Department of Neural and Pain Sciences, School of Dentistry, Program in Neuroscience, Center to Advance Chronic Pain Research, University of Maryland Baltimore, Baltimore, MD, 21201, USA.
Department of Oral & Maxillofacial Surgery, School of Dentistry, Programs in Integrated Biomedical Sciences, Translational Sciences, Biomedical Engineering, Radiological Sciences, University of Texas Health Science Center at San Antonio, USA.
Brain Stimul. 2024 Sep-Oct;17(5):987-1000. doi: 10.1016/j.brs.2024.08.007. Epub 2024 Aug 21.
Vagus nerve stimulation (VNS) is clinically useful for treating epilepsy, depression, and chronic pain. Currently, cervical VNS (cVNS) treatment is well-established, while auricular VNS (aVNS) is under development. Vagal stimulation regulates functions in diverse brain regions; therefore, it is critical to better understand how electrically-evoked vagal inputs following cVNS and aVNS engage with different brain regions.
As vagus inputs are predominantly transmitted to the nucleus of tractus solitarius (NTS), we directly compared the activation of NTS neurons by cVNS or aVNS and the brain regions directly projected by the activated NTS neurons in mice.
We adopted the targeted recombination in active populations method, which allows for the activity-dependent, tamoxifen-inducible expression of mCherry-a reporter protein-in neurons specifically associated with cVNS or aVNS.
cVNS and aVNS induced comparable bilateral mCherry expressions in neurons within the NTS, especially in its caudal section (cNTS). However, the numbers of mCherry-expressing neurons within different subdivisions of cNTS was distinctive. In both cVNS and aVNS, anterogradely labeled mCherry-expressing axonal terminals were similarly observed across different areas of the forebrain, midbrain, and hindbrain. These terminals were enriched in the rostral ventromedial medulla, parabrachial nucleus, periaqueductal gray, thalamic nuclei, central amygdala, and the hypothalamus. Sex difference of cVNS- and aVNS-induced labeling of NTS neurons was modest.
The central projections of mCherry-expressing cNTS terminals are comparable between aVNS and cVNS, suggesting that cVNS and aVNS activate distinct but largely overlapping projections into the brain through the cNTS.
迷走神经刺激(VNS)在治疗癫痫、抑郁和慢性疼痛方面具有临床应用价值。目前,颈部 VNS(cVNS)治疗已得到广泛应用,而耳部 VNS(aVNS)仍在开发中。迷走神经刺激调节着不同脑区的功能;因此,深入了解 cVNS 和 aVNS 诱发的电刺激迷走传入如何与不同脑区相互作用至关重要。
由于迷走神经传入主要传递到孤束核(NTS),我们直接比较了 cVNS 或 aVNS 对 NTS 神经元的激活作用,以及激活的 NTS 神经元直接投射到的脑区。
我们采用了靶向重组活性群体方法,该方法允许在活动依赖性、他莫昔芬诱导的条件下,在与 cVNS 或 aVNS 相关的神经元中表达 mCherry-a 报告蛋白。
cVNS 和 aVNS 均可在 NTS 内的神经元中诱导相似的双侧 mCherry 表达,特别是在其尾部(cNTS)。然而,cNTS 不同亚区中的 mCherry 表达神经元数量存在差异。在 cVNS 和 aVNS 中,顺行标记的 mCherry 表达轴突末梢在大脑前、中、后脑的不同区域均可见到类似的分布。这些末梢在吻侧腹内侧髓质、臂旁核、导水管周围灰质、丘脑核、中央杏仁核和下丘脑等区域富集。cVNS 和 aVNS 诱导的 NTS 神经元标记的性别差异较小。
aVNS 和 cVNS 诱导的 mCherry 表达的 cNTS 末梢的中枢投射相似,提示 cVNS 和 aVNS 通过 cNTS 激活了不同但大部分重叠的脑内投射。