Department of Psychiatry, University of California, San Diego School of Medicine, San Diego, CA, 92093, USA; Department of Neuroscience, The Scripps Research Institute, 10550 N.Torrey Pines Rd, La Jolla, CA, 92037, USA.
Department of Neuroscience, The Scripps Research Institute, 10550 N.Torrey Pines Rd, La Jolla, CA, 92037, USA.
Brain Stimul. 2022 Jan-Feb;15(1):13-22. doi: 10.1016/j.brs.2021.11.003. Epub 2021 Nov 3.
Cocaine addiction is a major public health problem. Despite decades of intense research, no effective treatments are available. Both preclinical and clinical studies strongly suggest that deep brain stimulation of the nucleus accumbens (NAcc) is a viable target for the treatment of cocaine use disorder (CUD).
Although previous studies have shown that DBS of the NAcc decreases cocaine seeking and reinstatement, the effects of DBS on cocaine intake in cocaine-dependent animals have not yet been investigated.
Rats were made cocaine dependent by allowing them to self-administer cocaine in extended access conditions (6 h/day, 0.5 mg/kg/infusion). The effects of monophasic bilateral high-frequency DBS (60 μs pulse width and 130 Hz frequency) stimulation with a constant current of 150 μA of the NAcc shell on cocaine intake was then evaluated. Furthermore, cocaine-induced locomotor activity, irritability-like behavior during cocaine abstinence, and the levels of the α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) receptor subunits 1 and 2 (GluR1/GluA1 and GluR2/GluA2) after DBS were investigated.
Contrary to our expectations, DBS of the NAcc shell induced a slight increase in cocaine self-administration, and increased cocaine-induced locomotion after extended access of cocaine self-administration. In addition, DBS decreased irritability-like behavior 18 h into cocaine withdrawal. Finally, DBS increased both cytosolic and synaptosomal levels of GluR1, but not GluR2, in the central nucleus of the amygdala but not in other brain regions.
These preclinical results with cocaine-dependent animals support the use of high-frequency DBS of the NAcc shell as a therapeutic approach for the treatment of the negative emotional state that emerges during cocaine abstinence, but also demonstrate that DBS does not decrease cocaine intake in active, long-term cocaine users. These data, together with the existing evidence that DBS of the NAcc shell reduces the reinstatement of cocaine seeking in abstinent animals, suggest that NAcc shell DBS may be beneficial for the treatment of the negative emotional states and craving during abstinence, although it may worsen cocaine use if individuals continue drug use.
可卡因成瘾是一个主要的公共卫生问题。尽管经过了几十年的深入研究,但仍没有有效的治疗方法。临床前和临床研究都强烈表明,伏隔核(NAcc)的深部脑刺激是治疗可卡因使用障碍(CUD)的可行目标。
尽管先前的研究表明,NAcc 的 DBS 可减少可卡因的寻求和复吸,但尚未研究 DBS 对可卡因依赖动物的可卡因摄入的影响。
通过允许动物在延长的访问条件下(6 小时/天,0.5mg/kg/剂量)自行摄取可卡因,使大鼠产生可卡因依赖。然后评估单侧高频双极 DBS(60μs 脉冲宽度和 130Hz 频率)对 NAcc 壳的 150μA 恒定电流刺激对可卡因摄入量的影响。此外,还研究了 DBS 后可卡因诱导的运动活动、可卡因戒断期间的易怒样行为以及α-氨基-3-羟基-5-甲基-4-异恶唑丙酸(AMPA)受体亚基 1 和 2(GluR1/GluA1 和 GluR2/GluA2)的水平。
与我们的预期相反,NAcc 壳的 DBS 诱导可卡因自我给药略有增加,并增加了可卡因自我给药延长后的可卡因诱导的运动。此外,DBS 可减少可卡因戒断 18 小时后的易怒样行为。最后,DBS 增加了杏仁核中央核的细胞质和突触体水平的 GluR1,但不增加 GluR2,但不增加其他脑区的 GluR1 和 GluR2。
这些可卡因依赖动物的临床前研究结果支持将 NAcc 壳的高频 DBS 用作治疗可卡因戒断期间出现的负面情绪状态的治疗方法,但也表明 DBS 不会减少活跃的长期可卡因使用者的可卡因摄入量。这些数据,再加上现有的证据表明,NAcc 壳的 DBS 减少了在戒断动物中可卡因寻求的复吸,表明 NAcc 壳的 DBS 可能有利于治疗戒断期间的负面情绪和渴望,尽管如果个体继续使用药物,它可能会恶化可卡因的使用。