Neuropsychopharmacology & Psychobiology Research Group, Area of Psychobiology, Department of Psychology, University of Cádiz, Cádiz, Spain; Instituto de Investigación e Innovación en Ciencias Biomédicas de Cádiz (INiBICA), Spain; CIBER of Mental Health (CIBERSAM), Spain.
Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; CIBER of Mental Health (CIBERSAM), Spain.
Brain Stimul. 2018 Nov-Dec;11(6):1348-1355. doi: 10.1016/j.brs.2018.06.010. Epub 2018 Jul 9.
An initial antidepressant effect when using deep brain stimulation (DBS) of the subcallosal area of the cingulate cortex (Cg25) to treat resistant depression that could be the result of electrode insertion has been described. We previously showed that electrode insertion into the infralimbic cortex (ILC; the Cg25 rodent correlate) provokes a temporally limited antidepressant-like effect that is counteracted by non-steroidal anti-inflammatory drugs, such as those routinely used for pain relief.
We characterized the effect of electrode insertion using functional neuroimaging and evaluated the impact of different analgesics on this effect.
The effect of electrode insertion into the ILC was evaluated by positron emission tomography. The effect of analgesics (ibuprofen, tramadol and morphine) on the behavioral effect induced by electrode insertion were evaluated through the forced swimming test and the novelty suppressed feeding test. Furthermore, glial fibrillary acidic protein (GFAP) and p11 expression were measured.
Electrode implantation produces an antidepressant- and anxiolytic-like effect, a local decrease in glucose metabolism, and changes in several brain regions commonly related to depression and the antidepressant response. Ibuprofen counteracted the behavioral and molecular changes produced by electrode insertion (changes in GFAP and p11 protein expression). However, analgesics with no anti-inflammatory properties (e.g., tramadol) neither counteract the behavioral effects of electrode implantation nor the molecular mechanisms triggered.
Analgesics without anti-inflammatory properties may not limit the transient benefit produced by electrode insertion reducing the time required to achieve remission in depressive DBS patients.
使用扣带回皮质下扣带 25 区（Cg25）深部脑刺激（DBS）治疗难治性抑郁症时，最初会出现抗抑郁作用，这可能是电极插入的结果。我们之前曾表明，将电极插入扣带回皮质下前扣带皮层（ILC；Cg25 啮齿动物对应物）会引起暂时的抗抑郁样作用，这种作用会被非甾体抗炎药（如常规用于缓解疼痛的药物）抵消。
我们使用功能神经影像学来描述电极插入的效果，并评估不同的镇痛药对这种效果的影响。
通过正电子发射断层扫描评估电极插入 ILC 的效果。通过强迫游泳试验和新异抑制摄食试验评估镇痛药（布洛芬、曲马多和吗啡）对电极插入诱导的行为效应的影响。此外，还测量了神经胶质纤维酸性蛋白（GFAP）和 p11 的表达。
电极植入产生抗抑郁和抗焦虑样作用、局部葡萄糖代谢减少，以及与抑郁和抗抑郁反应相关的几个大脑区域的变化。布洛芬抵消了电极插入引起的行为和分子变化（GFAP 和 p11 蛋白表达的变化）。然而，没有抗炎特性的镇痛药（例如曲马多）既不能抵消电极植入的行为作用，也不能抵消触发的分子机制。
没有抗炎特性的镇痛药可能不会限制电极插入产生的短暂益处，从而减少抑郁性 DBS 患者达到缓解所需的时间。
