Pain is both a sensory and affective experience (Price, Science 288, 1769-1772 (2000)). The unpleasant percept that dominates the affective dimension of pain is coupled with the motivational drive to engage protective behaviors that limit exposure to noxious stimuli (Baliki et al., Neuron 87, 474-491 (2015)). Although previous work has uncovered detailed mechanisms underlying the sensory detection of noxious stimuli and spinal processing of nociceptive information (Peirs et al., Science 354, 578-584 (2016)), how brain circuits transform emotionally inert information ascending from the spinal cord into an affective pain percept remains unclear (Garcia-Larrea et al., Prog. Neuropsychopharmacol. Biol. Psychiatry (2017)). Attaining a better understanding of the mechanisms underlying pain affect is important, because it could lead to novel therapeutic strategies to limit the suffering of patients with chronic pain.
The amygdala critically contributes to the emotional and autonomic responses associated with valence coding of neural information, such as responses during fear or pain (Janak et al., Nature 517, 284-292 (2015)). Damage to the basolateral amygdala (BLA) can induce a rare phenomenon in which noxious stimuli remain detected and discriminated but are devoid of perceived unpleasantness and do not motivate avoidance (Hebben et al., Behav. Neurosci. 99, 1031-1039 (1985); Neimann et al., Bull. Soc. Fr. Dermatol. Syphiligr. 71, 292-294 (1964)). Conversely, impairment of somatosensory cortex function reduces the ability to both localize noxious stimuli and describe their intensity, without altering aversion or avoidance (Ploner et al., Pain 81, 211-214 (1999); Uhelski et al., Pain 153, 885-892 (2012)). Thus, BLA affective neural circuits might link nociceptive inputs to aversive perceptions and behavior selection.
Patients with chronic pain often suffer allodynia, a pathological state in which an intense unpleasant percept arises in response to innocuous stimuli such as light touch (Costigan et al., Annu. Rev. Neurosci. 32, 1-32 (2009)). Notably, the BLA displays heightened activity during chronic pain (Neugebauer, Amygdala Pain Mechanisms. Handb. Exp. Pharmacol. 227, 261-284 (2015)), and longitudinal functional magnetic resonance imaging studies in humans and rodents show that neural hyperactivity and altered functional connectivity in the amygdala parallel the onset of chronic pain, suggesting that the BLA might play a critical role in shaping pathological pain perceptions (Chang et al., Pain 158, 488-497 (2017); Simons et al., Pain 155, 1727-1742 (2014); Hashmi et al., Brain 136, 2751-2768 (2013)). However, it remains unclear how the BLA influences the unpleasant aspects of innate acute and chronic pain perceptions (Gore et al., Cell 162, 134-145 (2015)), while the role of nociceptive circuits in the central amygdala are better understood (Neugebauer, et al., J. Neurosci. 23, 52-63 (2003); Han, et al., Cell 162, 363-374 (2015)).
The inventors identified an ensemble of neurons in the basolateral amygdala (BLA) that encodes nociceptive information. BLA neurons responsive to nociceptive stimuli were identified by tracking the somatic Ca2+ dynamics of individual BLA Camk2a+ principal neurons in mice presented with diverse noxious and innocuous stimuli. Noxious heat, cold, and pin prick stimuli elicited significant Ca2+ responses in the identified BLA neurons. Alignment of all stimulus-evoked ensemble responses to the noxious heat trials revealed an overlapping population of principal neurons that encode nociceptive information across pain modalities (i.e., noxious heat, cold, pin), which are referred to herein as the BLA nociceptive ensemble (see Examples).
In one aspect, a method of treating a subject for pain is provided, the method comprising administering a therapeutically effective amount of an agent that disrupts neural activity of one or more neurons of a BLA nociceptive ensemble in the brain of the subject. In some embodiments, the agent disrupts neural activity of a subset of neurons in the BLA nociceptive ensemble. In some embodiments, the subset comprises or consists of a nociceptive-specific subpopulation of neurons. In other embodiments, the agent disrupts neural activity of all of the neurons of the BLA nociceptive ensemble.
In certain embodiments, the agent is administered in an amount sufficient to attenuate pathological or neuropathic pain.
In certain embodiments, the agent is administered in an amount sufficient to relieve allodynia or hyperalgesia, including, without limitation, thermal, mechanical, or opioid-induced allodynia or hyperalgesia.
In certain embodiments, the agent is administered in an amount sufficient to reduce aversive pain avoidance behavior.
In certain embodiments, the nociceptive ensemble comprises c-Fos+ mid-anterior BLA Camk2a+ principal neurons that are activated by nociceptive stimuli.
In certain embodiments, the pain is acute pain or chronic pain.
In certain embodiments, the agent is administered locally to the BLA nociceptive ensemble. In some embodiments, the agent is administered locally by stereotactic injection into the BLA nociceptive ensemble in the brain of the subject.
In another aspect, a method of screening for an agent that modulates neural activity in a BLA nociceptive ensemble in a brain of a subject is provided, the method comprising: a) contacting the BLA nociceptive ensemble with a candidate agent; and b) measuring neural activity in the BLA nociceptive ensemble in response to the candidate agent.
In certain embodiments, the method further comprises monitoring pain perception in the subject to determine if the candidate agent modulates pain perception.
In certain embodiments, the neural activity in the BLA nociceptive ensemble and/or pain perception is monitored in response to a test stimulus. For example, the test stimulus may be a noxious stimulus or an innocuous stimulus. In some embodiments, the noxious stimulus is a noxious mechanical (e.g., noxious pin prick or filament) or thermal stimulus (e.g., noxious heat or noxious cold). In some embodiments, the innocuous stimulus is light touch.
In certain embodiments, reduced pain perception in response to the noxious stimulus in the presence of the candidate agent compared to in the absence of the candidate agent indicates that the candidate agent has analgesic activity.
In certain embodiments, the method further comprises monitoring the subject for reduced pain affective-motivational behavior in the presence of the candidate agent compared to in the absence of the candidate agent.
In certain embodiments, the candidate agent is a small molecule, a peptide, a protein, an aptamer, an antibody, an antibody mimetic, a receptor ligand, or an inhibitory nucleic acid that modulates neural activity of at least a subset of neurons in the BLA nociceptive ensemble. In some embodiments, the antibody is selected from the group consisting of a polyclonal antibody, a monoclonal antibody, a chimeric antibody, a humanized antibody, a F(ab) fragment, a F(ab′)2 fragment, a Fv fragment, and a nanobody. In some embodiments, the inhibitory nucleic acid is selected from the group consisting of a small interfering RNA (siRNA), a microRNA (miRNA), a Piwi-interacting RNA (piRNA), a small nuclear RNA (snRNA), an antisense oligonucleotide, and a peptide nucleic acid.
In certain embodiments, pain perception is monitored in the subject using a mechanical withdrawal test, an electronic Von Frey test, a manual Von Frey test, a Randall-Selitto test, a Hargreaves test, a hot plate test, a cold plate test, a thermal probe test, an acetone evaporation test, a cold plantar test, a temperature preference test, a grimace scale test, or weight bearing and gait analysis.
Candidate agents, identified by screening, as described herein, may be useful in alleviating pain and pain affective-motivational behavior.
In another aspect, a method of mapping nociceptive and aversive responses to neurons in a basolateral amygdala (BLA) nociceptive ensemble in the brain of a subject is provided, the method comprising: a) imaging neural activity within the BLA nociceptive ensemble associated with nociceptive and aversive responses to a test stimulus; and b) mapping responsive neurons exhibiting the neural activity. In certain embodiments, the neural activity is Ca2+ transient activity of one or more neurons in the BLA nociceptive ensemble.
The inventors have identified an ensemble of neurons in the basolateral amygdala (BLA) that encodes nociceptive information across pain modalities, including pain evoked by noxious thermal and mechanical stimuli. Methods are provided for screening candidate agents for inhibition of neural activity of neurons within the BLA nociceptive ensemble. Screening assays further include determining the effectiveness of candidate agents in alleviating pain and reducing aversive pain avoidance behavior.
Before the BLA nociceptive ensemble and methods of screening candidate agents for effectiveness in inhibiting neural activity within the BLA nociceptive ensemble and alleviating pain and/or reducing aversive pain avoidance behavior are further described, it is to be understood that this invention is not limited to a particular method or composition described, as such may, of course, vary. It is also to be understood that the terminology used herein is for the purpose of describing particular embodiments only, and is not intended to be limiting, since the scope of the present invention will be limited only by the appended claims.
Where a range of values is provided, it is understood that each intervening value, to the tenth of the unit of the lower limit unless the context clearly dictates otherwise, between the upper and lower limits of that range is also specifically disclosed. Each smaller range between any stated value or intervening value in a stated range and any other stated or intervening value in that stated range is encompassed within the invention. The upper and lower limits of these smaller ranges may independently be included or excluded in the range, and each range where either, neither or both limits are included in the smaller ranges is also encompassed within the invention, subject to any specifically excluded limit in the stated range. Where the stated range includes one or both of the limits, ranges excluding either or both of those included limits are also included in the invention.
Unless defined otherwise, all technical and scientific terms used herein have the same meaning as commonly understood by one of ordinary skill in the art to which this invention belongs. Although any methods and materials similar or equivalent to those described herein can be used in the practice or testing of the present invention, some potential and preferred methods and materials are now described. All publications mentioned herein are incorporated herein by reference to disclose and describe the methods and/or materials in connection with which the publications are cited.
It is understood that the present disclosure supersedes any disclosure of an incorporated publication to the extent there is a contradiction.
As will be apparent to those of skill in the art upon reading this disclosure, each of the individual embodiments described and illustrated herein has discrete components and features which may be readily separated from or combined with the features of any of the other several embodiments without departing from the scope or spirit of the present invention. Any recited method can be carried out in the order of events recited or in any other order which is logically possible.
As used herein the singular forms “a”, “an”, and “the” include plural referents unless the context clearly dictates otherwise. Thus, for example, reference to “an agent” includes a plurality of such agents and reference to “the drug” includes reference to one or more drugs and equivalents thereof (e.g., therapeutics, medicines, medicaments), known to those skilled in the art, and so forth.
The publications discussed herein are provided solely for their disclosure prior to the filing date of the present application. Nothing herein is to be construed as an admission that the present invention is not entitled to antedate such publication by virtue of prior invention. Further, the dates of publication provided may be different from the actual publication dates which may need to be independently confirmed.
The term “about,” particularly in reference to a given quantity, is meant to encompass deviations of plus or minus five percent.
By “pathological pain” is meant any pain resulting from a pathology, such as from functional disturbances and/or pathological changes, lesions, burns and the like. One form of pathological pain is “neuropathic pain” which is pain thought to initially result from nerve damage but extended or exacerbated by other mechanisms including glial cell activation. Examples of pathological pain include, but are not limited to, thermal or mechanical hyperalgesia, thermal or mechanical allodynia, diabetic pain, pain arising from irritable bowel or other internal organ disorders, endometriosis pain, phantom limb pain, complex regional pain syndromes, fibromyalgia, low back pain, cancer pain, pain arising from infection, inflammation or trauma to peripheral nerves or the central nervous system, multiple sclerosis pain, entrapment pain, and the like.
“Hyperalgesia” refers to an abnormally increased sensitivity to pain, including pain that results from excessive sensitivity to stimuli. Hyperalgesia can result from damage to nociceptors or nerves. Primary hyperalgesia refers to pain sensitivity that occurs in damaged tissues. Secondary hyperalgesia refers to pain sensitivity that occurs in undamaged tissue surrounding damaged tissue. Examples of hyperalgesia include, without limitation, thermal hyperalgesia (i.e., hypersensitivity to cold or heat) and opioid-induced hyperalgesia (e.g., hypersensitivity to pain as a result of long-term opioid use such as caused by treatment of chronic pain).
“Hypalgesia” or “hypoalgesia” refers to decreased sensitivity to pain.
“Allodynia” means pain that results from a normally non-painful, non-noxious stimulus to the skin or body surface. Examples of allodynia include, but are not limited to, thermal (hot or cold) allodynia (e.g., pain from normally mild temperatures), tactile or mechanical allodynia (e.g., static mechanical allodynia (pain triggered by pressure), punctate mechanical allodynia (pain when touched), or dynamic mechanical allodynia (pain in response to stroking or brushing)), movement allodynia (pain triggered by normal movement of joints or muscles), and the like.
“Nociception” is defined herein as pain sense. “Nociceptor” herein refers to a structure that mediates nociception. The nociception may be the result of a physical stimulus, such as, a mechanical, electrical, thermal, or a chemical stimulus. Nociceptors are present in virtually all tissues of the body.
“Analgesia” is defined herein as the relief of pain without the loss of consciousness. An “analgesic” is an agent or drug useful for relieving pain, again, without the loss of consciousness.
The term “administering” is intended to include routes of administration which allow the agent to perform its intended function (e.g., modulating pain perception and/or modulating neural activity of one or more neurons in the BLA nociceptive ensemble). Examples of routes of administration which can be used include injection (intraneural, intracranial, intracerebral, subcutaneous, intravenous, parenteral, intramuscular, intraperitoneal, intrathecal, intraspinal, etc.), oral, intranasal, inhalation, and transdermal. The injection can be bolus injections or can be continuous infusion. Depending on the route of administration, the agent can be coated with or disposed in a selected material to protect it from natural conditions which may detrimentally affect its ability to perform its intended function. The agent may be administered alone, or in conjunction with a pharmaceutically acceptable carrier. Further, the agent may be coadministered with a pharmaceutically acceptable carrier. The agent also may be administered as a prodrug, which is converted to its active form in vivo.
As used here, the term “modulating pain” refers to the modulation (e.g., inhibition or diminishment) of pain or the perception of pain in a given subject and includes absence from pain sensations as well as states of reduced or absent sensitivity to pain stimuli.
As used here, the term “modulating the activity” of a given target cell (e.g., neuron) refers to changing the activity level of a cell function. For example, altering the activity of a target neuron may include changing the membrane potential of a neuron, wherein the membrane potential of a neuron is important for its function (e.g., action potential firing). In some cases, the activity of the neuron is altered such that the membrane potential is increased (e.g., hyperpolarized). In some cases, the activity of the neuron is altered such that the membrane potential is decreased below a threshold potential, resulting in an action potential (e.g., depolarized).
The terms “pharmacologically effective amount” or “therapeutically effective amount” of a composition or agent, as provided herein, refer to a nontoxic but sufficient amount of the composition or agent to provide the desired response, such as a reduction or reversal of neuropathic pain, pathological pain, or chronic pain and/or reducing or eliminating aversive pain avoidance behavior. The exact amount required will vary from subject to subject, depending on the species, age, and general condition of the subject, the severity of the condition being treated, the particular drug or drugs employed, mode of administration, and the like. An appropriate “effective” amount in any individual case may be determined by one of ordinary skill in the art using routine experimentation, based upon the information provided herein.
“Treatment” or “treating” pain includes: (1) preventing pain, i.e., causing pain not to develop or to occur with less intensity in a subject that may be exposed to or predisposed to pain but does not yet experience or display pain, (2) inhibiting pain, i.e., arresting the development or reversing pain, (3) relieving pain, i.e., decreasing the amount of pain experienced by the subject, or (4) reducing or eliminating pain avoidance behavior.
By “treating existing pain” is meant attenuating, relieving or reversing pathological pain in a subject that has been experiencing pain for at least 24 hours, such as for 24-96 hours or more, such as at least 25, 30, 35, 40, 45, 48, 50, 55, 65, 72, 80, 90, 96, or 100 or more hours. The term also intends treating pain that has been occurring long-term, such as for weeks, months or even years.
As used herein, the term “determining” refers to both quantitative and qualitative determinations and as such, the term “determining” is used interchangeably herein with “assaying,” “measuring,” and the like.
“Pharmaceutically acceptable excipient or carrier” refers to an excipient that may optionally be included in the compositions of the invention and that causes no significant adverse toxicological effects to the patient.
“Pharmaceutically acceptable salt” includes, but is not limited to, amino acid salts, salts prepared with inorganic acids, such as chloride, sulfate, phosphate, diphosphate, bromide, and nitrate salts, or salts prepared from the corresponding inorganic acid form of any of the preceding, e.g., hydrochloride, etc., or salts prepared with an organic acid, such as malate, maleate, fumarate, tartrate, succinate, ethylsuccinate, citrate, acetate, lactate, methanesulfonate, benzoate, ascorbate, para-toluenesulfonate, palmoate, salicylate and stearate, as well as estolate, gluceptate and lactobionate salts. Similarly, salts containing pharmaceutically acceptable cations include, but are not limited to, sodium, potassium, calcium, aluminum, lithium, and ammonium (including substituted ammonium).
“Active molecule” or “active agent” as described herein includes any agent, drug, compound, composition of matter or mixture which provides some pharmacologic, often beneficial, effect that can be demonstrated in-vivo or in vitro. This includes foods, food supplements, nutrients, nutriceuticals, drugs, vaccines, antibodies, vitamins, and other beneficial agents. As used herein, the terms further include any physiologically or pharmacologically active substance that produces a localized or systemic effect in a patient.
“Substantially” or “essentially” means nearly totally or completely, for instance, 95% or greater of some given quantity.
“Substantially purified” generally refers to isolation of a substance (e.g., compound, polynucleotide, protein, polypeptide, antibody, aptamer, receptor ligand) such that the substance comprises the majority percent of the sample in which it resides. Typically in a sample, a substantially purified component comprises 50%, preferably 80%-85%, more preferably 90-95% of the sample. Techniques for purifying polynucleotides and polypeptides of interest are well-known in the art and include, for example, ion-exchange chromatography, affinity chromatography and sedimentation according to density.
By “isolated” is meant, when referring to a polypeptide or peptide, that the indicated molecule is separate and discrete from the whole organism with which the molecule is found in nature or is present in the substantial absence of other biological macro molecules of the same type. The term “isolated” with respect to a polynucleotide is a nucleic acid molecule devoid, in whole or part, of sequences normally associated with it in nature; or a sequence, as it exists in nature, but having heterologous sequences in association therewith; or a molecule disassociated from the chromosome.
By “subject” is meant any member of the subphylum chordata, including, without limitation, humans and other primates, including non-human primates such as chimpanzees and other apes and monkey species; farm animals such as cattle, sheep, pigs, goats and horses; domestic mammals such as dogs and cats; laboratory animals including rodents such as mice, rats and guinea pigs; birds, including domestic, wild and game birds such as chickens, turkeys and other gallinaceous birds, ducks, geese, and the like.
The term “antibody” encompasses polyclonal antibodies, monoclonal antibodies as well as hybrid antibodies, altered antibodies, chimeric antibodies, and humanized antibodies. The term antibody includes: hybrid (chimeric) antibody molecules (see, for example, Winter et al. (1991) Nature 349:293-299; and U.S. Pat. No. 4,816,567); F(ab′)2 and F(ab) fragments; Fv molecules (noncovalent heterodimers, see, for example, Inbar et al. (1972) Proc Nat Acad SciUSA 69:2659-2662; and Ehrlich et al. (1980) Biochem 19:4091-4096); single-chain Fv molecules (scFv) (see, e.g., Huston et al. (1988) Proc Natl Acad Sci USA 85:5879-5883); nanobodies or single-domain antibodies (sdAb) (see, e.g., Wang et al. (2016) Int J Nanomedicine 11:3287-3303, Vincke et al. (2012) Methods Mol Biol 911:15-26; dimeric and trimeric antibody fragment constructs; minibodies (see, e.g., Pack et al. (1992) Biochem 31:1579-1584; Cumber et al. (1992) J Immunology 149B:120-126); humanized antibody molecules (see, e.g., Riechmann et al. (1988) Nature 332:323-327; Verhoeyan et al. (1988) Science 239:1534-1536; and U.K. Patent Publication No. GB 2,276,169, published 21 Sep. 1994); and, any functional fragments obtained from such molecules, wherein such fragments retain specific-binding properties of the parent antibody molecule.
The phrase “specifically (or selectively) binds” with reference to binding of an antibody to an antigen refers to a binding reaction that is determinative of the presence of the antigen in a heterogeneous population of proteins and other biologics. Thus, under designated immunoassay conditions, the specified antibodies bind to a particular antigen at least two times the background and do not substantially bind in a significant amount to other antigens present in the sample. Specific binding to an antigen under such conditions may require an antibody that is selected for its specificity for a particular antigen. For example, antibodies raised to an antigen from specific species such as rat, mouse, or human can be selected to obtain only those antibodies that are specifically immunoreactive with the antigen and not with other proteins, except for polymorphic variants and alleles. This selection may be achieved by subtracting out antibodies that cross-react with molecules from other species. A variety of immunoassay formats may be used to select antibodies specifically immunoreactive with a particular antigen. For example, solid-phase ELISA immunoassays are routinely used to select antibodies specifically immunoreactive with a protein (see, e.g., Harlow & Lane. Antibodies, A Laboratory Manual (1988), for a description of immunoassay formats and conditions that can be used to determine specific immunoreactivity). Typically, a specific or selective reaction will be at least twice background signal or noise and more typically more than 10 to 100 times background.
Screening for Agents that Reduce Pain Perception or Aversive Pain Avoidance Behavior
The inventors have discovered a core set of neurons in the basolateral amygdala (i.e., the BLA nociceptive ensemble) that function in the perception of acute and chronic pain. Additionally, increasing activation of the BLA nociceptive ensemble correlates with increased pain affective-motivational behavior. Silencing the BLA neural ensemble alleviates pain affective-motivational behavior without altering the detection of noxious stimuli. Accordingly, screening methods for identifying candidate agents that inhibit neural activity of the BLA neural ensemble are provided.
In some embodiments, the screening method comprises contacting one or more neurons of the BLA nociceptive ensemble in the brain of a subject with a candidate agent and monitoring pain perception or pain avoidance behavior of the subject. A subset of neurons of the BLA nociceptive ensemble or all of the neurons of the BLA nociceptive ensemble may be contacted with the agent.
In some embodiments, a candidate agent is screened in a test subject. The test subject may be any subject having a BLA neural ensemble that is capable of perceiving pain. Various methods are known in the art for measuring the perception of pain by a subject. Test subjects may be human or non-human. Non-human test subjects may include, for example, mammals, including, without limitation, carnivores (e.g., dogs and cats), rodents (e.g., mice, guinea pigs and rats), and primates (e.g., chimpanzees and monkeys).
A variety of screening methods may be used for assessing whether an agent relieves pain and/or reduces pain affective-motivational behavior including sensory perception of pain, pain avoidance behavior, hyperalgesia, and allodynia. Exemplary screening methods include, without limitation, stimulus-evoked behavioral tests such as a mechanical withdrawal test, an electronic Von Frey test, a manual Von Frey test, a Randall-Selitto test, a Hargreaves test, a hot plate test, a cold plate test, a thermal probe test, an acetone evaporation test, cold plantar test, and a temperature preference test; and non-stimulus-evoked behavioral tests such as a grimace scale test, weight bearing and gait analysis, locomotive activity test (e.g., still, walking, trotting, running, distance traveled, velocity, eating/drinking and foraging behavior frequencies), and burrowing behavior test. See, e.g., Deuis et al. (2017) Front Mol Neurosci. 10:284, Yuan et al. (2016) Adv Exp Med Biol. 904:1-22, Navratilova et al. (2013) Ann N Y Acad Sci. 1282:1-11; herein incorporated by reference.
Pain induced by mechanical stimuli may include mechanical hyperalgesia or allodynia, which can be subdivided into dynamic (triggered by brushing), punctate (triggered by touch) and static (triggered by pressure) subtypes of hyperalgesia or allodynia. Testing for dynamic mechanical allodynia and hyperalgesia may include, for example, brushing the skin of a subject with a cotton ball or paintbrush. Punctate mechanical allodynia and hyperalgesia can be tested, for example, with a pinprick or von Frey filaments of varying forces (0.08-2940 mN). Static hyperalgesia can be tested, for example, by applying pressure to the skin or underlying tissue by pressing a finger or using a pressure algometer.
Pain induced by heat or cold stimuli may include thermal hyperalgesia or allodynia. Thermal hyperalgesia or allodynia may be tested, for example, by applying a metal probe to the skin that increases or decreases in temperature to determine a threshold temperature at which pain is experienced. Pain induced by heat is typically experienced at temperatures of 42-48° C., and pain induced by cold is typically experienced at temperatures of 23.7-1.5° C.
For testing of pain in animals, pain is inferred from “pain-like” behaviors, such as withdrawal from a nociceptive stimulus. An animal is considered to have allodynia if the animal withdraws from an innocuous stimulus that does not normally evoke a withdrawal response. An animal is considered to have hyperalgesia if an animal withdraws with an exaggerated response to a stimulus that does normally evoke a withdrawal response. Responses of animals to mechanical stimuli can be tested using a manual or electronic Von Frey test or the Randall Selitto test. Responses of animals to heat stimuli can be tested, for example, using the tail flick test, the Hargreaves test, a hot plate test, or a thermal probe test. Responses of animals to cold stimuli can be tested, for example, using a cold plate test, an acetone evaporation test, a cold plantar assay. Thermal hyperalgesia or allodynia can be tested in animals for example by using a temperature preference test. For example, an animal is allowed to choose between two adjacent areas maintained at different temperatures or a preferred position along a continuous temperature gradient (either in linear or circular form).
A grimace scales test can be used to score the subjective intensity of pain based on facial expressions of a subject. In rodents (e.g., rats and mice), facial features can be scored, including orbital tightening, nose/cheek bulge or flattening, ear position, and whisker position. Burrowing, which is a self-motivated behavior, can also be used as a measure of spontaneous or non-stimulus evoked nociception in mice and rats. Gait and weight bearing of rodents also can be analyzed as an indicator of nociception.
Other behavior that can be analyzed in test subjects include locomotive activity (still, walking, trotting, running), distance traveled, velocity, grooming, posture, eating/drinking and foraging. The frequencies of these behaviors in animal models of pain are compared to control states to determine if an agent alleviates pain or pain-motivated behavior.
A variety of different test agents may be screened for their effects on inhibition of neural activity of the of the BLA nociceptive ensemble and pain perception or pain affective-motivational behavior. Candidate agents encompass numerous chemical classes, e.g., small organic compounds having a molecular weight of more than 50 daltons and less than about 10,000 daltons, less than about 5,000 daltons, or less than about 2,500 daltons. Test agents can comprise functional groups necessary for structural interaction with proteins, e.g., hydrogen bonding, and can include at least an amine, carbonyl, hydroxyl or carboxyl group, or at least two of the functional chemical groups. The test agents can comprise cyclical carbon or heterocyclic structures and/or aromatic or polyaromatic structures substituted with one or more of the above functional groups. Test agents are also found among biomolecules including peptides, saccharides, fatty acids, steroids, purines, pyrimidines, derivatives, structural analogs or combinations thereof.
Test agents are obtained from a wide variety of sources including libraries of synthetic or natural compounds. For example, numerous means are available for random and directed synthesis of a wide variety of organic compounds and biomolecules, including expression of randomized oligonucleotides and oligopeptides. Alternatively, libraries of natural compounds in the form of bacterial, fungal, plant and animal extracts are available or readily produced. Additionally, natural or synthetically produced libraries and compounds are readily modified through conventional chemical, physical and biochemical means, and may be used to produce combinatorial libraries. Known pharmacological agents may be subjected to directed or random chemical modifications, such as acylation, alkylation, esterification, amidification, etc. to produce structural analogs. Moreover, screening may be directed to known pharmacologically active compounds and chemical analogs thereof, or to new agents with unknown properties such as those created through rational drug design.
In some embodiments, test agents are synthetic compounds. A number of techniques are available for the random and directed synthesis of a wide variety of organic compounds and biomolecules, including expression of randomized oligonucleotides. See for example WO 94/24314, hereby expressly incorporated by reference, which discusses methods for generating new compounds, including random chemistry methods as well as enzymatic methods.
In another embodiment, the test agents are provided as libraries of natural compounds in the form of bacterial, fungal, plant and animal extracts that are available or readily produced. Additionally, natural or synthetically produced libraries and compounds are readily modified through conventional chemical, physical and biochemical means. Known pharmacological agents may be subjected to directed or random chemical modifications, including enzymatic modifications, to produce structural analogs.
In some embodiments, the test agents are organic moieties. In this embodiment, test agents are synthesized from a series of substrates that can be chemically modified. “Chemically modified” herein includes traditional chemical reactions as well as enzymatic reactions. These substrates generally include, but are not limited to, alkyl groups (including alkanes, alkenes, alkynes and heteroalkyl), aryl groups (including arenes and heteroaryl), alcohols, ethers, amines, aldehydes, ketones, acids, esters, amides, cyclic compounds, heterocyclic compounds (including purines, pyrimidines, benzodiazepins, beta-lactams, tetracylines, cephalosporins, and carbohydrates), steroids (including estrogens, androgens, cortisone, ecodysone, etc.), alkaloids (including ergots, vinca, curare, pyrollizdine, and mitomycines), organometallic compounds, hetero-atom bearing compounds, amino acids, and nucleosides. Chemical (including enzymatic) reactions may be done on the moieties to form new substrates or candidate agents which can then be tested using the present invention.
In some embodiments test agents are assessed for any cytotoxic activity it may exhibit toward a living eukaryotic cell, using well-known assays, such as trypan blue dye exclusion, an MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-2 H-tetrazolium bromide) assay, and the like. Agents that do not exhibit significant cytotoxic activity are considered candidate agents.
In some embodiments, the test agent is an antibody that specifically binds to a receptor and alters neural activity of a neuron of the BLA nociceptive ensemble. Any type of antibody may be screened for the ability to inhibit neural activity of a neuron of the BLA nociceptive ensemble by the methods described herein, including polyclonal antibodies, monoclonal antibodies, hybrid antibodies, altered antibodies, chimeric antibodies and, humanized antibodies, as well as: hybrid (chimeric) antibody molecules (see, for example, Winter et al. (1991) Nature 349:293-299; and U.S. Pat. No. 4,816,567); F(ab′)2 and F(ab) fragments; Fv molecules (noncovalent heterodimers, see, for example, Inbar et al. (1972) Proc Natl Acad Sci USA 69:2659-2662; and Ehrlich et al. (1980) Biochem 19:4091-4096); single-chain Fv molecules (sFv) (see, e.g., Huston et al. (1988) Proc Natl Acad Sci USA 85:5879-5883); nanobodies or single-domain antibodies (sdAb) (see, e.g., Wang et al. (2016) Int J Nanomedicine 11:3287-3303, Vincke et al. (2012) Methods Mol Biol 911:15-26; dimeric and trimeric antibody fragment constructs; minibodies (see, e.g., Pack et al. (1992) Biochem 31:1579-1584; Cumber et al. (1992) J Immunology 149B:120-126); humanized antibody molecules (see, e.g., Riechmann et al. (1988) Nature 332:323-327; Verhoeyan et al. (1988) Science 239:1534-1536; and U.K. Patent Publication No. GB 2,276,169, published 21 Sep. 1994); and, any functional fragments obtained from such molecules, wherein such fragments retain specific-binding properties of the parent antibody molecule.
In other embodiments, the test agent is an aptamer that specifically binds to a receptor and alters neural activity of a neuron of the BLA nociceptive ensemble. Aptamers may be isolated from a combinatorial library and improved by directed mutation or repeated rounds of mutagenesis and selection. For a description of methods of producing aptamers, see, e.g., Aptamers: Tools for Nanotherapy and Molecular Imaging (R. N. Veedu ed., Pan Stanford, 2016), Nucleic Acid and Peptide Aptamers: Methods and Protocols (Methods in Molecular Biology, G. Mayer ed., Humana Press, 2009), Aptamers Selected by Cell-SELEX for Theranostics (W. Tan, X. Fang eds., Springer, 2015), Cox et al. (2001) Bioorg. Med. Chem. 9(10)2525-2531; Cox et al. (2002) Nucleic Acids Res. 30(20): e108, Kenan et al. (1999) Methods Mol. Biol. 118:217-231; Platella et al. (2016) Biochim. Biophys. Acta Nov 16 pii: S0304-4165(16)30447-0, and Lyu et al. (2016) Theranostics 6(9):1440-1452; herein incorporated by reference in their entireties.
In yet other embodiments, the test agent is an antibody mimetic that specifically binds to a receptor and alters neural activity of a neuron of the BLA nociceptive ensemble. Any type of antibody mimetic may be used, including, but not limited to, affibody molecules (Nygren (2008) FEBS J. 275 (11):2668-2676), affilins (Ebersbach et al. (2007) J. Mol. Biol. 372 (1):172-185), affimers (Johnson et al. (2012) Anal. Chem. 84 (15):6553-6560), affitins (Krehenbrink et al. (2008) J. Mol. Biol. 383 (5):1058-1068), alphabodies (Desmet et al. (2014) Nature Communications 5:5237), anticalins (Skerra (2008) FEBS J. 275 (11)2677-2683), avimers (Silverman et al. (2005) Nat. Biotechnol. 23 (12):1556-1561), darpins (Stumpp et al. (2008) Drug Discov. Today 13 (15-16):695-701), fynomers (Grabulovski et al. (2007) J. Biol. Chem. 282 (5):3196-3204), and monobodies (Koide et al. (2007) Methods Mol. Biol. 352:95-109).
Candidate agents can be detectably labeled by well-known techniques. Detectable labels include, for example, radioactive isotopes, fluorescent labels, chemiluminescent labels, bioluminescent labels and enzyme labels. Such labeled inhibitors can be used to determine cellular uptake efficiency, quantitate binding of inhibitors at target sites, or visualize inhibitor localization.
Assays may further include suitable controls (e.g., untreated with candidate agent or any other analgesic agent). Generally, a plurality of tests is run in parallel with different agent concentrations used on different test subjects to obtain a differential response to the various concentrations. Typically, one of these concentrations serves as a negative control, i.e., at zero concentration or below the level of detection.
Agents, identified by the screening methods described herein, as useful for alleviating pain and/or reducing aversive pain-motivated behavior can be formulated into pharmaceutical compositions optionally comprising one or more pharmaceutically acceptable excipients. Exemplary excipients include, without limitation, carbohydrates, inorganic salts, antimicrobial agents, antioxidants, surfactants, buffers, acids, bases, and combinations thereof. Excipients suitable for injectable compositions include water, alcohols, polyols, glycerine, vegetable oils, phospholipids, and surfactants. A carbohydrate such as a sugar, a derivatized sugar such as an alditol, aldonic acid, an esterified sugar, and/or a sugar polymer may be present as an excipient. Specific carbohydrate excipients include, for example: monosaccharides, such as fructose, maltose, galactose, glucose, D-mannose, sorbose, and the like; disaccharides, such as lactose, sucrose, trehalose, cellobiose, and the like; polysaccharides, such as raffinose, melezitose, maltodextrins, dextrans, starches, and the like; and alditols, such as mannitol, xylitol, maltitol, lactitol, xylitol, sorbitol (glucitol), pyranosyl sorbitol, myoinositol, and the like. The excipient can also include an inorganic salt or buffer such as citric acid, sodium chloride, potassium chloride, sodium sulfate, potassium nitrate, sodium phosphate monobasic, sodium phosphate dibasic, and combinations thereof.
A composition of the invention can also include an antimicrobial agent for preventing or deterring microbial growth. Nonlimiting examples of antimicrobial agents suitable for the present invention include benzalkonium chloride, benzethonium chloride, benzyl alcohol, cetylpyridinium chloride, chlorobutanol, phenol, phenylethyl alcohol, phenylmercuric nitrate, thimersol, and combinations thereof.
An antioxidant can be present in the composition as well. Antioxidants are used to prevent oxidation, thereby preventing the deterioration of the agent, or other components of the preparation. Suitable antioxidants for use in the present invention include, for example, ascorbyl palmitate, butylated hydroxyanisole, butylated hydroxytoluene, hypophosphorous acid, monothioglycerol, propyl gallate, sodium bisulfite, sodium formaldehyde sulfoxylate, sodium metabisulfite, and combinations thereof.
A surfactant can be present as an excipient. Exemplary surfactants include: polysorbates, such as “Tween 20” and “Tween 80,” and pluronics such as F68 and F88 (BASF, Mount Olive, N.J.); sorbitan esters; lipids, such as phospholipids such as lecithin and other phosphatidylcholines, phosphatidylethanolamines (although preferably not in liposomal form), fatty acids and fatty esters; steroids, such as cholesterol; chelating agents, such as EDTA; and zinc and other such suitable cations.
Acids or bases can be present as an excipient in the composition. Nonlimiting examples of acids that can be used include those acids selected from the group consisting of hydrochloric acid, acetic acid, phosphoric acid, citric acid, malic acid, lactic acid, formic acid, trichloroacetic acid, nitric acid, perchloric acid, phosphoric acid, sulfuric acid, fumaric acid, and combinations thereof. Examples of suitable bases include, without limitation, bases selected from the group consisting of sodium hydroxide, sodium acetate, ammonium hydroxide, potassium hydroxide, ammonium acetate, potassium acetate, sodium phosphate, potassium phosphate, sodium citrate, sodium formate, sodium sulfate, potassium sulfate, potassium fumerate, and combinations thereof.
The amount of the agent (e.g., when contained in a drug delivery system) in the composition will vary depending on a number of factors but will optimally be a therapeutically effective dose when the composition is in a unit dosage form or container (e.g., a vial). A therapeutically effective dose can be determined experimentally by repeated administration of increasing amounts of the composition in order to determine which amount produces a clinically desired endpoint.
The amount of any individual excipient in the composition will vary depending on the nature and function of the excipient and particular needs of the composition. Typically, the optimal amount of any individual excipient is determined through routine experimentation, i.e., by preparing compositions containing varying amounts of the excipient (ranging from low to high), examining the stability and other parameters, and then determining the range at which optimal performance is attained with no significant adverse effects. Generally, however, the excipient(s) will be present in the composition in an amount of about 1% to about 99% by weight, preferably from about 5% to about 98% by weight, more preferably from about 15 to about 95% by weight of the excipient, with concentrations less than 30% by weight most preferred. These foregoing pharmaceutical excipients along with other excipients are described in “Remington: The Science & Practice of Pharmacy”, 19th ed., Williams & Williams, (1995), the “Physician's Desk Reference”, 52nd ed., Medical Economics, Montvale, N.J. (1998), and Kibbe, A. H., Handbook of Pharmaceutical Excipients, 3rd Edition, American Pharmaceutical Association, Washington, D.C., 2000.
The compositions encompass all types of formulations and in particular those that are suited for injection, e.g., powders or lyophilates that can be reconstituted with a solvent prior to use, as well as ready for injection solutions or suspensions, dry insoluble compositions for combination with a vehicle prior to use, and emulsions and liquid concentrates for dilution prior to administration. Examples of suitable diluents for reconstituting solid compositions prior to injection include bacteriostatic water for injection, dextrose 5% in water, phosphate buffered saline, Ringer's solution, saline, sterile water, deionized water, and combinations thereof. With respect to liquid pharmaceutical compositions, solutions and suspensions are envisioned. Additional preferred compositions include those for intraneural, intracerebral, intrathecal, intraspinal, or localized delivery such as by stereotactic injection into the BLA nociceptive ensemble in the brain.
The pharmaceutical preparations herein can also be housed in a syringe, an implantation device, or the like, depending upon the intended mode of delivery and use. Preferably, the compositions comprising the agent are in unit dosage form, meaning an amount of a conjugate or composition of the invention appropriate for a single dose, in a premeasured or pre-packaged form.
The compositions herein may optionally include one or more additional agents, such as analgesics or one or more other drugs for treating pain or other medications. For example, compounded preparations may include at least one candidate agent and one or more other drugs for treating pain, including, without limitation, acetaminophen, nonsteroidal anti-inflammatory drugs (e.g., aspirin, ibuprofen and naproxen), COX-2 inhibitors (e.g., rofecoxib, celecoxib, and etoricoxib), opioids (e.g., morphine, codeine, oxycodone, hydrocodone, dihydromorphine, and pethidine), gabapentin, memantine, pregabalin, cannabinoids, tramadol, lamotrigine, carbamazepine, duloxetine, milnacipran, tricyclic antidepressants (e.g., amitriptyline, nortriptyline, and desipramine), and serotonin-norepinephrine reuptake inhibitors (e.g., duloxetine, venlafaxine, and milnacipran).
The following examples are put forth so as to provide those of ordinary skill in the art with a complete disclosure and description of how to make and use the present invention, and are not intended to limit the scope of what the inventors regard as their invention nor are they intended to represent that the experiments below are all or the only experiments performed. Efforts have been made to ensure accuracy with respect to numbers used (e.g., amounts, temperature, etc.) but some experimental errors and deviations should be accounted for. Unless indicated otherwise, parts are parts by weight, molecular weight is weight average molecular weight, temperature is in degrees Centigrade, and pressure is at or near atmospheric.
All publications and patent applications cited in this specification are herein incorporated by reference as if each individual publication or patent application were specifically and individually indicated to be incorporated by reference.
The present invention has been described in terms of particular embodiments found or proposed by the present inventor to comprise preferred modes for the practice of the invention. It will be appreciated by those of skill in the art that, in light of the present disclosure, numerous modifications and changes can be made in the particular embodiments exemplified without departing from the intended scope of the invention. For example, due to codon redundancy, changes can be made in the underlying DNA sequence without affecting the protein sequence. Moreover, due to biological functional equivalency considerations, changes can be made in protein structure without affecting the biological action in kind or amount. All such modifications are intended to be included within the scope of the appended claims.
An Amygdalar Neural Ensemble that Encodes the Unpleasantness of Pain
Previous studies attempting to define pain affect mechanisms recorded the acute nociceptive responses of single amygdalar neurons in anesthetized animals (11, 18). However, recent work has shown that the BLA encodes information via the coordinated dynamics of neurons within large ensembles (19); it is therefore important to resolve how the BLA processes pain affect at the neural ensemble level in awake, freely behaving animals. We first performed fluorescence in situ hybridization studies and used the immediate-early gene marker of neural activity, c-Fos, to determine that c-Fos+ neurons activated by nociceptive stimuli comprised a population of mid-anterior BLA Camk2a+ principal neurons (
Noxious heat, cold, and pin prick stimuli elicited significant Ca2+ responses in 15±2% (SEM), 13±2%, and 13±2% of active BLA neurons, respectively [3397 neurons (117±8 neurons per session)] (
This ensemble was composed of multimodal responsive neurons, as well as a unique population that appeared to encode nociception selectively and no other sensory information (6±1% of all imaged neurons) (
To determine whether the BLA nociceptive ensemble broadly encodes stimulus valence (22, 23), we presented mice with an appetitive stimulus (10% sucrose). Sucrose consumption was encoded by a distinct ensemble (18±3% of all neurons) that only overlapped with a subset of neurons in the nociceptive ensemble (7% of total neurons) (
We next determined if the nociceptive ensemble was engaged during aversive experiences other than pain by presenting a panel of sensory, but nonsomatosensory or nonnaturalistic, aversive stimuli, including repulsive odor, bitter taste, loud tone, facial air puff, and electric shock. We found that while there was overlap between the neural ensembles that encode nociceptive, aversive, and electric shock stimuli (˜10% of all imaged neurons), there remained a subset of BLA neurons (˜6% of imaged neurons) that responded only to naturalistic nociceptive stimuli (
By analyzing the neural ensemble dynamics with pattern classification methods, we were able to classify and distinguish with high accuracy noxious stimuli from other aversive stimuli (
To test the causal role of the BLA nociceptive ensemble for pain behaviors, we expressed a Cre-dependent inhibitory DREADD neuromodulator (hM4-mCherry) in mutant TRAP mice (FosCreERT2) by applying noxious pin pricks that induced activity-dependent, spatially, and temporally controlled DNA recombination and hM4-mCherry expression (noci-TRAPhM4 mice) (
Whether pain and anxiety rely on common or distinct BLA ensembles is unknown; therefore, we placed noci-TRAPhM4 mice within an elevated plus maze, in which anxiety drives avoidance of the open arms (
We next investigated the contribution of BLA neural ensemble activity to chronic pain. A hallmark of chronic neuropathic pain is the appearance of allodynia and hyperalgesia, both pathological perceptual states in which aversion is ascribed to innocuous somatosensory stimuli and exacerbated in response to noxious stimuli, respectively (
We next asked if we could prevent the neural transformation of light touch sensory information into an aversive signal and eliminate chronic pain unpleasantness by gaining genetic access to the nociceptive ensemble with innocuous stimuli in neuropathic TRAP mice. At 21 days post-nerve injury, when allodynia had fully developed (
We therefore ran neuropathic TRAPhM4 mice through a two-chamber thermal escape-avoidance assay in which the floor of one chamber was cooled (from 30° to 10° C.) (
Notably, CNO administration to neuropathic TRAPhM4 mice generated a near-total indifference between cold and neutral temperature chambers (
Thus, disrupting neural activity in a nociceptive ensemble in the BLA is sufficient to reduce the affective dimension of pain experiences, without altering their sensory component. The unconditioned nociceptive ensemble described here is a stable network of amygdalar principal neurons that is responsive to a diverse array of noxious stimuli. Within this ensemble, combinatorial neural ensemble codes distinguish the various thermal and mechanical nociceptive stimuli. These codes likely represent stimulus modality, intensity, salience, and valence to provide additional qualitative information that enriches individual pain affect percepts (30). The presence of a purely nociceptive-specific subpopulation of neurons within the larger BLA nociceptive ensemble, distinct from general aversion-encoding populations, suggests the capacity for computing and assigning an accompanying “pain tag” to valence information. This categorical signal could prioritize the negative valence of intense noxious stimuli and scale the selection of conative pain protective behaviors. It is thought that hierarchical pathways transform low-level sensory inputs into higher-order affective responses (5, 31). Our chemogenetic manipulations suggest that this critical node in the nociceptive brain circuitry plays a critical role in shaping pain experiences, by providing an evaluation of nociceptive information that, in turn, intrinsically motivates protective behaviors associated with pain (32).
The phenomenological description of a pain experience is normally that of a complex but unified sensory and emotional perception that can neither exist alone as an unanchored aversive state nor stand merely on its emotionally inert sensory qualities (33, 34). Though activity within the BLA nociceptive ensemble cannot account for the instantiation of the entire pain experience, we propose that the BLA nociceptive ensemble transmits abstracted valence information to the central amygdala, striatal, and cortical networks (35-37). For example, BLA neurons projecting to the CeA may send a “pain tag” that helps select for appropriate defensive responses to impending or immediate threats (23). In parallel, connected cortical regions might coalesce BLA affective signals with sensory-discriminative information to process them against prior experiences and internal states for further evaluation at cognitive levels, all of which contribute to the construction of a pain experience (4, 38).
During chronic pain states, BLA ensemble coding of innocuous somatosensory information changes to engage the nociceptive ensemble, leading to perceived aversion and protective behavioral responses when encountering normally nonpainful stimuli, such as light touch. Whether this change in ensemble activity results from peripheral or central sensitization (3, 39), amygdalar input, or intra-amygdala plasticity (11) remains an open question. Chronic pain is not simply a sensory disorder but a neurological disease with affective dysfunction that profoundly impacts the mental state of millions of pain patients (40). Clinical management of chronic pain remains a staggering challenge, given the heterogeneity of underlying causes, and the overreliance on opioid analgesics has contributed to the opioid epidemic (41, 42). Comprehensive strategies that provide substantive relief across pain types are urgently needed (43). To make progress along this translational path, we have identified in the BLA a critical neural ensemble target that mediates chronic pain unpleasantness. This finding may enable the development of chronic pain therapies that could selectively diminish pain unpleasantness, regardless of etiology, without influencing reward, and importantly, preserving reflexes and sensory-discriminative processes necessary for the detection and localization of noxious stimuli (44, 45). Collectively, our findings begin to refine the neural basis and coding principles underlying the multiple dimensions and complexity of the pain experience for developing more effective analgesic therapies.
All procedures were approved by the Stanford University Administrative Panel on Laboratory Animal Care in accordance with American Veterinary Medical Association guidelines and the International Association for the Study of Pain. We housed mice 1-5 per cage and maintained them on a 12-hour light/dark cycle in a temperature-controlled environment with ad libitum access to food and water. Animals undergoing active Ca imaging experiments (after mounting the miniature microscope baseplate) were singly housed. For behavioral manipulation and neuroanatomy experiments, we utilized Fos-CreERT2 mice (B6.129(Cg)-Fostml.1(cre/ERT2) Luo/J, Jackson Laboratory, stock #21882, male, aged 8-15 weeks at the start of all experiments). For BLA miniature microscope imaging experiments, we utilized C57BV/6J mice (Jackson Laboratory, stock #664, male, aged 8-12 weeks at the start of experiments). For dorsomedial striatum (DMS) miniature microscope imaging experiments, we utilized wild-type (Shank3B+/+) or knockout (Shank3B−/−) Shank3B;Drd1aCre/+ or Shank3B;A2ACre/+. mice obtained from Guoping Feng (MIT).
4-hydroxytamoxifen (Sigma, #H6278) prepared in Kolliphor EL (Sigma, #27963), Clozapine-N-oxide (Tocris, #4936), and 0.9% Sodium chloride (Hospira, #NDC 0409-4888-10).
For Ca2+ imaging using GCaMP6m (68) in BLA Camk2a+ principal neurons, we intracranially injected 500 nL of AAV2/5-Camk2a-GCaMP6m-WPRE (Schnitzer lab custom preparation; titre: 6.7×1012 GC/mL for
For chemogenetic activity manipulation of BLA neuronal ensembles, we intracranially injected 100 nL of either AAV5-hSyn-DIO-hM4-mCherry (U. North Carolina Viral Core; titre: 3.98×1012), AAV5-hSyn-DIO-mCherry (U. North Carolina Viral Core; titre: 4.72×1012), AAVDJ-Ef1a-DIO-eYFP (Stanford Viral Core; titre: 2.65×1011) into both the left and right BLA at coordinates AP: −1.20 mm, ML: ±3.1 mm, DV: −4.60 mm.
For transdermal optogenetic activation of primary afferent nociceptors, we intrathecally injected 2.5 μL of AAV6-hSyn-ChR2(H134R)-eYFP (U. North Carolina Viral Core; titre: 2.17×1013) directly into the subarachnoid space so that the virus reaches the CSF and can infect nociceptors.
We conducted all surgeries under aseptic conditions using a digital small animal stereotaxic instrument (David Kopf Instruments). We anaesthetized mice with isoflurane (5% induction, 1-2% maintenance) in the stereotaxic frame for the entire surgery and maintained their body temperature using a heating pad. We injected mice with a beveled 33G needle facing medially, attached to a 10-μL microsyringe (Nanofil, WPI) for delivery of viral reagents at a rate of 20 nL/min for more precise targeting (e.g., of DREADD (hM4) expression) using a microinjection unit (Model 5000, Kopf). After reagent injection, the needle was raised 100 μm for an additional 10 min to allow the virus to diffuse at the injection site and then slowly withdrawn over an additional 3 min. After surgery, we maintained the animal's body temperature using a radiant heat lamp until fully recovered from anesthesia.
We conducted all surgeries under aseptic conditions with glass bead sterilized surgical tools (Dent-Eq, BS500) and used a digital small animal stereotaxic instrument (David Kopf Instruments). We anaesthetized mice with isoflurane (2-5% induction, 1-2% maintenance) in the stereotaxic frame for the entire surgery and maintained body temperature using a heating pad (FHC, DC Temperature Regulation System). For
For BLA-implanted mice run through the protocol in
For implantation surgeries, we anaesthetized mice with isoflurane (2-5% induction, 1-2% maintenance, both in oxygen) and maintained their body temperature using a heating pad (FHC, DC Temperature Regulation System). After head hair removal (Nair, Church and Dwight Co. NRSL-22339-05) and opening the mouse skin, we performed small craniotomies in three locations—ML: (−0.7, 2.1, −3.1) mm and AP: (5.2, −3.6, −3.6) mm. We screwed three stainless steel screws (Component Supply Company, MX-000120-01SF) into the skull right up to dura and then performed a craniotomy using a drill (Osada Model EXL-M40) and 1.4 mm round drill burr (FST, 19007-14). We cleaned away bone fragments and other detritus from the opening using sterilized forceps (Fine Science Tools, Dumont #5 Forceps, 11252-20). We continuously applied mammalian Ringers (Fisher Scientific, 50-980-246) to the surgical area when necessary for the remainder of the surgery. To prevent increased intracranial pressure and improve quality of the imaging site, we aspirated all overlying tissue down to ˜DV: −4.20 mm (BLA mice) or −2.10 mm (DMS mice) with a 27G needle (Sai-Infusion, B27-50-27G or VWR Cat. No. 89134-172).
We attached a 1.06-mm stainless steel cannula onto a custom designed 3D printed cannula holder (Stratasys Objet30 printer, VeroBlackPlus material). For BLA-implanted mice, we lowered the cannula to AP: −1.70 mm, ML: +3.30 mm (right BLA) or −3.30 mm (left BLA), DV: −4.50 mm. For DMS-implanted mice, we lowered the cannula to AP: −0.80 mm, ML: +1.50 mm, DV: −2.35 mm. This placed the cannula ˜100-300 μm above the imaging plan based on the specifications of the GRIN lens microendoscope's imaging side working distance. Next, we immediately retracted the cannula from the craniotomy site and aspirated any additional debris or blood that had been pushed down during the initial implant then relowered the cannula into the implant site, covered the cannula with adhesive cement (C&B, S380 Metabond Quick Adhesive Cement System), and allowed the cement to fix for 2-3 min. We placed custom designed laser cut headbars (LaserAlliance, 18-24G thickness stainless steel) over the left posterior skull screw and applied alayer of dental cement (Coltene Whaledent, Hygenic Perm) to affix both the headbar and cannula to the skull. The cement dried for 7-10 min before we covered the cannula with bio tape (NC9033794 Tegaderm Transparent Dressing), fixed the tape to the cement with ultraviolet (UV) glue (Loctite® Light-Activated Adhesive #4305), and allowed the animal to recover from anesthesia on a heated pad.
Several weeks after implantation, we checked awake animals for GCaMP6m fluorescence and Ca2+ transient activity on a custom designed apparatus. We avoided using anesthesia as this causes the BLA to exhibit reduced activity or become silent, which might have potentially led us to classify animals incorrectly as unusable due to lack of neural activity even though their neurons might have been active if the animal had been awake. We head-fixed mice by clamping (Siskiyou, CC-1) their headbar and allowed them to run on a running wheel (Fisher Scientific, InnoWheel, Catalog No. 14-726-577), which was attached via a custom designed 3D printed part (Stratasys Objet30 printer, VeroBlackPlus material) to a rotary encoder (Signswise 600P/R Incremental Rotary Encoder). We then lowered a custom-designed 1.0-mm-diameter microendoscope probe based on a gradient refractive index (GRIN) lens (Grintech GmBH) into the stainless steel cannula using forceps or a 27G needle attached to a vacuum line. We attached the miniature microscope onto a holder (Inscopix, Gripper Part, ID: 1050-002199) connected to a goniometer (Thorlabs, GN1) that allowed us to tilt the miniature microscope in x-z and y-z planes. We connected the holder to a three-axis micromanipulator and used it to lower the miniature microscope until we were in the microendoscope's focal plane. To determine an optimal part of the microendoscope to image neural activity, we made minor position adjustments of the miniature microscope in the x-y plane using the micromanipulator. To ensure the entire field-of-view was in focus, we adjusted the miniature microscope's tilt relative to the microendoscope. We used the imaging software (Inscopix, nVista 2.0) to display incoming imaging frames in units of relative fluorescence changes (AF/F); this allowed us to observe Ca2+ transient activity in the awake behaving mice. We checked for time-locked responses to both auditory (e.g., clap) and sensory (e.g., tail pinch) stimuli, along with any signs of indicator overexpression (i.e., brightly fluorescent neurons lacking Ca2+ transient activity). Mice passing both tests moved onto mounting of the miniature microscope baseplate.
In anesthetized (2% isoflurane in oxygen) mice that met the criteria described above, we fixed the microendoscope in place with UV curable epoxy (Loctite® Light-Activated Adhesive #4305) and stereotaxically lowered the miniature microscope, with the baseplate attached, toward the top of the microendoscope until the brain tissue was in focus. To ensure that the entire field-of-view was in focus, we used a goniometer (Thorlabs, GN1) to adjust the orientation of the miniature microscope until it was parallel to that of the microendoscope. To fix the baseplate onto the skull, we built alayer of blue-light curable composite (Pentron, Flow-It N11VI) from the dental cement on the mouse's skull toward, but not touching, the baseplate, followed by a layer of UV-curable epoxy (Loctite® Light-Activated Adhesive #4305) that affixed the baseplate to the composite. To prevent external light from contaminating the imaging field-of-view, we coated the outer layer of the composite and UV glue with black nail polish (OPI, Black Onyx NL T02). We attached a custom-designed cover (LaserAlliance, 16G thickness stainless steel) to the baseplate to protect the microendoscope. After surgery, mice recovered from anesthesia on a heating pad (FHC, DC Temperature Regulation System). For animals run through the protocol of
After mounting the miniature microscope onto a mouse and checking for adequate GCaMP6m expression, we habituated each mouse to the testing environment for at least three days prior to imaging. To preclude any emotional contagion between mice, we brought only one mouse into the isolated, light-, sound- and temperature-controlled testing environment. Further, we housed mice individually.
The experimental procedure for mice (n=9) analyzed in
At the start of each imaging session, we head-fixed the mouse (using a Siskiyou CC-1), mounted the miniature microscope, checked for GCaMP6m fluorescence, aligned the field of view (FOV) to the previous session FOV, and placed the mouse within the test chamber. Before sensory stimulation, we measured spontaneous neural activity by recording Ca2+ activity for 10 min while the mouse habituated to, and freely moved within, the testing box. The mouse received no explicit experimenter-delivered sensory stimuli during this period. After baseline recording, the mouse had 15 min of access to an incentive (sucrose) to capture BLA neural responses to positive valence stimuli. To induce mice to lick without needing prior water deprivation, we used a 10% sucrose solution. We detected licks and delivered sucrose using a custom-built circuit based on a previous design (69). A custom electronic circuit (built using Arduino elements) collected lick data and synchronized all incoming data using output TTL pulses from the miniature microscope DAQ. Control signals from this circuit drove a solenoid (NResearch, 161P011) that delivered 10% sucrose instantly after the 1st lick in a bout. We programmed a 5-s-period between liquid deliveries. Thus, even if the mouse licked continuously, this approach provided a sufficient interval between incentive deliveries to relate the evoked neural activity with specific delivery time points. Next, the mouse began the sensory testing protocol, in which the experimenter delivered a battery of stimuli: 0.07-g and 1.4- or 2.0-g von Frey hairs (light and mild touch); 25G needle (noxious pin prick); water drops at 5° C. or acetone (noxious cold), 30° C. (innocuous liquid, for
Subsequently,
For mice given the procedure in
For animals run through the procedure in
In the second setup (
For all mice, we manually checked each session's annotated stimulus-onset time, using a custom MATLAB program to scroll manually through a video recorded from a camera positioned below the mouse. Using this program, we corrected instances in which the annotation did not match the actual onset time of stimulus delivery. To ensure accuracy, we frame-locked this camera to the miniature microscope by triggering each video frame collected by the microscope's DAQ ‘sync out’ TTL line. We used the stimulus timestamps collected in the imaging sessions of
We recorded all miniature fluorescent microscope videos at a frame rate of 10 or 20 Hz using between 213±3 and 390±7 μW LED light intensity (measured from miniature microscope GRIN with a Thorlabs PM100D and S120C) and saved each frame as a 12 bit image (of varying size, analyzed in a range of 250-275×250-270 pixels after down-sampling in each spatial dimension by a factor of 4 from the raw data). We used a stage micrometer (WARD's Natural Science, 94 W 9910) to empirically calculate each pixel to be 2.51 μm×2.51 μm.
We delivered a range of noxious, aversive, and appetitive stimuli to animals (
We delivered noxious cold (acetone), noxious heat (55° C. water), noxious pin (25G needle), and loud noise (˜85 dB) as described above. Isopentylamine (Sigma-Aldrich SKU #126810, CAS #107-85-7) is an odor shown to be aversive in multiple previous studies (71-73). We placed 50 μL of isopentylamine onto a small piece of tissue paper (Kimtech, #05511) and placed this immediately into a 10-mL blood serum tube (Fisher #02685A) and re-capped. We then inserted two 16G needles through the tube cap and attached these to a valve (Gems Sensors and Controls, MB202-VB30-L203) controlling air delivery to a metal tube used to manually direct odorant to animals in the test chamber. We delivered air puffs through a blunt, 16G needle. We delivered both isopentylamine and air puff for 300 ms with medical-grade compressed air (UN1002) at between 20 to 30 PSI. We aimed isopentylamine and air puff stimuli during delivery at the nose and front half of the face, respectively. Mice received quinine (0.06 mM in deionized water (74)) after licking a metal tube in an identical manner as 10% sucrose but through a different tube to avoid contamination. For footshock trials, we habituated mice for 10 min followed by five deliveries of a 0.6-mA electric footshock, with 2 min between each stimulation. To synchronize the onset time of each footshock with Ca2+ imaging data and each behavior cameras' videos, we collected TTLs output by the miniature microscope DAQ and footshock software (Freeze Frame, Actimetrics) on a Saleae Logic 8 DAQ box, which allowed us to determine the specific image frames of the Ca2+ video that were synchronous with each footshock. We collected all subsequent data, processed the Ca2+ videos, and performed analyses as in the main protocol used in
To check for possible alterations of neural activity in the presence of CNO alone (i.e., no hM4 expression), we conducted a shortened version of the main protocol (
We processed all Ca2+ imaging data in the MATLAB software environment using methods similar to previous studies (19, 20). To reduce computational processing times and boost signal-to-noise, we down-sampled imaging movies collected from the miniature microscope in both x and y lateral spatial dimensions using 4×4 bi-linear interpolation. To remove motion artifacts, we registered all frames in an imaging session to a chosen reference frame using Turboreg (75). Rather than register the entire frame, we selected and registered a sub-region of the field-of-view; this allowed us to choose a region with high-contrast features and without artifacts (e.g., dust particles on the optics) that could impede registration.
To improve the performance of motion correction, we first normalized the image frames by subtracting from each frame its mean value. We then spatially bandpass-filtered each frame of the movie (cutoff frequency: ˜0.10-0.16 cycle/μm using a Gaussian cut-off filter, which highlighted spatial features at the ˜6-10 μm scale). We performed an image complement operation on each frame, by subtracting each pixel value from the maximum pixel value in that frame (i.e., dark areas became light, and vice versa); this inverted the image and generally made the blood vessels and other dark static features appear more prominently, which benefited image registration. We obtained two-dimensional spatial translation coordinates from Turboreg by having the algorithm compare each processed frame to a reference frame (the 100th movie frame). We then used the translation values so obtained for each image frame to register the raw Ca2′ movie, but pre-processed in a different manner so as to aid cell extraction, rather than spatial registration.
To facilitate cell extraction, we divided each frame of the raw Ca2+ movie by a low-frequency bandpass-filtered version of itself (cutoff frequency: ˜0.0014-0.0063 or ˜0.0014-0.01 cycle/μm using a Gaussian cut-off filter). This served to diminish neuropil and other background fluctuations. We then registered the resulting image frames using the two-dimensional spatial translation coordinates obtained previously.
Since motion correction can cause the movie edges to take on inconsistent borders due to variable translations, we determined the maximum amount all frames were translated during the motion correction procedure in each dimension (tmax) and then added a border of size tmax pixels extending from the edge of each frame toward the middle of the frame. We set a maximum border size (tmax) of 14 pixels (˜35 μm). We converted each movie frame to relative changes in fluorescence using the following formula:
where F0 was the mean image over the entire movie. Lastly, we temporally smoothed each movie by down-sampling from the original 20 or 10 Hz to 5 Hz; specifically, for a x×y×t movie, we bilinearly down-sampled in x×t to reduce computational processing times, which is equivalent to performing a 1D linear interpolation in time of the intensity values at each pixel. Extraction of neuron shapes, locations, and activity traces
After processing each session's Ca2′ imaging videos, we computationally extracted individual neurons and their activity traces using the PCA-ICA algorithm (76). We used the following parameters for PCA-ICA: p=0.1 and a maximum of 750 iterations. The parameter p is the relative weight of temporal information in ICA, and p=0.1 indicates we performed a spatio-temporal ICA with greater weight given to the spatial than to the temporal skewness. The algorithm output a series of candidate spatial filters (x×y×n) and temporal traces (n×f)—where n is the number of neurons, t is the frame, and (x, y) are spatial dimensions-associated with temporally varying sources, which we then manually verified as neurons.
For all imaging sessions analyzed in this study, we used neurons manually identified by a single human scorer. For each imaging session, we loaded a custom MATLAB GUI that displayed the spatial filter and activity trace of each candidate cell, along with the candidate cell's average Ca2+ transient waveform. The human scorer also viewed a maximum projection image of all output spatial filters (
In addition, we noted that ICA (and other neuron extraction algorithms) often yielded candidate sources with images and activity traces that look highly similar to those of real neurons but that are actually associated with neuropil or other sources of contamination in the movie. Thus, we added another GUI interface to avoid including these false positives. Specifically, we cropped the movie to a 31 pixel×31 pixel (˜78 μm×−78 μm) region centered on the centroid of each candidate cell; we then created movies containing 10 frames before and after the onset of an individual peak in the candidate Ca2+ activity trace to help visualize actual transient-related activity in the movie. Each ICA output had up to 24 of these movies created based on each output's highest signal-to-noise (SNR) peaks. We spatially concatenated all of these movies associated with a specific ICA output to create a montage movie that allowed the human scorer to view movie data associated with peaks in the activity trace for each output at once, which eased decision-making. We used several criteria to classify an ICA output as a neuron: minimal overlap of an output's spatial filter with blood vessels or other contaminating signal sources, resemblance of each output's spatial filter to a 2D Gaussian or an expected neuron shape based on prior knowledge (
For animals in which the internal capsule was present and neurons from the piriform cortex were within the imaging plane, we used a custom MATLAB GUI to manually select a region corresponding to the location of putative BLA neurons and excluded all other neurons in the imaging plane not within this region (
To detect Ca2+ events (used in analysis of movement-related, stimulus-induced, and spontaneous neuronal activity), we used a threshold-crossing algorithm similar to previously described methods (20). To reduce detection of spurious, high SNR noise, we spatially smoothed the signal by averaging over a 600 ms sliding window. To remove baseline fluctuations, we calculated a sliding median (40 s window) and subtracted this from the activity trace. To capture transient events during the rise time, we took the time-derivative of the resulting trace, calculated the standard deviation (a) for each signal, and identified any peaks that were ≥2.5 s.d. above baseline noise while enforcing a limit of a minimum inter-event time of >10 frames (2 s). We created a binarized activity vector for each neuron in which all frames associated with candidate peaks were assigned values of one and all other non-event frames assigned values of zero. We concatenated all n neurons binarized activity vectors into an n×f matrix that we used in subsequent analysis, where indicated.
To assess whether the spontaneous firing rate of BLA neurons changed. For all mice run through the
Identification of Neurons with Significant Stimulus-Evoked Responses
To determine which neurons significantly responded to a given stimuli, we took neuronal activity data (PCA-ICA output traces) from a 2-s-post-stimulus interval for all trials (creating a n×t×f matrix, where n=number of neurons, t=number of trials, and f=number of frames per trial) and binned it into 1-s bins by taking the mean of each bin's ΔF/F activity. For each cell, we then compared the binned activity response values to those in an identically binned 2-s window from −5 s to −3 s before the stimuli. We pooled this activity across all presentations of a specific stimulus and calculated a p-value for each neuron using a one-tailed Wilcoxon rank-sum. We designated any neurons for which P<0.01 as being significantly responsive to a given stimulus.
We defined the BLA nociceptive ensemble in two ways throughout this study. For studies of mice in a normal, non-neuropathic state (
To calculate the spatial distributions of significantly responsive neurons, we first computed each neuron's centroid location. For each neuron's x×y spatial filter output by PCA-ICA, we binarized the image by calculating the maximum value and set all values below 50% of this value to ‘zero’ (not part of the neuron) and the remainder to ‘one’ (part of the neuron). We then set to ‘zero’ any pixels not connected to the maximum value using a union-finding algorithm implemented in a standard MATLAB function. The x and y coordinates for all parts of each neuron's spatial filter image that are still labeled ‘one’ were found and multiplied by their true values in the original spatial filter imaged. We then calculated the arithmetic mean of each dimension's weighted coordinate vector and rounded it to the nearest whole pixel value. This allowed us to obtain centroids that are centered closer to the peak intensity of the spatial filter. We converted all neuron centroid pixel values to metric units (2.51 μm/pixel) and computed the full pairwise Euclidean distance matrix for all neuron-neuron pairs in a session. We then binned distances in 1-μm increments and the empirical cumulative distribution calculated for both all neurons and only for neurons significantly responsive to each stimulus (
To match neurons across days we implemented a multi-step algorithm similar to previously published work (19, 20). We thresholded spatial filters from PCA-ICA by setting to zero any values below 40% the maximum for each spatial filter and used these thresholded filters to calculate each neuron's centroid, see “Spatial distribution of significantly responsive neurons and neuron centroid calculation”. We modified that procedure for cross-day alignment by not rounding each neuron's centroid coordinates to the nearest pixel value in order to improve accuracy of cross-day alignment. We created simplified spatial filters that contained a 10-pixel-radius circle centered on each neuron's centroid location; this allowed us to register different days while ignoring any slight day-to-day differences in PCA-ICA's estimate of each neuron's shape even if the centroid locations were similar.
For each animal, if we had N sessions to align, we chose the N/2 session (rounded down to the nearest whole number) to align to (align session) in order to compensate for any drift that may have occurred during the course of the imaging protocol. For all other imaging sessions, we first created two neuron maps based on the threshokied spatial (“thresholded neuron maps”) and 10-pixel-radius circle (“circle neuron maps”) filters described above (see
After registering all sessions to the align session, we then recalculated all the centroid locations as described above. We set the align session centroids as the initial seed for all global cells. Global cells are a tag to identify which neurons are matched across imaging sessions; for example, global cell #1 might be associated with neurons #1, #22, #300, #42, and #240 across each of five imaging sessions, respectively. Starting with the first imaging session for an animal, we calculated the pairwise Euclidean distance between all global cells' and the selected session's neurons' centroids. We then determined any cases in which a global cell was within 5 μm (nominally ˜2 pixels) of a selected session's neurons. In such cases, the algorithm added that neuron to that global cell's pool of neurons, the global cell's centroid recalculated as the mean location between all associated session neurons' centroid locations, and any unmatched neurons in that session annotated as new candidate global cells. We repeated this process for all sessions associated with a given animal (see
After assigning all neurons across all animal's imaging sessions to a global cell, we then conducted a manual visual inspection of each animal's cross-day registration. We removed imaging sessions that did not align well with other sessions associated with a particular animal. This led to us removing n=42 sessions from this analysis across all
To calculate the number of sessions a global cell responded to specific stimuli, we used the classification of significantly coding neurons in “Determination of significantly responding stimuli neurons”. We then checked for each global cell the number of sessions it responded to a given stimuli while ignoring any global cells who only had activity on a single session (
We sought to determine whether the neuronal ensembles responsive to two different stimuli were consistent with a hypothesis of statistical independent coding channels. To test this hypothesis, we needed to compute the likelihood that statistically independent assignments of cells' coding identities would yield the observed level of overlap in the two coding ensembles. There are two ways to calculate the expected level of overlap under an assumption of independence. Prior methods used bootstrapping to estimate an empirical null distribution and compared the actual overlap to that. Here we introduce an alternative, exact solution.
We calculated the extent to which the observed overlap was unexpected by chance as a specific instance of the classic statistics thought-experiment of drawing without replacement balls from an urn containing black and white balls. In our case, we had a population of N neurons and were seeking the probability, p, of having k successes (number of significant neurons for stimulus #2) in a population with pre-defined Ksuccesses (number of significant neurons for stimulus #1) in n drawings (number of significant neurons for stimulus #2). Using the hygecdf and hygestat functions in MATLAB, we calculated p and the expected number of overlap neurons given the actual number of significantly responsive neurons observed for stimuli #1 and #2 (
To determine whether the overlap in coding ensembles became more expected than chance, either before or after spared nerve injury (
We performed all statistical analyses within the R or MATLAB (2015b or 2017a) software environments, unless otherwise noted. Throughout the text, “signed-rank” and “rank-sum” tests refer to Wilcoxon signed-rank and rank-sum tests, respectively. We used the Benjamini-Hochberg (B-H) procedure for all non-ANOVA multiple comparisons correction (77). For ANOVA analyses, we performed either a one-way or two-way repeated measures ANOVA via the aov function in R followed by a Tukey test, when appropriate. When comparing specific hypotheses, we ran the necessary pairwise statistical test followed by a B-H correction. We did not blind the experimenters performing the imaging analyses regarding the cohorts (neuropathic or uninjured) or pain states (pre- or post-SNI) of the mice. However, we used identical code and analysis methods for all cohorts throughout the study. Unless otherwise noted, values and error bars in the text denote means±SEM.
For Ca2+ imaging video motion correction, the C code is available on the author's website (75). Our MATLAB implementation of the image registration is also available upon request. Code used for pre-processing Ca2+ imaging data, neuron identification and activity trace extraction, ICA output manual cell classification GUI, and animal behavior tracking is available at (46). Any other code used in this study's findings, to generate graphs and perform statistical analysis, are available upon reasonable request.
The datasets of this study, approximately 43 TB in size, are available upon reasonable request to the corresponding authors.
We transcardially perfused all mice used in the imaging protocol in
To induce a chronic pain state, we used a modified version of the Spared Nerve Injury (SNI) model of neuropathic pain, as previously described (70). This model entails surgical section of two of the sciatic nerve branches (common peroneal and tibial branches) while sparing the third (sural branch). Following SNI, the receptive field of the lateral aspect of the hindpaw skin (innervated by the sural nerve) displays hypersensitivity to tactile and cool stimuli, eliciting pathological reflexive and affective-motivational behaviors (allodynia). To perform this peripheral nerve injury procedure, anesthesia was induced and maintained throughout surgery with isoflurane (4% induction, 1.5% maintenance in oxygen). The left hind leg was shaved and wiped clean with alcohol and betadine. We made a 1-cm incision in the skin of the mid-dorsal thigh, approximately where the sciatic nerve trifurcates. The biceps femoris and semimembranosus muscles were gently separated from one another with blunt scissors, thereby creating a <1-cm opening between the muscle groups to expose the common peroneal, tibial, and sural branches of the sciatic nerve. Next, −2 mm of both the common peroneal and tibial nerves were transected and removed, without suturing and with care not to distend the sural nerve. The leg muscles are left uncultured and the skin was closed with tissue adhesive (3M Vetbond), followed by a Betadine application. During recovery from surgery, mice were placed under a heat lamp until awake and achieved normal balanced movement. Mice were then returned to their home cage and closely monitored over the following three days for well-being.
For all TRAP Procedures, Stereotaxic Bilateral Injections of Viral Reagents Occurred 3-5 Weeks Prior to TRAP. Please See
We habituated mice to a first testing room (room-A) for three consecutive days. Execution of all TRAP procedures occurred in Room-A. During these habituation days, no nociceptive stimuli were delivered, and no baseline thresholds were measured (i.e., mice were naïve to pain experience before the TRAP procedure). In room-A, we placed individual mice within red plastic cylinders (10.16-cm D), with a red lid, on a raised perforated, flat metal platform (60.96-cm H). The male experimenter's lab coat was present in the testing room for the first 30 min of acclimation, and then the experimenter entered the room for the final 30 min of habituation; this was done to mitigate potential alterations to the animal's stress and endogenous antinociception levels. To execute the TRAP procedure, we placed mice in their habituated cylinder for 60 min, and then a 25G sharp pin was applied to the central-lateral plantar pad of the left hindpaw (tibial-sural nerve paw innervation territory), once every 30 s over 10 min. This stimulus frequency was selected to closely match the protocols used in the microendoscope imaging experiments in which significant Ca2 transients were reliably detected in BLA Camk2a+ neurons. Following the pin stimulations, the mice remained in the cylinder for an additional 60 min before injection of 4-hydroxytamoxifen (20 mg/kg in ˜0.25-mL vehicle; subcutaneous). After the injection, the mice remained in the cylinder for an additional 2 hrs to match the temporal profile for c-FOS expression, at which time the mice were returned to the home cage (Note: an immediate return to the home cage following the pin stimulations was considered, but ultimately avoided as potential safety-related neural activity could occur and thus TRAP BLA neurons of putative positive valence in addition to the nociceptive ensemble). To mitigate the influence of contextual memory recall from the noxious TRAP procedure, all subsequent behavioral assays occurred in a second testing room (room-B). In room-B, we placed the noci-TRAP mice within different holding chambers (7.62×15.25×15.25 cm plastic chamber [white opaque walls]), atop a different metal platform floor (smooth hexagon-hole perforated sheet, McMaster-Carr, #92725T22). Furthermore, the experimenter wore daily disposable lab coats; different from the coat used in the room-A context. After completion of all experiments, we perfused mice and dissected the brains for verification of hM4-mCherry expression in the BLA. We excluded mice with off-target viral expression in the central amygdalar nucleus from the behavioral analysis. Based on this criteria, n=7 mice study were removed from the final analysis.
We habituated mice inside individual red plastic cylinders (10.16-cm D) on a raised flat, perforated metal platform (60.96-cm H) for 3 days prior to the start of behavioral sensory testing. After basal thermal and mechanical thresholds were measured, mice underwent a peripheral nerve injury surgery (Spared Nerve Injury, SNI; see “Chronic neuropathic pain model” above for details of the surgical procedure). At Day 21 post injury, when mice display significant mechanical and thermal hypersensitivity at the plantar surface of the left hindpaw, we habituated mice as stated above (see “Acute nociceptive TRAP (noci-TRAP)). To execute the light touch-TRAP procedure, a von Frey filament (0.07-g) was lightly applied to the lateral aspect of ventral hindpaw (sural nerve innervation receptive field) with enough force to cause a slight bend of the filament for up to 1 s before being retracted. The filament stimulus was applied once every 30 s over 10 min. We selected this stimulus frequency to closely match the protocols used in microendoscope imaging experiments. Following the filament stimulations, the mice remained in the cylinder for an additional 60 min before injection of 4-hydroxytamoxifen (20 mg/kg in ˜0.25-mL vehicle; subcutaneous). After the injection, the mice remained in the cylinder for an additional 2 hrs, at which time the mice were returned to the home cage. At Day 28 post injury, we confirmed neuropathic hypersensitivity persisted. Subsequent behavioral studies to assess chronic neuropathic hypersensitivity and affective-motivational behaviors were conducted beginning at Day 42 post SNI in order to allow sufficient expression of the viral DREADD cargo. After completion of all experiments, we perfused mice and dissected the brains for verification of hM4-mCherry expression in the BLA. We excluded mice with off-target viral expression in the central amygdalar nucleus from the behavioral analysis. Based on this criteria, n=5 mice were removed from the final analysis.
Different AAV serotypes display unique infection tropisms. In particular, serotype-6 shows a preferential infection of peripheral primary afferent nociceptor populations (80). To express the light-sensitive cation channel channelrhodopsin2 (ChR2) in putative primary afferent nociceptors, we intrathecally injected AAV6-hSyn-ChR2(H134R)-eYFP immediately following the i.c. BLA injections of AAV-DIO-DREADD(Gi)-mCherry in TRAP mice while remaining anesthetized under isoflurane (1-2% maintenance). Specifically, we shaved a small patch of fur on the back, wiped with alcohol and Betadine, and then inserted a 33G beveled needle connected to a WPI Nanofil syringe between the L5/L6 vertebrae and through the dura (confirmation by presence of reflexive tail flick). We slowly administered the virus was over 20 s. We retuned mice to their home cage for 4-6 weeks before behavioral verification of ChR2 expression. In pilot studies, we observed that intrathecal delivery of AAV6 does not uniformly infect all dorsal root ganglion (DRG) neurons across segmental levels. As we sought expression in lumbar DRGs for the purposes of our behavioral experiments that involve sensory testing on the hind limbs, we performed a behavioral screening of each mouse for transdermal light-responsivity when light was applied to the hindpaw. We placed mice inside individual red plastic cylinders (10.16-cm D) on a thin glass surface. A remotely movable fiber optic arm, connected to a 453-nm LED light source (SugarCube) below the glass (−′8 mm from the fiber tip to the plantar surface of the paw), was positioned under the heel of the left hindpaw, and a 453-nm −′1-s light pulse was delivered (3 mW/mm2). We measured whether an immediate nociceptive hindpaw reflex and/or pain affective-motivational behaviors (described below) occurred in response to the light indicated ChR2 expression in nociceptors. If no immediate responses were observed, the fiber optic was moved distally toward the toes and the stimulation was repeated; the location of light-responsivity on the paw was noted for future targeting during the TRAP protocol. We excluded mice from this experiment that exhibited no light-evoked pain behaviors. One week later, we habituated mice on the glass surface for 3 consecutive days (no blue light stimulus was given). Next, on the day of the TRAP procedure, we placed mice inside the cylinders for 30 min. The fiber optic was positioned under the left hindpaw at the previously noted light-responsive site, and we then delivered transdermal light pulses (1 s, 3 mW/mm2) once every 30 s over 10 min. Following light stimulations, mice remained in the cylinder for an additional 60 min before injection of 4-hydroxytamoxifen (20 mg/kg in −′0.25-mL vehicle; subcutaneous). After the injection, mice remained in the cylinder for an additional 2 hrs, at which time we returned mice to their home cage. Subsequent behavioral experiments were performed 5-8 weeks later.
For all Behavioral Tests the Experimenter was Blind to Either the SNI Vs. Sham Procedure, or the Injection of CNO Vs. Saline. Classification of Mouse Pain Behaviors into Reflex and Affective-Motivational Behaviors
In mice, we previously reported our observation that a cutaneous noxious stimulus can elicit several distinct behavioral responses (81, 82): 1. Withdrawal reflexes: rapid reflexive retraction or digit splaying of the paw that occur in response to noxious stimuli, but cease once the noxious stimulus is removed; and 2. Affective-motivational behaviors: temporally-delayed (relative to the noxious stimulation), directed licking and biting of the paw (termed “attending”), extended lifting or guarding of the paw, and/or escape responses characterized by hyperlocomotion, rearing or jumping away from the noxious stimulus. Please see
To evaluate mechanical reflexive sensitivity, we used a logarithmically increasing set of 8 von Frey filaments (Stoelting), ranging in gram force from 0.07- to 6.0-g (93). These filaments were applied perpendicular to the plantar hindpaw with sufficient force to cause a slight bending of the filament. A positive response was characterized as a rapid withdrawal of the paw away from the stimulus within 4 s. Using the Up-Down statistical method, the 50% withdrawal mechanical threshold scores were calculated for each mouse and then averaged across the experimental groups. The response frequency was calculated as the number of positive responses out of 10 stimulations, delivered at 30-s intervals.
To evaluate affective-motivational responses evoked by mechanical stimulation, we used three von Frey filaments (0.07-g, 0.4-g, and 2.0-g) and a sharp 25G syringe needle (pin prick) (94). Each filament was applied for 1 s and the pin prick was applied as a sub-second poke to the hindpaw, and the duration of attending behavior was collected for up to 30 s after the stimulation. Only one stimulation per filament was applied on a given testing session.
To evaluate affective-motivational responses evoked by thermal stimulation (81), we applied either a single, unilateral 50-μL drop of water (5, 30, or 55° C.) or acetone (evaporative cooling) to the left hindpaw, and the duration of attending behavior was collected for up to 60 s after the stimulation. Only one drop stimulation was applied on a given testing session. To evaluate adaptive thermal avoidance and temperature preference, we placed mice in the center of a linear Thermal Gradient Track (121.92-cm L×8.25-cm W metal alloy floor; 15.24-cm H black plastic walls), with the floor featuring a temperature gradient along the long axis. Mice freely explored the track for 60 min. To create the temperature gradient, we placed either heating or cooling plates (Bioseb) under the outermost 16.51 cm of the metal floor, with one plate set to 50.0° C. and the other set to 0.0° C., creating an actual floor gradient of 48° C.→5° C., respectively. The track was subdivided into 25 temperature zones (4.8-cm D per zone), and we assessed the temperature at the center of each zone by a K-probe thermocouple. “Noxious zone blocks” were designated based on the temperature thresholds for nociceptive behaviors (>42° C. and <17° C.). The track was illuminated by a centered, overhead light (104 lux), and the ambient room temperature was 26° C. Only one mouse was present in the room during all trials. A video camera placed above the track recorded the position of the mouse within the temperature zones, and videos were later analyzed using a video-tracking software (Etho-vision, Noldus) for duration of zone occupancy, zone visits, distance, velocity, and acceleration.
To evaluate active avoidance and escape behaviors to optogenetically driven nociception, mice expressing ChR2 in peripheral primary afferent nociceptors freely explored a custom-built two-choice chamber with LED-lit floor panels. A 32×32 LED array (8×8 cm) illuminated half the array in blue light, and the other half in red light (˜0.3 mW/mm2). A thin glass surface (0.5 cm thick) covered the array floor, upon which we fitted a black plastic chamber (38 cm H) with a center divider wall containing a square passage hole (5-cm D) raised 2.5 cm from the array floor. The entire LED chamber was maintained in a quiet room with low ambient light (˜5 lux). We first placed mice in the red-light chamber and then allowed them to freely explore the chambers for 15 min. A camera placed above the chamber recorded the location of the mouse in the apparatus. We manually scored the videos to determine the time spent by the mouse in each chamber (automated tracking was not possible given the light from the LED floor). Only one mouse was present in the room during all trials.
To evaluate neuropathic adaptive cool/cold avoidance behavior, mice with SNI freely explored a two-temperature choice chamber. The chamber was constructed from adjoining two thermal plates (Bioseb): one reference plate set at 30° C., and a test plate with the temperature adjusted to either 30, 25, 20, 15, or 10° C. for independent trials. The test plate temperature order was randomized for each trial within the day. The chamber (white opaque plastic with no distinguishing features and no divider, 30.48×15.24×15.24 cm) was fitted onto the conjoined plates. At Day 56 post SNI and at 30-min post CNO injection, we placed mice on the reference plate facing the back wall. Mice then freely explored the chamber for 5 min, while an overhead camera recorded the chamber position and locomotion. After each trial, the mouse was returned to the holding cylinder, while the test plate temperature was rapidly cooled or heated to the next randomly assigned temperature trial. This procedure was repeated until all temperature trials were collected (6 temperature trials total). Video files for each trial were later analyzed using automated tracking software (Ethovision, Noldus) for path tracking, time spent on the test plate, and number of entries onto the test plate.
The Elevated Plus Maze apparatus was made of blue plastic floors, and consisted of two open arms (30×8 cm), two arms enclosed in black plastic walls (30×8×30 cm) extending from a central platform (8×8×8 cm) at 90 degrees in the form of a “+”. The maze was elevated 30 cm above the floor. We placed individual mice in the center of the apparatus, as an overhead video camera recorded the locomotor paths throughout the 15 min trial. A diffuse overhead fluorescent light (102 lux) illuminated the track. The ambient room temperature was 26° C. Only one mouse was present in the room during all trials. Videos were later analyzed using a video-tracking software (Ethovision, Noldus) for distance, velocity, time spent in the open arms (body center-point tracking), and entries to the open arm (nose-point tracking).
The open field chamber (circular, 60.96-cm D, 38.1-cm H, opaque white polyethylene walls and floor) was divided into a central zone (center, 25-cm D) and an outer zone (peripheral). We placed individual mice in the peripheral zone, facing toward the chamber wall as an overhead video camera recorder the locomotor paths throughout the 15-min trial. A diffuse overhead fluorescent light (102 lux) illuminated the track, and the ambient room temperature was 26° C. Only one mouse was present in the room during all trials. Videos were later analyzed using a video-tracking software (Ethovision, Noldus) for total distance traveled, total time spent in the center zone, and mean locomotion velocity as the mouse exited the center zone.
To evaluate incentive motivational behavior, we placed mice in a custom-made plastic chamber (7.62×15.25×15.25 cm, 3 white opaque walls, 1 clear plastic wall for video monitoring) with two rounded gavage syringe spouts protruding from small holes in one of the two side walls: one spout dispensed room temperature water, while the other dispensed a room temperature 10% sucrose solution (in water). Mice then had 20 min to freely sample the spouts. A custom microprocessor-controlled release of either solution, which were set to dispense 12 μL of solution upon the first lick, with a minimum 1-s interval between all subsequent lick-induced dispensions. An Arduino using a custom circuit design described previously recorded the number of licks and lick rate while experimenters recorded consumption volume for each spout. To enhance the propensity of mice to actively sample the lick spouts, mice were water deprived 5-8 hr prior to the start of experiments. We repeated the protocol for 7 consecutive days to determine whether any changes in sucrose preference occurred.
Anesthetized mice (Fatal-PLUS, Vortech Pharmaceuticals) were transcardially perfused with room temperature 0.1 M phosphate buffered saline (PBS), followed by 10% formalin in 0.1 M PBS. The brain, DRG (L3-L5), and/or spinal cord (lumbar cord L3-L5 segments) were dissected, post-fixed overnight (brains) or for 4 hrs (DRG or cord) at 4° C., and cryoprotected in 30% sucrose in PBS. Tissues were then frozen in O.C.T. (Sakura Finetek, Inc.). Tissue sections (50 μm for brains; 30 μm for spinal cord; and 10 μm for DRG) were prepared using a cryostat (Leica Biosystems) and blocked with PBS containing 5% normal donkey serum and 0.3% Triton X-100 for 1 hr at room temperature. The sections were then incubated overnight with primary antibodies at 4° C. For the chicken anti-GFP antibody, the incubation was performed at 37° C. for 2 hrs. After extensive wash with PBS containing 1% normal donkey serum and 0.3% Triton X-100, sections were incubated with appropriate secondary antibody conjugated to AlexaFluor for 2 hrs at room temperature. Sections were then mounted in the glass slide with Fluoromount (Southern Biotech) after washing with PBS for 3 times for 5 min. Images were collected under a Leica TCS SP511 confocal microscope with LAS AF Lite software (Leica Microsystems).
The following primary antibodies were used: Anti-c-Fos (Rabbit, Abcam # ab7963-1), Anti-c-Fos (Rabbit, Synaptic Systems #226003), Anti-CGRP (Sheep, Abcam # ab22560), Anti-GFP (Chicken, Aves Labs # GFP-1020), Anti-RFP (Rabbit, Abcam # ab62341), Anti-NeuN (Mouse, Millipore # MAB377), Anti-Ret (Goat, R&D Systems # AF482), Anti-NF200 (Chicken, Aves Labs # NFH0211).
Anesthetized mice (C57BI/6J, male, 5-8 weeks, Fatal-PLUS (Vortech Pharmaceuticals)) were transcardially perfused with 0.1 M PBS followed by 10% formalin in 0.1 M PB. Brains were dissected, cryoprotected in 30% sucrose overnight, and then frozen in OCT. Frozen tissue was cut into 14 μm thick slices, placed onto Superfrost Plus slides, and kept at −80° C. Tissue was thawed from −80° C., washed with PBS at room temperature, and subsequently processed according to the Advanced Cell Diagnostics RNAscope Technology protocol (ACD Bioscience). We first washed the tissue with solutions from the pretreatment kit to permeabilize the tissue, incubated with protease for 30 min followed by the hybridization probe(s) for 2 hr at 40° C. Images were collected under a Leica TCS SP511 confocal microscope with LAS AF Lite software (Leica Microsystems).
The following RNAscope probes were used: Mm-Camk2a-C1 (#445231), Mm-Sc32a1-C1 (#319191), Mm-Sst-C1 (#404631), Mm-Pvalb-C2 (#421931), Mm-Vip-C2 (#502231), Mm-Rspo2-C2 (#402001), and Mm-Ppp1rb-C3 (#405901).
1Consist of cells responsive to 55° C. water, 5° C. water, Acetone, or Pin prick.
2N = 5 mice, analysis from 3 or 4 (uninjured) and 5 or 7 (neuropathic) sessions per mice. All values mean ± s.e.m.
3 N = 4 mice, analysis from 3 (uninjured) and 7 (sham surgery) sessions per mice. All values mean ± s.e.m.
4Consist of cells responsive to Acetone and Pin prick.
5 N = 8 mice, analysis from 22 (uninjured) and 26 (injured) total sessions pooled across all mice. All values mean ± s.e.m.
Table 1. Associated data for
This invention was made with Government support under contracts DA031777, NS106301, DA043609, DA041029, and DA035165 awarded by the National Institutes of Health. The Government has certain rights in the invention.
Number | Date | Country | |
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62962581 | Jan 2020 | US |