Netherlands Institute for Neuroscience, Royal Netherlands Academy of Arts and Sciences, Amsterdam, the Netherlands.
Netherlands Institute for Neuroscience, Royal Netherlands Academy of Arts and Sciences, Amsterdam, the Netherlands; Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands.
Biol Psychiatry. 2018 Dec 15;84(12):917-925. doi: 10.1016/j.biopsych.2018.05.011. Epub 2018 May 23.
Deep brain stimulation (DBS) is an effective treatment for patients with obsessive-compulsive disorder (OCD) that do not respond to conventional therapies. Although the precise mechanism of action of DBS remains unknown, modulation of activity in corticofugal fibers originating in the prefrontal cortex is thought to underlie its beneficial effects in OCD.
To gain more mechanistic insight into DBS in OCD, we used Sapap3 mutant mice. These mice display excessive self-grooming and increased anxiety, both of which are responsive to therapeutic drugs used in OCD patients. We selected two clinically relevant DBS targets through which activity in prefronto-corticofugal fibers may be modulated: the internal capsule (IC) and the dorsal part of the ventral striatum (dVS).
IC-DBS robustly decreased excessive grooming, whereas dVS-DBS was on average less effective. Grooming was reduced rapidly after IC-DBS onset and reinstated upon DBS offset. Only IC-DBS was associated with increased locomotion. DBS in both targets induced c-Fos expression around the electrode tip and in different regions of the prefrontal cortex. This prefronto-cortical activation was more extensive after IC-DBS, but not associated with behavioral effects. Furthermore, we found that the decline in grooming cannot be attributed to altered locomotor activity and that anxiety, measured on the elevated plus maze, was not affected by DBS.
DBS in both the IC and dVS reduces compulsive grooming in Sapap3 mutant mice. However, IC stimulation was more effective, but also produced motor activation, even though both DBS targets modulated activity in a similar set of prefrontal cortical fibers.
深部脑刺激(DBS)是一种有效的治疗方法,对传统疗法无效的强迫症(OCD)患者有效。尽管 DBS 的确切作用机制尚不清楚,但皮质传出纤维活动的调节被认为是其在 OCD 中有益作用的基础。
为了更深入地了解 OCD 中的 DBS,我们使用了 Sapap3 突变小鼠。这些小鼠表现出过度的自我梳理和增加的焦虑,两者都对用于 OCD 患者的治疗药物有反应。我们选择了两个临床相关的 DBS 靶点,通过这些靶点可以调节prefronto-corticofugal 纤维的活动:内囊(IC)和腹侧纹状体的背侧部分(dVS)。
IC-DBS 强烈减少了过度梳理,而 dVS-DBS 平均效果较差。IC-DBS 开始后梳理迅速减少,并在 DBS 关闭后重新开始。只有 IC-DBS 与运动增加有关。两个靶点的 DBS 都在电极尖端周围和前额皮质的不同区域诱导 c-Fos 表达。IC-DBS 后这种prefronto-cortical 激活更为广泛,但与行为效应无关。此外,我们发现梳理的减少不能归因于运动活动的改变,并且在高架十字迷宫上测量的焦虑不受 DBS 的影响。
IC 和 dVS 中的 DBS 均可减少 Sapap3 突变小鼠的强迫性梳理。然而,IC 刺激更有效,但也产生运动激活,尽管两个 DBS 靶点都以相似的一组前额皮质纤维调节活动。