. The effect of flow on the relation between pressure and diameter has not been fully evaluated in these vessels. This study was conducted to investigate this interaction and to determine the role of the endothelium in mediating it. METHODS Rat pial arterioles from the territory of the posterior cerebral artery were mounted in a perfusion myograph. In some arterioles, the endothelium was removed by air perfusion. Diameters were recorded at pressures from 20 to 200 mmHg in the presence and absence of flow (10 microl/min). The response to flow (0-30 microl/min) was recorded at 60 and 120 mmHg. RESULTS In the absence of flow, endothelium-intact arterioles demonstrated tone at distending pressures between 40 and 140 mmHg. In the presence of flow, tone did not develop until pressure exceeded 100 mmHg, and the vessels remained active at pressures up to 200 mmHg. Endothelium-denuded arterioles developed tone at the same pressure when perfused as when unperfused, but perfused vessels were able to maintain active tone at higher pressures. At 60 mmHg, flow caused dilation if the endothelium was intact and constriction if it had been removed. At 120 mmHg, flow caused constriction. Endothelium-dependent flow-relaxation was inhibited by N(G)-nitro-L-arginine methyl ester (10(-5) M) and abolished by indomethacin (10(-5) M). CONCLUSION Flow inhibits the development of pial arteriolar tone at low intraluminal pressures through endothelium-dependent mechanisms. Conversely, perfusion extends the upper limit of the myogenically regulated pressure range through endothelium-independent activation of arteriolar smooth muscle contraction.
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Affiliation(s)
- M E Ward
- Department of Neuroanaesthesia, Montreal Neurological Institute, McGill University, Quebec, Canada.
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Blanch L, Roussos C, Brotherton S, Michel RP, Angle MR. Effect of tidal volume and PEEP in ethchlorvynol-induced asymmetric lung injury. J Appl Physiol (1985) 1992; 73:108-16. [PMID: 1506357 DOI: 10.1152/jappl.1992.73.1.108] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
We examined the effects of positive end-expiratory pressure (PEEP) and tidal volume on the distribution of ventilation and perfusion in a canine model of asymmetric lung injury. Unilateral right lung edema was established in 10 animals by use of a selective infusion of ethchlorvynol. Five animals were tested in the supine position (horizontal asymmetry) and five in the right decubitus position (vertical asymmetry). Raising PEEP from 5 to 12 cmH2O improved oxygenation despite a redistribution of blood flow toward the damage lung and a consistent decrease in total respiratory system compliance. This improvement paralleled a redistribution of tidal ventilation to the injured lung. This was effected primarily by a fall in the compliance of the noninjured lung due to hyperinflation. The effects of higher tidal volume were additive to those of PEEP. We propose that the major effect of PEEP in inhomogeneous lung injury is to restore tidal ventilation to a population of alveoli recruitable only at high airway pressures.
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Affiliation(s)
- L Blanch
- Critical Care Division, Royal Victoria Hospital, Montreal, Quebec, Canada
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12
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Angle MR, Molloy DW, Penner B, Jones D, Prewitt RM. The cardiopulmonary and renal hemodynamic effects of norepinephrine in canine pulmonary embolism. Chest 1989; 95:1333-7. [PMID: 2721272 DOI: 10.1378/chest.95.6.1333] [Citation(s) in RCA: 44] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Autologous blood clot was injected into six dogs to produce a graduated decrease in cardiac output (CO). The effects of an infusion of norepinephrine, titrated to specific end points, were recorded before embolization and at two levels of pulmonary hypertension. Simultaneous measurements of systemic and renal hemodynamics were made. Sequential blood clot injection increased (p less than .01) pulmonary vascular resistance (PVR) from 1.3 to 13 to 33 mm Hg.L-1.min and reduced CO 45 percent and 75 percent (p less than .01). Norepinephrine increased both stroke volume and CO (p less than .01) in each condition and did not increase PVR. Since the biventricular filling pressures remained constant or fell slightly with norepinephrine, the increase in CO is best explained by an improvement in pump performance. There was no deterioration in renal blood flow or creatinine clearance with norepinephrine. The data suggested that in this model of right ventricular dysfunction, norepinephrine consistently improved myocardial performance without provoking further vasoconstriction in either the pulmonary or renal circulations.
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Affiliation(s)
- M R Angle
- Department of Medicine, Health Sciences Centre, Winnipeg, Manitoba
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