Dvorzhak Anton, Gertler Christoph, Harnack Daniel, Grantyn Rosemarie
Cluster of Excellence NeuroCure, Department of Experimental Neurology, University Medicine Charité, Berlin, Germany.
Department of Experimental Neurology, University Medicine Charité, Berlin, Germany.
PLoS One. 2013 Dec 23;8(12):e82191. doi: 10.1371/journal.pone.0082191. eCollection 2013.
Patients with akinesia benefit from chronic high frequency stimulation (HFS) of the subthalamic nucleus (STN). Among the mechanisms contributing to the therapeutic success of HFS-STN might be a suppression of activity in the output region of the basal ganglia. Indeed, recordings in the substantia nigra pars reticulata (SNr) of fully adult mice revealed that HFS-STN consistently produced a reduction of compound glutamatergic excitatory postsynaptic currents at a time when the tetrodotoxin-sensitive components of the local field potentials had already recovered after the high frequency activation. These observations suggest that HFS-STN not only alters action potential conduction on the way towards the SNr but also modifies synaptic transmission within the SNr. A classical conditioning-test paradigm was then designed to better separate the causes from the indicators of synaptic depression. A bipolar platinum-iridium macroelectrode delivered conditioning HFS trains to a larger group of fibers in the STN, while a separate high-ohmic glass micropipette in the rostral SNr provided test stimuli at minimal intensity to single fibers. The conditioning-test interval was set to 100 ms, i.e. the time required to recover the excitability of subthalamo-nigral axons after HFS-STN. The continuity of STN axons passing from the conditioning to the test sites was examined by an action potential occlusion test. About two thirds of the subthalamo-nigral afferents were occlusion-negative, i.e. they were not among the fibers directly activated by the conditioning STN stimulation. Nonetheless, occlusion-negative afferents exhibited signs of presynaptic depression that could be eliminated by blocking GABA(B) receptors with CGP55845 (1 µM). Further analysis of single fiber-activated responses supported the proposal that the heterosynaptic depression of synaptic glutamate release during and after HFS-STN is mainly caused by the tonic release of GABA from co-activated striato-nigral afferents to the SNr. This mechanism would be consistent with a gain-of-function hypothesis of DBS.
运动不能的患者从丘脑底核(STN)的慢性高频刺激(HFS)中获益。有助于HFS-STN治疗成功的机制之一可能是基底神经节输出区域的活动受到抑制。事实上,在完全成年小鼠的黑质网状部(SNr)进行的记录显示,HFS-STN在局部场电位的河豚毒素敏感成分在高频激活后已经恢复时,始终会使复合谷氨酸能兴奋性突触后电流减少。这些观察结果表明,HFS-STN不仅改变了向SNr传导的动作电位,还改变了SNr内的突触传递。然后设计了一种经典的条件-测试范式,以更好地将突触抑制的原因与指标区分开来。一个双极铂铱宏观电极向STN中的一大组纤维传递条件性HFS序列,而在SNr前部的一个单独的高电阻玻璃微电极以最小强度向单根纤维提供测试刺激。条件-测试间隔设定为100毫秒,即HFS-STN后丘脑底核-黑质轴突兴奋性恢复所需的时间。通过动作电位阻断测试检查从条件刺激部位到测试部位的STN轴突的连续性。大约三分之二的丘脑底核-黑质传入纤维是阻断阴性的,即它们不在条件性STN刺激直接激活的纤维之中。尽管如此,阻断阴性的传入纤维表现出突触前抑制的迹象,这种抑制可以通过用CGP55845(1μM)阻断GABA(B)受体来消除。对单纤维激活反应的进一步分析支持了这样的观点,即HFS-STN期间及之后突触谷氨酸释放的异突触抑制主要是由共同激活的纹状体-黑质传入纤维向SNr的GABA持续性释放引起的。这种机制与深部脑刺激的功能获得假说一致。