Coma induced by cholinergic activation of a restricted region in the pontine reticular formation--a model of reversible forms of coma

Multimodal assessment of recovery from coma in a rat model of diffuse brainstem tegmentum injury

Despite the association between brainstem lesions and coma, a mechanistic understanding of coma pathogenesis and recovery is lacking. We developed a coma model in the rat mimicking human brainstem coma, which allowed multimodal analysis of a brainstem tegmentum lesion's effects on behavior, cortical electrophysiology, and global brain functional connectivity. After coma induction, we observed a transient period (∼1h) of unresponsiveness accompanied by cortical burst-suppression. Comatose rats then gradually regained behavioral responsiveness concurrent with emergence of delta/theta-predominant cortical rhythms in primary somatosensory cortex. During the acute stage of coma recovery (∼1-8h), longitudinal resting-state functional MRI revealed an increase in functional connectivity between subcortical arousal nuclei in the thalamus, basal forebrain, and basal ganglia and cortical regions implicated in awareness. This rat coma model provides an experimental platform to systematically study network-based mechanisms of coma pathogenesis and recovery, as well as to test targeted therapies aimed at promoting recovery of consciousness after coma.

Loss of forebrain cholinergic neurons following fluid-percussion injury: implications for cognitive impairment in closed head injury

Disturbances in memory, concentration, and problem solving are common after even mild to moderate traumatic brain injury. Because these functions are mediated in part by forebrain cholinergic and catecholaminergic innervation, in this study the authors sought to determine if experimental concussive injury produces detectable morphological damage to these systems. Fluid-percussion head injury, sufficient to cause a 13- to 14-minute loss of righting reflex, was produced in rats that had been anesthetized with halothane. Injury was delivered either at midline or 2 mm off midline and compared with appropriate sham-injured controls. After 11 to 15 days, the rat brains were stained in serial sections for choline acetyltransferase, tyrosine hydroxylase, dopamine beta-hydroxylase, acetylcholinesterase, and nicotinamide adenine dinucleotide phosphate diaphorase. Cell counts were determined for the entire population of ventrobasal forebrain cholinergic cells. Midline injury produced a bilateral loss of cholinergic neurons averaging 36% in area Ch1 (medial septal nucleus), 45% in Ch2 (nucleus of the diagonal band of Broca), and 41% in Ch4 (nucleus basalis of Meynart), (p < or = 0.05). Lateralized injury resulted in cholinergic neuron loss of similar magnitude ipsilaterally (p < or = 0.05), but a smaller contralateral loss of between 11% and 28%. No loss of neurons was detected in the pontomesencephalic cholinergic groups Ch5 and Ch6. There was no visible effect of head injury on forebrain dopamine or noradrenergic innervation. A significant and apparently selective loss of ventrobasal forebrain cholinergic neurons following brief concussive injury in rats is demonstrated in this study. This type of injury is known to produce significant disturbance in cognitive tasks linked to neocortical and hippocampal cholinergic function. It remains to be determined how this neuron loss occurs, whether it can be prevented with neuroprotective agents, how it affects innervation in target tissues, and whether it occurs in human victims of traumatic brain injury.

Systemic carbachol used in radiation-controlled focal brain pharmacology can decrease rat running

Radiation-controlled focal brain pharmacology is a method to concentrate a neuropharmacologic agent in any selected portion of the brain by irradiating that selected area and thereby lowering the BBB in that area. Then, when a drug that does not cross the normal BBB is administered systemically, the drug will preferentially penetrate and act only in the selected part of the brain. Rats received 20 Gy to the brainstem and then were tested with normal 0.9% saline 1 ml/kg, GABA 400 mg/kg, taurine 200 mg/kg, carbachol 1 mg/kg, amphetamine 2 mg/kg, and bicuculline methiodide 27 mg/kg. Opening the BBB produced no change in the average amount of running following the injection of saline. With the BBB closed, carbachol, bicuculline methiodide and taurine produced no statistically significant effect compared to saline. Comparing the effects of a drug when the BBB is open to that of saline when the BBB is open showed no significant effect of bicuculline methiodide, taurine and GABA. Carbachol produced a 73% reduction, significant at p less than .0001. Comparing a drug when the BBB is open to the same drug when the BBB is closed showed no significant effect of bicuculline methiodide, taurine and GABA. Carbachol produced a 65% reduction, significant at p less than .001. This shows that radiation-controlled focal brain pharmacology with carbachol can decrease the complex behavior of running.