Mechanism of Suppression of Epileptiform Burst by Closed-Loop Electrical Stimulation
College of Biomedical Engineering and Instrumentation Science, Key Lab for Biomedical Engineering of Education Ministry, Zhejiang University, Hangzhou, 310027, China
Abstract:Deep brain stimulation (DBS) is an attractive alternative strategy to surgical excision of the seizure focuses for epilepsy treatments in clinic. However, epilepsy can be generated by various mechanisms, and this highlights a need in designing pertinent DBS patterns with customized parameters for the effective therapy. In the present study, high-frequency stimulation (HFS) pulse trains with short durations were used against the epileptic form activity induced by picrotoxin, an antagonist of GABAergic receptors, in the hippocampal CA1 region of anaesthetized rats. In a closedloop manner, the HFS train was applied during each period of epileptic form bursts to the afferent axon tracts (i.e. the Schaffer collaterals) of CA1 region. The experiment results from 9 rats show that HFS trains with a frequency over 100 Hz and duration of 0.3 s during bursts suppressed 60-70% of the spikes in the bursts. Meanwhile, during the periods of HFS against bursts, the neurons of CA1 region failed to respond to the excitation of antidromic stimulation applied to the efferent axon tracts (i.e. the alveus), indicating that the neurons temporarily lost their ability to generate action potentials. Therefore, presumably, the mechanism of spike suppression by HFS might be a depolarization block generated within neuronal membranes. The finding of the study provides important insight into the development of novel closedloop stimulation patterns of DBS in treating epilepsy.
[1]Hauser WA, Beghi E. First seizure definitions and worldwide incidence and mortality [J]. Epilepsia, 2008, 49(Supplement 1): 8-12.
[2]Eadie MJ. Shortcomings in the current treatment of epilepsy [J]. Expert Review of Neurotherapeutics, 2012, 12(12): 1419-1427.
[3]Laxpati NG, Kasoff WS, Gross RE. Deep brain stimulation for the treatment of epilepsy: circuits, targets, and trials [J]. Journal of the American Society for Experimental Neurotherapeutics, 2014, 11(3): 508-526.
[4]Morrell M. Brain stimulation for epilepsy: can scheduled or responsive neurostimulation stop seizures [J]. Current Opinion in Neurology, 2006, 5(2): 164-168.
[5]Montgomery EB Jr, Gale JT. Mechanisms of action of deep brain stimulation (DBS) [J]. Neuroscience & Biobehavioral Reviews, 2008, 32(3): 388–407.
[6]Mcintyre CC, Grill WM. Selective microstimulation of central nervous system neurons [J]. Annals of Biomedical Engineering, 2000, 28(3): 219-233.
[7]Schiller Y, Bankirer Y. Cellular mechanisms underlying antiepileptic effects of low and highfrequency electrical stimulation in acute epilepsy in neocortical brain slices in vitro [J]. Journal of Neurophysiology, 2007, 97(3): 1887-1902.
[8]Dostrovsky JO, Levy R, Wu JP, et al. Microstimulationinduced inhibition of neuronal firing in human globus pallidus [J]. Journal of Neurophysiology, 2000, 84(1): 570-574.
[9]Chiken, S, Nambu A. Highfrequency pallidal stimulation disrupts information flow through the pallidum by gabaergic inhibition [J]. Journal of Neuroscience, 2013, 33(6): 2268-2280.
[10]Jensen AL, Durand DM. High frequency stimulation can block axonal conduction [J]. Experimental Neurology, 2009, 220(1):57-70.
[11]Feng Zhouyan, Zheng Xiaojing, Yu Ying, et al. Functional disconnection of axonal fibers generated by high frequency stimulation in the hippocampal ca1 region invivo [J]. Brain Research, 2013, 1509(7): 32–42.
[12]Bikson M, Lian J, Hahn PJ, et al. Suppression of epileptiform activity by high frequency sinusoidal fields in rat hippocampal slices [J]. The Journal of Physiology, 2001, 531(1): 181-191.
[13]大熊辉雄. 脑电图判读Step by Step (第4版) [M]. 北京:科学出版社, 2009:13-51, 70-80.
[14]封洲燕, 光磊, 郑晓静, 等. 应用线性硅电极阵列检测海马场电位和单细胞动作电位[J]. 生物化学与生物物理进展, 2007,
34(4): 401-407.
[15]封洲燕, 余颖, 曹嘉悦, 等. 大鼠海马神经元群体对于高频电刺激的响应[J]. 中国生物医学工程学报, 2014, 33(2): 186-193.
[16]封洲燕, 邢昊昱, 田聪, 等. 大鼠海马CA1区前馈抑制和反馈抑制的作用特性[J]. 航天医学与医学工程, 2011, 24(3): 167-172.
[17]Andersen P, Morris R, Amaral D, et al, eds. The Hippocampus Book [M]. Oxford: Oxford University Press, 2007.
[18]Theoret Y, Brown A, Fleming SP, et al. Hippocampal field potential: a microcomputer aided comparison of amplitude and integral.[J]. Brain Research Bulletin, 1984, 12(5): 589-595.
[19]光磊, 封洲燕. 神经细胞群峰电位的自动定量分析[J]. 浙江大学学报(工学版), 2008, 42(9): 1641-1647.
[20]封洲燕, 陈丹, 肖乾江. 一种闭环式神经电刺激系统的设计[J]. 仪器仪表学报, 2012, 33(2): 279-285.
[21]封洲燕, 肖乾江, 胡振华. 电刺激期间神经细胞单元锋电位的检测[J]. 中国生物医学工程学报, 2013, 32(4): 403-410.
[22]Beurrier C, Bioulac B, Audin J, et al. Highfrequency stimulation produces a transient blockade of voltagegated currents in subthalamic neurons[J]. Journal of Neurophysiology, 2001, 85(4): 1351-1356.
[23]McIntyre CC, Grill WM, Sherman DL, et al. Cellular effects of deep brain stimulation: modelbased analysis of activation and inhibition[J]. Journal of Neurophysiology, 2004, 91(4): 1457-1469.
[24]Lesser RP, Kim SH, Beyderman L, et al. Brief bursts of pulse stimulation terminate afterdischarges caused by cortical stimulation[J]. Neurology, 1999, 53(9): 2073-2081.
[25]Sun FT, Morrell MJ. Closedloop neurostimulation: the clinical experience[J]. Neurotherapeutics, 2014, 11(3): 553-563.
[26]Motamedi GK, Lesser RP, Miglioretti DL, et al. Optimizing parameters for terminating cortical afterdischarges with pulse stimulation[J]. Epilepsia, 2002, 43(8): 836-846.