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Zhao HH, Du H, Cai Y, Liu C, Xie Z, Chen KC. Time-resolved quantification of the dynamic extracellular space in the brain: study of cortical spreading depression. J Neurophysiol 2019; 121:1735-1747. [PMID: 30786223 DOI: 10.1152/jn.00348.2018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Extracellular diffusion in the brain is customarily characterized by two parameters, the extracellular space (ECS) volume fraction α and the diffusion tortuosity λ. How these two parameters are temporarily modified and correlated in a physiological/pathological event remains unclear to date. Using tetramethylammonium (TMA+) as an ECS ion tracer in a newly updated iontophoretic sinusoidal method, we studied in this work the dynamic α(t) and λ(t) in rat somatosensory cortex during spreading depression (SD). Temporal variations of α(t) and λ(t), as evoked by SD, were obtained through analyses of the extracellular TMA+ diffusion waveform resulting from a sinusoidally modulated point source. Most of the time, cortical SD induced coordinated α(t) decreases and λ(t) increases. In rare occasions, SD induced sole decreases of α(t) with no changes in λ(t). The independent modulation of α(t) and λ(t) was neither associated with cortical anatomy nor with the specific shape of the SD field potential wave. Changes of α(t) and λ(t) often took place acutely at the onset of SD, followed by a more transient modulation. Compared with the prior iontophoretic methods of TMA+, the sinusoidal method provides time-resolved quantification of α(t) and λ(t) in relative terms but also raises a higher property requirement on the TMA+-selective microelectrode. The sinusoidal method could become a valuable tool in the studies of the dynamic ECS response in various brain events. NEW & NOTEWORTHY An iontophoretic sinusoidal method was applied to study the dynamic changes of two extracellular space parameters, the extracellular volume fraction α(t) and tortuosity λ(t), in the brain during cortical spreading depression. Both parameters showed coordinated (most often) and independent (rarely) modulations in spreading depression. The sinusoidal method is equally applicable to other acute pathological events and a valuable tool to study the functional role of extracellular space in brain events.
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Affiliation(s)
- Hui-Hui Zhao
- Multidisciplinary Research Center, Shantou University , Shantou, Guangdong , China
| | - Hong Du
- Multidisciplinary Research Center, Shantou University , Shantou, Guangdong , China
| | - Yujie Cai
- Multidisciplinary Research Center, Shantou University , Shantou, Guangdong , China
| | - Chao Liu
- Multidisciplinary Research Center, Shantou University , Shantou, Guangdong , China
| | - Zeyu Xie
- Neurosurgery Division, Second Affiliated Hospital of the School of Medicine, Shantou University , Shantou, Guangdong , China
| | - Kevin C Chen
- Multidisciplinary Research Center, Shantou University , Shantou, Guangdong , China.,Department of Biomedical Engineering, Shantou University , Shantou, Guangdong , China
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Abstract
Spreading depolarization (SD) occurs alongside brain injuries and it can lead to neuronal damage. Therefore, pharmacological modulation of SD can constitute a therapeutic approach to reduce its detrimental effects and to improve the clinical outcome of patients. The major objective of this article was to produce a systematic review of all the drugs that have been tested against SD. Of the substances that have been examined, most have been shown to modulate certain SD characteristics. Only a few have succeeded in significantly inhibiting SD. We present a variety of strategies that have been proposed to overcome the notorious harmfulness and pharmacoresistance of SD. Information on clinically used anesthetic, sedative, hypnotic agents, anti-migraine drugs, anticonvulsants and various other substances have been compiled and reviewed with respect to the efficacy against SD, in order to answer the question of whether a drug at safe doses could be of therapeutic use against SD in humans.
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Affiliation(s)
- Anna Klass
- Neurosurgery Department, University of Heidelberg, Heidelberg, Germany
| | | | - Edgar Santos
- Neurosurgery Department, University of Heidelberg, Heidelberg, Germany
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Abstract
Spreading depression (SD) is a transient wave of near-complete neuronal and glial depolarization associated with massive transmembrane ionic and water shifts. It is evolutionarily conserved in the central nervous systems of a wide variety of species from locust to human. The depolarization spreads slowly at a rate of only millimeters per minute by way of grey matter contiguity, irrespective of functional or vascular divisions, and lasts up to a minute in otherwise normal tissue. As such, SD is a radically different breed of electrophysiological activity compared with everyday neural activity, such as action potentials and synaptic transmission. Seventy years after its discovery by Leão, the mechanisms of SD and its profound metabolic and hemodynamic effects are still debated. What we did learn of consequence, however, is that SD plays a central role in the pathophysiology of a number of diseases including migraine, ischemic stroke, intracranial hemorrhage, and traumatic brain injury. An intriguing overlap among them is that they are all neurovascular disorders. Therefore, the interplay between neurons and vascular elements is critical for our understanding of the impact of this homeostatic breakdown in patients. The challenges of translating experimental data into human pathophysiology notwithstanding, this review provides a detailed account of bidirectional interactions between brain parenchyma and the cerebral vasculature during SD and puts this in the context of neurovascular diseases.
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Affiliation(s)
- Cenk Ayata
- Neurovascular Research Laboratory, Department of Radiology, and Stroke Service and Neuroscience Intensive Care Unit, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts; Department of Neuroscience and Pharmacology and Center for Healthy Aging, University of Copenhagen, Copenhagen, Denmark; and Department of Clinical Neurophysiology, Glostrup Hospital, Glostrup, Denmark
| | - Martin Lauritzen
- Neurovascular Research Laboratory, Department of Radiology, and Stroke Service and Neuroscience Intensive Care Unit, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts; Department of Neuroscience and Pharmacology and Center for Healthy Aging, University of Copenhagen, Copenhagen, Denmark; and Department of Clinical Neurophysiology, Glostrup Hospital, Glostrup, Denmark
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Affiliation(s)
| | - Inês Alice Teixeira Leão
- Headache Outpatient Unit, Hospital da Polícia Militar de Minas Gerais - Belo Horizonte/MG Brazil
| | - João Bosco Lima Gomes
- Headache Outpatient Unit, Hospital da Polícia Militar de Minas Gerais - Belo Horizonte/MG Brazil
- Headache Clinic, Department of Internal Medicine, Faculdade de Medicina da Universidade Federal de Minas Gerais - Belo Horizonte/MG Brazil
| | - Ariovaldo Alberto da Silva
- Headache Clinic, Department of Internal Medicine, Faculdade de Medicina da Universidade Federal de Minas Gerais - Belo Horizonte/MG Brazil
| | - Antonio Lucio Teixeira
- Headache Clinic, Department of Internal Medicine, Faculdade de Medicina da Universidade Federal de Minas Gerais - Belo Horizonte/MG Brazil
- , Tel.: 55 31 3409.2651
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Kudo C, Nozari A, Moskowitz MA, Ayata C. The impact of anesthetics and hyperoxia on cortical spreading depression. Exp Neurol 2008; 212:201-6. [PMID: 18501348 PMCID: PMC2459317 DOI: 10.1016/j.expneurol.2008.03.026] [Citation(s) in RCA: 77] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2008] [Revised: 03/15/2008] [Accepted: 03/31/2008] [Indexed: 11/16/2022]
Abstract
Cortical spreading depression (CSD), a transient neuronal and glial depolarization that propagates slowly across the cerebral cortex, is the putative electrophysiological event underlying migraine aura. It negatively impacts tissue injury during stroke, cerebral contusion and intracranial hemorrhage. Susceptibility to CSD has been assessed in several experimental animal models in vivo, such as after topical KCl application or cathodal stimulation. Various combinations of anesthetics and ambient conditions have been used by different laboratories making comparisons problematic and differences in data difficult to reconcile. We systematically studied CSD susceptibility comparing commonly used experimental anesthetics (isoflurane, alpha-chloralose, and urethane) with or without N(2)O or normobaric hyperoxia (100% O(2) inhalation). The frequency of evoked CSDs, and their propagation speed, duration, and amplitude were recorded during 2 h topical KCl (1 M) application. We found that N(2)O reduced CSD frequency when combined with isoflurane or urethane, but not alpha-chloralose; N(2)O also decreased CSD propagation speed and duration. Urethane anesthesia was associated with the highest CSD frequency that was comparable to pentobarbital. Inhalation of 100% O(2) did not alter CSD frequency, propagation speed or duration in combination with any of the anesthetics tested. Our data show anesthetic modulation of CSD susceptibility in an experimental model of human disease, underscoring the importance of proper study design for hypothesis testing as well as for comparing results between studies.
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Affiliation(s)
- Chiho Kudo
- Stroke and Neurovascular Regulation Laboratory, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA 02129
| | - Ala Nozari
- Stroke and Neurovascular Regulation Laboratory, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA 02129
- Department of Anesthesia and Critical Care, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA 02129
| | - Michael A. Moskowitz
- Stroke and Neurovascular Regulation Laboratory, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA 02129
| | - Cenk Ayata
- Stroke and Neurovascular Regulation Laboratory, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA 02129
- Stroke Service and Neuroscience Intensive Care Unit, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA 02129
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Abstract
Prolonged migraine auras can be disabling and potentially can cause permanent neurologic deficits. Several medicinal agents have shown some efficacy in aborting prolonged auras, but results are inconsistent. Greater occipital nerve blockade can alleviate the pain of migraine and in 1 case report the migraine aura. Hemiplegic migraine attacks are marked by motor weakness that can last for minutes to days. Two case patients with a history of hemiplegic migraine with prolonged auras are presented, who both had complete alleviation of their aura symptoms with GON blockade. A hypothesis on how GON blockade may inhibit cortical spreading depression is also presented.
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Abstract
Cortical spreading depression (CSD) is a well-characterized phenomenon in experimental animals. Recent data show that CSD actually can occur in the injured human brain and compelling evidence is accumulating to support the concept that CSD is responsible for migraine aura. The aim of this review is to highlight recent key advances regarding our understanding of CSD in animal and human studies and its relevance to the pathophysiology of migraine and its potential treatment options.
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Affiliation(s)
- Andrew A Parsons
- Neurology and GI Centre of Excellence for Drug Discovery, New Frontiers Science Park, GlaxoSmithKline, Harlow, Essex CM19 5AW, UK.
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SMITH JM, JAMES MF, BOCKHORST KHJ, SMITH MI, BRADLEY DP, PAPADAKIS NG, CARPENTER TA, PARSONS AA, LESLIE RA, HALL LD, HUANG CLH. Investigation of feline brain anatomy for the detection of cortical spreading depression with magnetic resonance imaging. J Anat 2001; 198:537-54. [PMID: 11430693 PMCID: PMC1468243 DOI: 10.1046/j.1469-7580.2001.19850537.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Cortical spreading depression (CSD) and peri-infarct depolarisation (PID) are related phenomena that have been associated with the human clinical syndromes of migraine (CSD), head injury and stroke (PID). Nevertheless the existence of CSD in man remains controversial, despite the detection of this phenomenon in the brains of most, if not all, other animal species investigated. This failure to unambiguously detect CSD clinically may be at least partly due to the anatomically complex, gyrencephalic structure of the human brain. This study was designed to establish conditions for the study of CSD in the brain of a gyrencephalic species using the noninvasive technique of magnetic resonance imaging (MRI). The 3-dimensional (3D) gyrencephalic anatomy of the cat brain was examined to determine the imaging conditions necessary to detect CSD events. Orthogonal transverse, sagittal and horizontal T1-weighted image slices showed that the marginal and suprasylvian gyri were the most appropriate cortical structures to study CSD. This was in view of (1) their simple geometry: (2) their lengthy extent of grey matter orientated rostrocaudally in the cortex: (3) their separation by a sulcus across which CSD spread could be studied and (4) the discontinuity in the grey matter in these regions between the right and left hemispheres dorsal to the corpus callosum. The structure suggested by the T1-weighted images was corroborated by systematic diffusion tensor imaging to map the fractional anisotropy and diffusion trace. Thus a single horizontal image plane could visualise the neighbouring suprasylvian and marginal gyri of both cerebral hemispheres, whereas its complex shape and position ruled out the ectosylvian gyrus for CSD studies. With the horizontal imaging plane, CSD events were reproducibly detected by animating successive diffusion-weighted MR images following local KCl stimulation of the cortical surface. In single image frames, CSD detection and characterisation required image subtraction or statistical mapping methods that, nevertheless, yielded concordant results. In repeat experiments, CSD events were qualitatively similar in appearance whether elicited by sustained or transient KCl applications. Our experimental approach thus successfully describes cat brain anatomy in vivo, and elucidates the necessary conditions for the application of MRI methods to detect CSD propagation.
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Affiliation(s)
- J. M.
SMITH
- Physiological Laboratory, University of Cambridge
- Herchel Smith Laboratory for Medicinal Chemistry, University of Cambridge School of Clinical Medicine, Cambridge
- Equal contributors to this paper
| | - M. F.
JAMES
- Neuroscience Research, SmithKline Beecham Pharmaceuticals, Harlow, UK
- Equal contributors to this paper
| | - K. H. J.
BOCKHORST
- Herchel Smith Laboratory for Medicinal Chemistry, University of Cambridge School of Clinical Medicine, Cambridge
- Present address: Universität Bremen, FBII, Instrumetelle Analytik, Postfach 330440, 28334 Bremen, Germany
| | - M. I.
SMITH
- Neuroscience Research, SmithKline Beecham Pharmaceuticals, Harlow, UK
| | - D. P.
BRADLEY
- Physiological Laboratory, University of Cambridge
- Herchel Smith Laboratory for Medicinal Chemistry, University of Cambridge School of Clinical Medicine, Cambridge
| | - N. G.
PAPADAKIS
- Physiological Laboratory, University of Cambridge
- Herchel Smith Laboratory for Medicinal Chemistry, University of Cambridge School of Clinical Medicine, Cambridge
| | - T. A.
CARPENTER
- Herchel Smith Laboratory for Medicinal Chemistry, University of Cambridge School of Clinical Medicine, Cambridge
- Present address: Wolfson Brain Imaging Centre, University of Cambridge, Box 65 Addenbrooke's Hospital, Hills Road, Cambridge, CB2 2QQ, UK
| | - A. A.
PARSONS
- Neuroscience Research, SmithKline Beecham Pharmaceuticals, Harlow, UK
| | - R. A.
LESLIE
- Neuroscience Research, SmithKline Beecham Pharmaceuticals, Harlow, UK
| | - L. D.
HALL
- Herchel Smith Laboratory for Medicinal Chemistry, University of Cambridge School of Clinical Medicine, Cambridge
| | - C. L.-H.
HUANG
- Physiological Laboratory, University of Cambridge
- Correspondence to Dr C. L.-H. Huang, Physiological Laboratory, University of Cambridge, Downing Street, Cambridge, CB2 3EG, UK: e-mail:
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Abstract
Increases in concentration of brain NO are proposed to initiate and mediate migraine headache. Triggered by focal depolarisation, spreading depression (SD) represents a suitable mechanism for eliciting widespread release of nitric oxide. The current study examines the effect of sumatriptan, a 5-HT(1B/1D) agonist and effective antimigraine therapy, on free radical release (nitric oxide and superoxide) in SD in the simple and complex cortices of the rat and cat. Following initiation of SD, sumatriptan pretreatment (300 microg kg(-1) i.v., 15 min prior to SD) modulated all phases of nitric oxide release associated with each SD in both cats and rats. As a result, superoxide levels were observed to significantly (ANOVA, post hoc LSD) increase versus vehicle treated animals (saline 1 ml kg(-1) i.v. 15 min prior to SD) during specific phases of each SD depolarisation. Averaged over all SD depolarisations, mean peak SD nitric oxide levels per depolarisation were 0.73+/-0.23 microM (n=29) in cats, and 0.42+/-0.09 microM (n=34) in rats. Sumatriptan significantly (Students t-test, P<0.05, two tailed hypothesis, P<0.05) modulated this increase in cortical nitric oxide concentrations to 0.32+/-0.06 microM (n=25) and 0. 22+/-0.07 microM (n=37) in cats and rats. Sumatriptan appears to decrease the amplitude of nitric oxide release but enhances extracellular superoxide concentrations in both lissencephalic and gyrencephalic cortices during SD.
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Affiliation(s)
- S J Read
- Neuroscience Research, SmithKline Beecham Pharmaceuticals, Third Avenue, Harlow, CM19 5AW, Essex, UK
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Müller M. Effects of chloride transport inhibition and chloride substitution on neuron function and on hypoxic spreading-depression-like depolarization in rat hippocampal slices. Neuroscience 2000; 97:33-45. [PMID: 10771337 DOI: 10.1016/s0306-4522(00)00025-7] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Chloride fluxes play a crucial role in synaptic inhibition, cell pH regulation, as well as in cell volume control. In many neuropathological processes, cell swelling is a pivotal parameter, since cell volume changes and the dimension of the interstitial space critically modulate synchronized neuronal activity as well as the tissue's susceptibility to seizures or spreading depression. This study therefore focuses on the effects of different Cl(-) transport inhibitors and Cl(-) substitution on neuronal function and hypoxia-induced changes in rat hippocampal tissue slices. Orthodromically evoked focal excitatory postsynaptic potentials were depressed by furosemide (2mM), 4,4'-diisothiocyanatostilbene-2, 2'-disulfonic acid (1mM) and Cl(-) substitution by methylsulfate, but were enhanced by 4,4'-dinitrostilbene-2,2'-disulfonic acid (1mM). All four treatments induced multiple population spike firing in response to single orthodromic volleys, suggesting reduced synaptic inhibition. Antidromic population spikes increased following Cl(-) withdrawal, were unaffected in the presence of furosemide and 4, 4'-dinitrostilbene-2,2'-disulfonic acid, but were abolished by 4, 4'-diisothiocyanatostilbene-2,2'-disulfonic acid. The amplitude of the hypoxic spreading-depression-like extracellular potential shift was reduced by furosemide, 4,4'-diisothiocyanatostilbene-2, 2'-disulfonic acid and Cl(-) withdrawal, i.e. by the same treatments that depressed orthodromically evoked postsynaptic potentials. Furosemide prolonged the time to onset and the duration of the spreading-depression-like extracellular potential shift, while 4, 4'-dinitrostilbene-2,2'-disulfonic acid shortened the time to onset. Spreading-depression-related cell swelling was recorded as the shrinkage of relative interstitial space, which was measured as tetramethylammonium-chloride space. Neither the Cl(-) transport inhibitors nor Cl(-) withdrawal had any detectable effect on spreading-depression-related cell swelling. CA1 pyramidal neurons usually hyperpolarized during drug application and their input resistance decreased. Cl(-) withdrawal increased their input resistance and caused spontaneous burst firing. Hypoxia caused the expected spreading-depression-like rapid, near complete depolarization of single pyramidal neurons and drastically reduced their input resistance. The three Cl(-) transport inhibitors and Cl(-) withdrawal delayed the onset of the hypoxic depolarization. In low Cl(-) solutions, the apparent threshold potential at which spreading depression was triggered shifted to more positive membrane potentials. The final voltage of the hypoxic depolarization was, however, not affected. It appears from these results that the reduction in the hypoxic spreading-depression-like extracellular potential shifts by Cl(-) transport inhibitors is at least partially attributable to desynchronization of depolarization, not to decreased depolarization in individual cells. Other contributing factors could be changes in recording conditions, depression of swelling-induced amino acid release from glial cells and unspecific side-effects of the applied drugs. Desynchronization could also account for the delayed spreading-depression onset. It is concluded that Cl(-) fluxes play a role in the triggering of spreading depression, but the spreading-depression-like depolarization itself or its self-regenerative character is not mediated by Cl(-).
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Affiliation(s)
- M Müller
- Department of Cell Biology, Box 3709, Duke University Medical Center, Durham, NC, USA.
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Read SJ, Smith MI, Hunter AJ, Upton N, Parsons AA. SB-220453, a potential novel antimigraine agent, inhibits nitric oxide release following induction of cortical spreading depression in the anaesthetized cat. Cephalalgia 2000; 20:92-9. [PMID: 10961764 DOI: 10.1046/j.1468-2982.2000.00022.x] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Profound nitric oxide release associated with cortical spreading depression (SD), has been implicated in stroke, traumatic brain injury and migraine pathophysiology. SB-220453 represents a mechanistically novel, well-tolerated class of compounds which may have therapeutic potential in the treatment of conditions associated with neuronal hyperexcitability and inflammation. The aim of the present study was to investigate the effects of SB-220453 on the nitric oxide (NO) release associated with SD in the anaesthetized cat. In vehicle treated animals, KCl application for 6 min to the cortical suface produced repeated changes in extracellular direct current field potential with associated NO release. This activity was sustained for a median duration of 55 min (25-75% range, 32-59 min) and 59 min (25-75% range, 34-59 min), respectively. SB-220453 (1, 3 and 10 mg/kg i.p.) produced a dose-related inhibition of this activity and at the highest dose tested, the median duration of changes in extracellular field potential and NO release were reduced to 4 min (25-75% range, 4-5 min) and 5 min (25-75% range, 5-5 min), respectively. No effect was observed on basal systemic haemodynamic parameters or resting cerebral laser Doppler blood flux at any of the doses of SB-220453 tested. SB-220453 therefore represents a novel compound to assess the potential benefit of inhibiting SD associated nitric oxide release in neurological disease.
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Affiliation(s)
- S J Read
- Neuroscience Research, Smithkline Beecham Pharmaceuticals, New Frontiers Science Park, Harlow, UK
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Abstract
Although spreading depression has been known for over 50 years, recent research into this interesting experimental phenomenon provides evidence for an integrative role of spreading depression in brain pathophysiology. Spreading depression activates neurophysiological pathways that may have widespread consequences on brain function, but depends on the basal energy state of the brain.
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Affiliation(s)
- A A Parsons
- SmithKline Beecham Pharmaceuticals, Harlow, Essex, UK
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