Neurovascular Research Laboratory, Department of Radiology, Massachusetts General Hospital, Charlestown, MA, USA.
Vascular Division, Department of Neurology, Massachusetts General Hospital, Boston, MA, USA.
Ann Neurol. 2021 Jan;89(1):99-110. doi: 10.1002/ana.25926. Epub 2020 Oct 27.
Cortical spreading depression (SD) is an intense depolarization underlying migraine aura. Despite the weight of evidence linking SD to the pain phase of migraine, controversy remains over a causal role of SD in cephalgia because of the invasive nature of previous SD induction methods. To overcome this problem, we used a novel minimally invasive optogenetic SD induction method and examined the effect of SD on behavior.
Optogenetic SD was induced as a single event or repeatedly every other day for 2 weeks. End points, including periorbital and hindpaw mechanical allodynia, mouse grimace, anxiety, and working memory, were examined in male and female mice.
A single SD produced bilateral periorbital mechanical allodynia that developed within 1 hour and resolved within 2 days. Sumatriptan prevented periorbital allodynia when administered immediately after SD. Repeated SDs also produced bilateral periorbital allodynia that lasted 4 days and resolved within 2 weeks after the last SD. In contrast, the hindpaw withdrawal thresholds did not change after repeated SDs suggesting that SD-induced allodynia was limited to the trigeminal region. Moreover, repeated SDs increased mouse grimace scores 2 days after the last SD, whereas a single SD did not. Repeated SDs also increased thigmotaxis scores as a measure of anxiety. In contrast, neither single nor repeated SDs affected visuospatial working memory. We did not detect sexual dimorphism in any end point.
Altogether, these data show a clinically congruent causal relationship among SD, trigeminal pain, and anxiety behavior, possibly reflecting SD modulation of hypothalamic, thalamic, and limbic mechanisms. ANN NEUROL 2021;89:99-110.
皮层扩散性抑制(SD)是偏头痛先兆的强烈去极化。尽管有大量证据将 SD 与偏头痛的疼痛阶段联系起来,但由于先前 SD 诱导方法的侵入性,SD 在头痛中的因果作用仍存在争议。为了解决这个问题,我们使用了一种新的微创光遗传学 SD 诱导方法,并研究了 SD 对行为的影响。
单次或每隔一天重复诱导光遗传学 SD 共 2 周。在雄性和雌性小鼠中检查眶周和后爪机械性超敏反应、小鼠面部表情、焦虑和工作记忆等终点。
单次 SD 可引起双侧眶周机械性超敏反应,该反应在 1 小时内出现,并在 2 天内消退。舒马曲坦在 SD 后立即给药可预防眶周超敏反应。重复 SD 也可引起双侧眶周超敏反应,持续 4 天,在最后一次 SD 后 2 周内消退。相比之下,重复 SD 后后爪退缩阈值没有变化,表明 SD 诱导的超敏反应仅限于三叉神经区域。此外,重复 SD 在最后一次 SD 后 2 天增加了小鼠面部表情评分,而单次 SD 则没有。重复 SD 还增加了作为焦虑测量的趋触性评分。相比之下,单次或重复 SD 均不影响视空间工作记忆。我们没有在任何终点检测到性别二态性。
总的来说,这些数据显示 SD、三叉神经痛和焦虑行为之间存在临床一致的因果关系,可能反映了 SD 对下丘脑、丘脑和边缘机制的调节。神经病学年鉴 2021;89:99-110.