The locus coeruleus projects to the mesencephalic trigeminal nucleus in rats

Takahashi, Takeshi; Shirasu, Masayoshi; Shirasu, Mari; Kubo, Kin‐ya; Onozuka, Minoru; Sato, Sadao; Itoh, Kazuyoshi; Nakamura, Hiroyuki

doi:10.1016/j.neures.2010.06.012

Cited by 27 publications

(25 citation statements)

References 19 publications

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“…It is well documented that the forehead acupoints innervated by the trigeminal sensory pathway have intimate collateral connections with the brainstem reticular formation, in particular the dorsal raphe nucleus (DRN) [32], [33] and the locus coeruleus (LC) [34]–[37]. The latter two brain structures are the major resources of 5-HT and NA neuronal bodies, respectively, sending diffuse projections to subcortical and cortical areas, including the prefrontal cortex and the amygdala known to be heavily involved in the pathogenesis of depressive disorders [38].…”

Section: Discussionmentioning

confidence: 99%

Dense Cranial Electroacupuncture Stimulation for Major Depressive Disorder—A Single-Blind, Randomized, Controlled Study

Zhang

Man

et al. 2012

PLoS ONE

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BackgroundPrevious studies suggest that electroacupuncture possesses therapeutic benefits for depressive disorders. The purpose of this study was to determine whether dense cranial electroacupuncture stimulation (DCEAS) could enhance the antidepressant efficacy in the early phase of selective serotonin reuptake inhibitor (SSRI) treatment of major depressive disorder (MDD).MethodsIn this single-blind, randomized, controlled study, patients with MDD were randomly assigned to 9-session DCEAS or noninvasive electroacupuncture (n-EA) control procedure in combination with fluoxetine (FLX) for 3 weeks. Clinical outcomes were measured using the 17-item Hamilton Depression Rating Scale (HAMD-17), Clinical Global Impression-severity (CGI-S), and Self-rating Depression Scale (SDS) as well as the response and remission rates.ResultsSeventy-three patients were randomly assigned to n-EA (n = 35) and DCEAS (n = 38), of whom 34 in n-EA and 36 in DCEAS group were analyzed. DCEAS-treated patients displayed a significantly greater reduction from baseline in HAMD-17 scores at Day 3 through Day 21 and in SDS scores at Day 3 and Day 21 compared to patients receiving n-EA. DCEAS intervention also produced a higher rate of clinically significant response compared to n-EA procedure (19.4% (7/36) vs. 8.8% (3/34)). The incidence of adverse events was similar in the two groups.ConclusionsDCEAS is a safe and effective intervention that augments the antidepressant efficacy. It can be considered as an additional therapy in the early phase of SSRI treatment of depressed patients.Trial Registration Controlled-Trials.com ISRCTN88008690

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Section: Discussionmentioning

confidence: 99%

Dense Cranial Electroacupuncture Stimulation for Major Depressive Disorder—A Single-Blind, Randomized, Controlled Study

Zhang

Man

et al. 2012

PLoS ONE

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“…As previously discussed with NTS and Sp5, locus coeruleus is also located just medial to another structure related with trigemino-sensory afference, the mesencephalic trigeminal nucleus (MTN) [51]. This nucleus has been involved in the processing of proprioceptive signals of the face [73]. Thus, our cluster may also include MTN.…”

Section: Discussionmentioning

confidence: 86%

Modulation of brainstem activity and connectivity by respiratory-gated auricular vagal afferent nerve stimulation in migraine patients

García

Lin

Lee

et al. 2017

Pain

117

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Migraine pathophysiology includes altered brainstem excitability, and recent neuromodulatory approaches aimed at controlling migraine episodes have targeted key brainstem relay and modulatory nuclei. In this study, we evaluated the impact of respiratory-gated auricular vagal afferent nerve stimulation (RAVANS), a novel neuromodulatory intervention based on an existing transcutaneous Vagus Nerve Stimulation approach, in the modulation of brainstem activity and connectivity in migraine patients. We applied 3T-functional magnetic resonance imaging with improved in-plane spatial resolution (2.62×2.62 mm) in episodic migraine (interictal) and age- and sex-matched healthy controls to evaluate brain response to RAVANS (gated to either inhalation or exhalation) and sham stimulation. We further investigated RAVANS modulation of tactile trigeminal sensory afference response in the brainstem using air-puff stimulation directed to the forehead during functional magnetic resonance imaging. Compared to sham and inhalatory-gated RAVANS (iRAVANS), exhalatory-gated RAVANS (eRAVANS) activated an ipsilateral pontomedullary region consistent with nucleus tractus solitarii (NTS). During eRAVANS, NTS connectivity was increased to anterior insula and anterior mid-cingulate cortex, compared to both sham and iRAVANS, in migraine patients. Increased connectivity was inversely correlated with relative time to the next migraine attack, suggesting clinical relevance to this change in connectivity. Post-stimulation effects were also noted immediately following eRAVANS, as we found increased activation in putative pontine serotonergic (i.e. nucleus raphe centralis) and noradrenergic (i.e. locus coeruleus) nuclei in response to trigeminal sensory afference. Regulation of activity and connectivity of brainstem and cortical regions involved in serotonergic and noradrenergic regulation and pain modulation may constitute an underlying mechanism supporting beneficial clinical outcomes for eRAVANS applied for episodic migraine.

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“…Unlike previous studies in which most acupoints used for neuropsychiatric sequelae of stroke are located on the body and generally stimulated only with manual manipulation, this study utilized a combination of dense forehead and body acupoints and electrical stimulation was further conducted on the forehead acupoints. The forehead acupoints are innervated by the trigeminal sensory pathway that has more intimate collateral connections with the brainstem reticular formation, particularly the raphe nuclei containing serotonin (5‐HT)‐producing neurons and the locus coeruleus containing noradrenaline (NA)‐producing neurons . A large body of evidence confirms that the brainstem 5‐HT and NA neuronal systems play a pivotal role in acupuncture modulation of multiple brain functions, including the processing of locomotor, mood, and cognition information .…”

Section: Discussionmentioning

confidence: 99%

“…The forehead acupoints are innervated by the trigeminal sensory pathway that has more intimate collateral connections with the brainstem reticular formation, particularly the raphe nuclei containing serotonin (5-HT)-producing neurons 19,20 and the locus coeruleus containing noradrenaline (NA)-producing neurons. 21,22 A large body of evidence confirms that the brainstem 5-HT and NA neuronal systems play a pivotal role in acupuncture modulation of multiple brain functions, including the processing of locomotor, mood, and cognition information. 23,24 The addition of electrical stimulation can enhance neuromodulatory effects of acupuncture.…”

Section: Discussionmentioning

confidence: 99%

Assessor‐ and participant‐blinded, randomized controlled trial of dense cranial electroacupuncture stimulation plus body acupuncture for neuropsychiatric sequelae of stroke

Zhang

Zhao

Jin

et al. 2019

Psychiatry Clin Neurosci

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Aim Acupuncture has benefits in the rehabilitation of neuropsychiatric sequelae of stroke. This study was aimed to evaluate the effectiveness of dense cranial electroacupuncture stimulation plus body acupuncture (DCEAS+BA) in treating poststroke depression (PSD), functional disability, and cognitive deterioration. Methods In this assessor‐ and participant‐blinded, randomized controlled trial, 91 stroke patients who initially had PSD were randomly assigned to either DCEAS+BA (n = 45) or minimum acupuncture stimulation as controls (n = 46) for three sessions per week over 8 consecutive weeks. The primary outcome was baseline‐to‐end‐point change in score of the 17‐item Hamilton Depression Rating Scale. Secondary outcomes included the Montgomery–Åsberg Depression Rating Scale for depressive symptoms, the Barthel Index for functional disability, and the Montreal Cognitive Assessment for cognitive function. Results DCEAS+BA‐treated patients showed strikingly greater end‐point reduction than MAS‐treated patients in scores of the three symptom domains. The clinical response rate, defined as an at least 50% baseline‐to‐end‐point reduction in 17‐item Hamilton Depression Rating Scale score, was markedly higher in the DCEAS+BA‐treated group than that of controls (40.0% vs 17.4%, P = 0.031). Incidence of adverse events was not different in the two groups. Subgroup analysis revealed that DCEAS+BA with electrical stimulation on forehead acupoints was more apparent in reducing Barthel‐Index‐measured disability than that without electrical stimulation. Conclusion DCEAS+BA, particularly with electrical stimulation on forehead acupoints, reduces PSD, functional disability, and cognitive deterioration of stroke patients. It can serve as an effective rehabilitation therapy for neuropsychiatric sequelae of stroke.

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The locus coeruleus projects to the mesencephalic trigeminal nucleus in rats

Cited by 27 publications

References 19 publications

Dense Cranial Electroacupuncture Stimulation for Major Depressive Disorder—A Single-Blind, Randomized, Controlled Study

Dense Cranial Electroacupuncture Stimulation for Major Depressive Disorder—A Single-Blind, Randomized, Controlled Study

Modulation of brainstem activity and connectivity by respiratory-gated auricular vagal afferent nerve stimulation in migraine patients

Assessor‐ and participant‐blinded, randomized controlled trial of dense cranial electroacupuncture stimulation plus body acupuncture for neuropsychiatric sequelae of stroke

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