Motor Coordination Disorders Evaluated through the Grid Test and Changes in the Nigral Nrf2 mRNA Expression in Rats with Pedunculopontine Lesion.

Neurotoxic lesion of the pedunculopontine nucleus (PPN) is known to cause subtle motor dysfunctions. However, motor coordination during advance on a discontinuous and elevated surface has not been studied. It is also not known whether there are changes in the mRNA expression of nuclear factor (erythroid-derived 2)-like 2 (Nrf2) in nigral tissue. METHODS: The effects of the unilateral neurotoxic lesion of the PPN in motor coordination evaluated through grid test and Nrf2 mRNA expression in nigral tissue were evaluated. Two experimental designs (ED) were organized: ED#1 behavioral study (7 and 30 days after PPN lesion) and ED#2 molecular biology study (24 h, 48 h and 7 days) after PPN lesion. RESULTS: ED#1-The number of faults made with left limbs, were significant higher in the lesioned groups (p < 0.01) both 7 and 30 days post-lesion. The number of failures made by the right limbs, was also significantly higher (p < 0.05) vs. control groups. ED#2-Nrf2 mRNA expression showed an increase 24 h after PPN injury (p < 0.01), followed by a peak of expression 48 h post injury (p < 0.001). CONCLUSIONS: Disorders of motor coordination associated with PPN injury are bilateral. The increased Nrf2 mRNA expression could represent an adaptive response to oxidative stress in the nigral tissue following pontine injury.

Nurr1, Pitx3, and α7 nAChRs mRNA Expression in Nigral Tissue of Rats with Pedunculopontine Neurotoxic Lesion.

Background and Objectives: The knowledge that the cholinergic neurons from pedunculopontine nucleus (PPN) are vulnerable to the degeneration in early stages of the Parkinson disease progression has opened new perspectives to the development of experimental model focused in pontine lesions that could increase the risk of nigral degeneration. In this context it is known that PPN lesioned rats exhibit early changes in the gene expression of proteins responsible for dopaminergic homeostasis. At the same time, it is known that nicotinic cholinergic receptors (nAChRs) mediate the excitatory influence of pontine-nigral projection. However, the effect of PPN injury on the expression of transcription factors that modulate dopaminergic neurotransmission in the adult brain as well as the α7 nAChRs gene expression has not been studied. The main objective of the present work was the study of the effects of the unilateral neurotoxic lesion of PPN in nuclear receptor-related factor 1 (Nurr1), paired-like homeodomain transcription factor 3 (Pitx3), and α7 nAChRs mRNA expression in nigral tissue. Materials and Methods: The molecular biology studies were performed by means of RT-PCR. The following experimental groups were organized: Non-treated rats, N-methyl-D-aspartate (NMDA)-lesioned rats, and Sham operated rats. Experimental subjects were sacrificed 24 h, 48 h and seven days after PPN lesion. Results: Nurr1 mRNA expression, showed a significant increase both 24 h (p < 0.001) and 48 h (p < 0.01) after PPN injury. Pitx3 mRNA expression evidenced a significant increase 24 h (p < 0.001) followed by a significant decrease 48 h and seven days after PPN lesion (p < 0.01). Finally, the α7 nAChRs nigral mRNA expression remained significantly diminished 24 h, 48 h (p < 0.001), and 7 days (p < 0.01) after PPN neurotoxic injury. Conclusion: Taking together these modifications could represent early warning signals and could be the preamble to nigral neurodegeneration events.

7. 0T ultrahigh-field MRI directly visualized the pedunculopontine nucleus in Parkinson's disease patients

OBJECTIVES: The pedunculopontine nucleus (PPN) is considered a promising new target for neurostimulation in Parkinson's disease (PD) patients with postural instability and gait disturbance that is refractory to other treatment modalities. However, the PPN is typically difficult to visualize with magnetic resonance imaging (MRI) at clinical field strengths, which greatly limits the PPN as a viable surgical target for deep brain stimulation (DBS). Thus, the aim of this study is to directly visualize the PPN based on 7.0T ultrahigh-field MRI. METHODS: Five PD patients were enrolled and scanned using the MP2RAGE sequence on a 7.0T ultrahigh-field MRI scanner. Then, the MP2RAGE sequences were imported into a commercially available navigation system. The coordinates of the directly localized PPN poles were recorded in the navigation system relative to the anterior commissure-posterior commissure plane. RESULTS: Our results indicated that the PPN presented intermediate signal intensity in the 7.0T ultrahigh-field MR images in comparison with the surrounding structure, such as the hypo-intensity of the periaqueductal gray and the hyperintensity of the neighboring white matter tracts, in PD patients. The mean coordinates for the rostral and caudal poles of PPN were 6.50 mm and 7.20 mm lateral, 1.58 mm and 2.21 mm posterior, and 8.89 mm and 13.83 mm relative to the posterior commissure. CONCLUSION: Our findings provide, for the first time, direct visualization of the PPN using the MP2RAGE sequence on a 7.0T ultrahigh-field MRI, which may improve the accuracy of stereotactic targeting of the PPN and improve the outcomes in patients undergoing DBS.

Tyrosine Hydroxylase, Vesicular Monoamine Transporter and Dopamine Transporter mRNA Expression in Nigrostriatal Tissue of Rats with Pedunculopontine Neurotoxic Lesion.

BACKGROUND: The degeneration of the pedunculopontine nucleus (PPN) precedes the degeneration of the nigral cells in the pre-symptomatic stages of Parkinson's disease (PD). Although the literature recognizes that a lesion of the PPN increases the vulnerability of dopaminergic cells, it is unknown if this risk is associated with the loss of capability of handling the dopaminergic function. METHODS: In this paper, the effects of a unilateral neurotoxic lesion of the PPN in tyrosine hydroxylase (TH), vesicular monoamine transporter 2 (VMAT2) and dopamine transporter (DAT) mRNA expression in nigrostriatal tissue were evaluated. Three experimental groups were organized: non-treated rats, NMDA-lesioned rats and Sham-operated rats. RESULTS: Seven days after the PPN lesion, in nigral tissue, TH mRNA expression was higher in comparison with control groups (p < 0.05); in contrast, VMAT2 mRNA expression showed a significant decrease (p < 0.01). DAT mRNA expression showed a significant decrease (p < 0.001) in the striatal tissue. Comparing nigral neuronal density of injured and control rats revealed no significant difference seven days post-PPN injury. CONCLUSIONS: Findings suggest that the PPN lesion modifies the mRNA expression of the proteins associated with dopaminergic homeostasis at nigrostriatal level. It could represent vulnerability signals for nigral dopaminergic cells and further increase the risk of degeneration of these cells.

Magnetic resonance diffusion tensor imaging for the pedunculopontine nucleus: proof of concept and histological correlation.

The pedunculopontine nucleus (PPN) has been proposed as target for deep brain stimulation (DBS) in patients with postural instability and gait disorders due to its involvement in muscle tonus adjustments and control of locomotion. However, it is a deep-seated brainstem nucleus without clear imaging or electrophysiological markers. Some studies suggested that diffusion tensor imaging (DTI) may help guiding electrode placement in the PPN by showing the surrounding fiber bundles, but none have provided a direct histological correlation. We investigated DTI fractional anisotropy (FA) maps from in vivo and in situ post-mortem magnetic resonance images (MRI) compared to histological evaluations for improving PPN targeting in humans. A post-mortem brain was scanned in a clinical 3T MR system in situ. Thereafter, the brain was processed with a special method ideally suited for cytoarchitectonic analyses. Also, nine volunteers had in vivo brain scanning using the same MRI protocol. Images from volunteers were compared to those obtained in the post-mortem study. FA values of the volunteers were obtained from PPN, inferior colliculus, cerebellar crossing fibers and medial lemniscus using histological data and atlas information. FA values in the PPN were significantly lower than in the surrounding white matter region and higher than in areas with predominantly gray matter. In Nissl-stained histologic sections, the PPN extended for more than 10 mm in the rostro-caudal axis being closely attached to the lateral parabrachial nucleus. Our DTI analyses and the spatial correlation with histological findings proposed a location for PPN that matched the position assigned to this nucleus in the literature. Coregistration of neuroimaging and cytoarchitectonic features can add value to help establishing functional architectonics of the PPN and facilitate neurosurgical targeting of this extended nucleus.

Utilidad de la estimulación continua del núcleo pedunculopontino para el tratamiento de la enfermedad de Parkinson / Utility Continuous Stimulation of Pedunculopontine Nucleus for treating Parkinson's Disease

El núcleo pedunculopontmo contiene gran cantidad de conexiones que modulan la actividad motora en los humanos; por este motivo, se ha planteado que su estimulación profunda tendría beneficios significativos en el tratamiento de la enfermedad de Parkinson. Con una carga orgánica y social significativa, la enfermedad de Parkinson reúne una serie de signos y síntomas, principalmente motores, que afectan significativamente la calidad de vida de los pacientes que la padecen. Actualmente, se encuentran dentro de un área de investigación con gran potencial para dar manejo a los síntomas de esta enfermedad, y se desconoce si su estimulación cerebral profunda podría orientar futuras intervenciones con resultados óptimos. Por esta razón, la revisión busca esclarecer la utilidad de este procedimiento; sin embargo, es bastante controvertido y su evidencia escasa, además de que es difícil centrarse únicamente en un núcleo para resolver los problemas relacionados con dicha enfermedad.

The pendunculopontine nucleus contains many connections responsible or modulate motor activity. It has been suggested that deep stimulation would have significant benefits in the treatment of Parldnson's disease, intervention that could improve the patient5s quality of life and generare a positive impact in public health due Parkmson's disease has important organic and social burden. There is a growmg area of research in this fíeld, however is still uncertain if deep brain stimulation could guide future interventíons with optimal results. For this reason, we pretend to darify the existing knowledge of this procedure, nevertheless, it is quite controversial, we consider that it is difficult to focusing on a unique nucleus to solve the problems associated with this disease.

Neural Correlates of the Antinociceptive Effects of Stimulating the Anterior Pretectal Nucleus in Rats.

Stimulation-evoked antinociception (SEA) from the anterior pretectal nucleus (APtN) activates mechanisms that descend to the spinal cord through the dorsolateral funiculus, but the encephalic route followed by the descending pathways from the APtN is not completely known. This study evaluated the changes in the SEA from the APtN in the Wistar rat tail-flick test after lidocaine-induced neural block or N-methyl-d-aspartate-induced neurotoxic lesion of the deep mesencephalic nucleus (DpMe), tegmental pedunculopontine nucleus (PPTg), or lateral paragigantocellular nucleus (LPGi). The SEA from the APtN was less intense after neural block of the contralateral DpMe or PPTg or the ipsilateral LPGi, but was not changed by the neural block of the ipsilateral DpMe or PPTg or the contralateral LPGi. Antinociception did not occur when APtN stimulation was carried out 5 minutes after lidocaine or 6 days after N-methyl-d-aspartate injections into the contralateral DpMe and the ipsilateral LPGi, or into the contralateral PPTg and the ipsilateral LPGi. We conclude that the SEA from the APtN activates 2 descending pain inhibitory pathways, one relaying in the ipsilateral LPGi and another relaying sequentially in the contralateral DpMe and PPTg. PERSPECTIVE: The antinociceptive effect of the APtN stimulation involves 2 descending pathways: one relaying in the ipsilateral LPGi and another descending contralaterally via relays in the DpMe and PPTg.

Unraveling a new circuitry for sleep regulation in Parkinson's disease.

Sleep disturbances are among the most disabling non-motor symptoms in Parkinson's disease. The pedunculopontine tegmental nucleus and basal ganglia are likely involved in these dysfunctions, as they are affected by neurodegeneration in Parkinson's disease and have a role in sleep regulation. To investigate this, we promoted a lesion in the pedunculopontine tegmental nucleus or substantia nigra pars compacta of male rats, followed by 24 h of REM sleep deprivation. Then, we administrated a dopaminergic D2 receptor agonist, antagonist or vehicle directly in the striatum. After a period of 24 h of sleep-wake recording, we observed that the ibotenic acid infusion in the pedunculopontine tegmental nucleus blocked the so-called sleep rebound effect mediated by REM sleep deprivation, which was reversed by striatal D2 receptors activation. Rotenone infusion in the substantia nigra pars compacta also blocked the sleep rebound, however, striatal D2 receptors activation did not reverse it. In addition, rotenone administration decreased the time spent in NREM sleep, which was corroborated by positive correlations between dopamine levels in both substantia nigra pars compacta and striatum and the time spent in NREM sleep. These findings suggest a new circuitry for sleep regulation in Parkinson's disease, involving the triad composed by pedunculopontine nucleus, substantia nigra pars compacta and striatum, evidencing a potential therapeutic target for the sleep disturbances associated to this pathology.

Arousal and the control of perception and movement.

Recent discoveries on the nature of the activity generated by the reticular activating system (RAS) suggest that arousal is much more involved in perception and movement than previously thought. The RAS is not simply an amorphous, unspecific region but rather a distinct group of nuclei with specific cell and transmitter types that control waking and modulate such processes as perception and movement. Thus, disturbances in the RAS will affect a number of neurological disorders. The discovery of gamma band activity in the RAS determined that high threshold calcium channels are responsible for generating gamma band activity in the RAS. Results showing that waking is mediated by CaMKII modulation of P/Q-type channels and REM sleep is modulated by cAMP/PK modulation of N-type channels points to different intracellular pathways influencing each state. Few studies address these important breakthroughs. Novel findings also show that the same primate RAS neurons exhibiting activity in relation to arousal are also involved in locomotion. Moreover, deep brain stimulation of this region, specifically the pedunculopontine nucleus (PPN DBS), in Parkinson's disease has salutary effects on movement, sleep, and cognition. Gamma oscillations appear to participate in sensory perception, problem solving, and memory, and coherence at these frequencies may occur at cortical or thalamocortical levels. However, rather than participating in the temporal binding of sensory events, gamma band activity generated in the RAS may help stabilize coherence related to arousal, providing a stable activation state during waking, and relay such activation to the cortex. Continuous sensory input will thus induce gamma band activity in the RAS to participate in the processes of preconscious awareness, and provide the essential stream of information for the formulation of many of our perceptions and actions. Such a role has received little attention but promises to help understand and treat a number of neurological disorders.

Effect of neurotoxic lesion of pedunculopontine nucleus in nigral and striatal redox balance and motor performance in rats.

Early degeneration of pedunculopontine nucleus (PPN) is considered part of changes that characterize premotor stages of Parkinson's disease (PD). In this paper, the effects of unilateral neurotoxic lesion of the PPN in motor execution and in the development of oxidative stress events in striatal and nigral tissues in rats were evaluated. The motor performance was assessed using the beam test (BT) and the cylinder test (CT). Nigral and striatal redox balance, was studied by means of biochemical indicators such as malondialdehyde (MDA), nitric oxide (NO) and the catalase enzymatic activity (CAT EA). Lesioned rats showed fine motor dysfunction expressed both as an increase in the length (p<0.001) and deviation (p<0.001) of the traveled path and also in the time spent (p<0.01) in the circular small beam (CBS) (p<0.01) in comparison with control groups. In addition, the lesioned rats group presented a right asymmetry index greater than 0.5 which is consistent with a significant increase in the percentage of use of the right forelimb (ipsilateral to the lesion), compared with the control group (p<0.05). Biochemical studies revealed that after 48-h PPN neurotoxic injury, the CAT EA showed a significant increase in the subtantia nigra pars compacta (SNpc) (p<0.05). This significant increase of CAT EA persisted in the nigral tissue (p<0.001) and reached the striatal tissue (p<0.001) seven days after PPN injury. Also at seven days post-injury PPN, increased concentrations of MDA (p<0.01) and a tendency to decrease in the concentrations of NO in both structures (SNpc and striatum) were found. The events associated with the generation of free radicals at nigral and striatal levels, can be part of the physiological mechanisms underlying motor dysfunction in rats with unilateral PPN neurotoxic lesion.

Núcleo pedúnculo pontino, y su relación con la fisiopatología de la enfermedad de Parkinson / Core pontine peduncle, and its relationship to the pathophysiology of Parkinson’s disease

El núcleo pedúnculopóntico (NPP) se encuentra localizado en el tegmento pontomesencefálico en su región dorsolateral.Este núcleo es un complejo de neuronas colinérgicas y nocolinérgicas que por su situación anatómica y sus numerosas conexiones con estructuras como los ganglios de la base, juega un papel importante en la produccióny la modulación del movimiento, aspecto que lo involucra en la fisiopatología de la Enfermedad de Parkinson.Estudios post-mortem en pacientes que padecieron enfermedad de Parkinson, mostraron una significativa degeneración del NPP. También se han explicado las manifestaciones clínicas de la Enfermedad del Parkinson, desde la disfunción del núcleo, y se ha propuesto la estimulación cerebral profunda del mismo como parte de la terapia de la Enfermedad de Parkinson. Este artículo de revisión, pretende explorar el papel fisiopatológico y funcional del NPP.

The pedunculopontine nucleus (PPN) is located in the dorsolateral region of the pontomesencephalic tegmentum.This nucleus is a neuronal complex; it has cholinergic and non-cholinergic neurons. Its situation and anatomical connections with many structures such as the basal ganglia give it an important role in the production and modulation of the movement. This nucleus can be implicated in the physiopathology of Parkinson’s disease (PD). Inpost mortem researches in human brains of patients suffering from Parkinson’s disease, a significant degeneration of the PPN was found. We have also explained the clinical manifestations of Parkinson’s disease, since dysfunction of the pedunculopontine nucleus, and we have analyzed the deep brain stimulation of the nucleus as part of the therapy of PD.

El núcleo pedunuulopontino y su relación con la fisiopatología de la enfermedad de parkinson / The Pedunculopontine Nucleus and its Relationship to the Pathophysiology of Parkinson's Disease

Varias décadas de investigaciones neuropatológicas e imagenológicas han proporcionado suficientes evidencias acerca de las alteraciones en la neurotransmisión colinérgica que acompañan a la disfunción dopaminérgica en la enfermedad de Parkinson (EP). El núcleo pedunculopontino tegmental laterodorsal (NPP) representa una de las fuentes principales de proyecciones colinérgicas en el cerebro y a su vez es el origen de la única proyección colinérgica que recibe la substantia nigra pars compacta (SNpc). Actualmente el estudio de la participación del NPP en la fisiopatología de la EP toma en cuenta dos vertientes: el impacto de la pérdida temprana de la influencia excitatoria pontina sobre la SNpc asociado a la degeneración temprana del NPP y la estimulación a baja frecuencia del NPP como tratamiento quirúrgico beneficioso para los signos axiales de la EP. El NPP ha emergido como una estructura esencial en la comprensión de la fisiopatología de la EP dado sus relaciones con los núcleos de los ganglios basales, el tálamo, la corteza motora y la médula espinal. La degeneración de algunas de sus poblaciones neuronales en etapas presintomáticas de la EP ha sugerido una relación causa-efecto entre este hallazgo y la muerte de las células dopaminérgicas nigrales. Por otra parte la estimulación del NPP tiene resultados favorables sobre los trastornos posturales y de la marcha, los cuales se presentan en etapas tardías de la EP y son refractarios a otros tratamientos farmacológicos y quirúrgicos.

Several decades of neuropathologic and imagenologic investigations have provided sufficient evidences about alterations in cholinergic neurotransmission that go together with the dopaminergic dysfunction in Parkinson s disease (PD). The laterodorsal tegmental pedunculopontine nucleus (PPN) represents one of the main sources of cholinergic projections into the brain and at the same time the origin of the only cholinergic projection that substantia nigra pars compacta (SNpc) receives. At present, the study of the PPN participation as part of the physiopathology of PD has two notions: the impact of the lack of pontine excitatory influence on SNpc, associated to the early degeneration of PPN as well as the low frequency stimulation in the PPN as a beneficial surgical treatment for the axial symptoms of PD. PPN has emerged as an essential structure in the comprehension of PD physiopathology, given by its relation with the basal ganglia nuclei, thalamus, motor cortex and the spinal cord. The degeneration of some of its neuronal populations in PD pre symptomatic steps, has suggested a cause- and-effect relation on this finding and the death of nigral dopaminergic cells. On the other hand, PPN stimulation has favorable results on postural and gait disorders, which present themselves in late PD stages and are refractory to other pharmacological and surgical treatments.

Efecto de la adiinistración intracerebral de mk801 y (-) nicotina en las conceentraciones extracelulares de glu y gaba en el núcleo pedunculopontino de ratas / Effect of the Mk801 and (-) Nicotine Intracerebral Administration on Glu and Gaba Extracellular Concentration in the Pedunculopontine Nucleus from Rats

Aunque la manipulación farmacológica de los sistemas glutamatérgico y colinérgico se ha tratado en modelos experimentales de enfermedad de Parkinson (EP), pocos autores han realizado estudios de esta temática a nivel del núcleo pedunculopontino (NPP). El presente trabajo aborda los cambios en las concentraciones extracelulares (CE) de glutamato (Glu) y ácido δ-amino butírico (GABA) en el NPP de ratas hemiparkinsonizadas por inyección de 6-hidroxidopamina (6-OHDA) y sometidas a infusión local de MK-801 (10 µmol/L) o (-) nicotina (10 mM). La infusión se realizó mediante microdiálisis cerebral y la determinación de CE de neurotransmisores se realizó a través de cromatografía líquida de alta resolución acoplada a detección de fluorescencia. La infusión de MK-801 en el NPP produjo disminución significativa de CE de Glu (p< 0,01) y de GABA (p < 0,01) en ratas hemiparkinsonizadas y controles. La infusión de (-) nicotina mostró un incremento significativo de CE de Glu (p < 0,001) y GABA (p< 0,001) en el NPP de ratas hemiparkinsonizadas y controles. El bloqueo local de receptores NMDA por MK-801 facilita la interacción de Glu con sus receptores metabotrópicos que participan en mecanismos de inhibición presináptica y bloquean la liberación de neurotransmisores. Mientras que la infusión de nicotina en el NPP suma los efectos de activación de los receptores nicotínicos a los cambios conocidos en la neurotransmisión glutamatérgica y gabaérgica en el NPP en parkinsonismo. La infusión de fármacos glutamatérgicos y colinérgicos en el NPP, impone un reajuste a la neurotransmisión a este nivel que se añade a los cambios neuroquímicos asociados a denervación dopaminérgica.

Although the pharmacological manipulation of the glutamatergic and cholinergic systems have been studied in animal models of Parkinson´s disease (PD), only some authors have done work on this topic at the pedunculopontine nucleus (PPN). The present work studied the changes in glutamate (Glu) and δ-aminobutyric acid (GABA) extracellular concentrations (EC) in the PPN from hemiparkinsonian rats by 6hydroxydopamine injection. The rats were locally perfused by MK-801 (10 µmol/L) or (-) nicotine (10 mM) solutions by cerebral microdyalisis. The biochemical studies were carried out through high performance liquid chromatography coupled to fluorescence detection. MK-801 infusion induced a significant decrease of Glu (p< 0.01) and GABA (p< 0.01) EC in PPN. On the other hand (-) nicotine infusion induced a significant increase of Glu (p< 0.001) and GABA (p< 0.001) EC in PPN from hemiparkinsonian rats. The local blockade of NMDA receptors by MK-801 infusion facilitates the interaction between Glu and their metabotropic receptors that take part in presynaptic inhibition mechanisms and interfere with neurotransmitters release. Meanwhile, the nicotine infusion sums the effects of nicotinic receptor activation with the glutamatergic and gabaergic neurotransmission changes produced in the PPN in the parkinsonian condition. The cholinergic and glutamergic drug infusion in PPN impose a new adjustment to the neurotransmition at this level that is added to the neurochemical changes associated to dopaminergic denervation.