Key Laboratory for Biomedical Engineering of Ministry of Education, College of Biomedical Engineering & Instrument Science, Zhejiang University, Hangzhou, China.
CNS Neurosci Ther. 2021 Mar;27(3):352-362. doi: 10.1111/cns.13535. Epub 2020 Dec 16.
Deep brain stimulation (DBS) is a promising technology for treating epilepsy. However, the efficacy and underlying mechanisms of the high-frequency stimulation (HFS) utilized by DBS to suppress epilepsy remain uncertain. Previous studies have shown that HFS can desynchronize the firing of neurons. In this study, we investigated whether the desynchronization effects of HFS can suppress epileptiform events.
HFS trains with seconds of duration (short) and a minute of duration (long) were applied at the afferent fibers (ie, Schaffer collaterals) of the hippocampal CA1 region in anesthetized rats in vivo. The amplitude and the rate of population spikes (PS) appeared in the downstream of stimulation were calculated to evaluate the intensity of synchronized firing of neuronal populations between short and long HFS groups. A test of paired-pulse depression (PPD) was used to assess the alteration of inhibitory neuronal circuits.
The sustained stimulation of a 60-s long HFS suppressed the afterdischarges that were induced by a 5-s short HFS to impair the local inhibitions. During the sustained HFS, the mean PS amplitude reduced significantly and the burst firing decreased, while the amount of neuronal firing did not change significantly. The paired-pulse tests showed that with a similar baseline level of small PS2/PS1 ratio indicating a strong PPD, the 5-s HFS increased the PS2/PS1 ratio to a value that was significantly greater than the corresponding ratio during sustained HFS, indicating that the PPD impaired by a short HFS may be restored by a sustained HFS.
The sustained HFS can desynchronize the population firing of epileptiform activity and accelerate a recovery of inhibitions to create a balance between the excitation and the inhibition of local neuronal circuits. The study provides new clues for further understanding the mechanism of DBS and for advancing the clinical application of DBS in treating epilepsy.
深部脑刺激(DBS)是治疗癫痫的一种很有前途的技术。然而,DBS 用于抑制癫痫的高频刺激(HFS)的疗效和潜在机制仍不确定。先前的研究表明,HFS 可以使神经元的放电去同步。在这项研究中,我们研究了 HFS 的去同步效应是否可以抑制癫痫样事件。
在体内麻醉大鼠的海马 CA1 区传入纤维(即 Schaffer 侧支)上施加持续时间为秒(短)和分钟(长)的 HFS 刺激。计算刺激下游出现的群体锋电位(PS)的幅度和频率,以评估短和长 HFS 组之间神经元群体同步放电的强度。使用成对脉冲抑制(PPD)测试评估抑制性神经元回路的变化。
持续 60 秒的 HFS 刺激抑制了由 5 秒的短 HFS 诱导的后放电,从而损害了局部抑制。在持续 HFS 期间,PS 幅度的平均值显著降低,爆发性放电减少,而神经元放电的量没有显著变化。成对脉冲测试表明,具有相似的小 PS2/PS1 比值的基线水平(表示强 PPD),5 秒的 HFS 增加了 PS2/PS1 比值,使其显著大于持续 HFS 期间的相应比值,表明短 HFS 引起的 PPD 可能被持续 HFS 恢复。
持续的 HFS 可以使癫痫样活动的群体放电去同步,并加速抑制的恢复,从而在局部神经元回路的兴奋和抑制之间建立平衡。该研究为进一步了解 DBS 的机制以及推进 DBS 在治疗癫痫中的临床应用提供了新的线索。