We have examined dopaminergic cell survival after alteration of the subthalamic nucleus (STN) in methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)-treated monkeys. The STN was lesioned with kainic acid (B series) or underwent deep brain stimulation (DBS) at high frequency (C series). In another series, MPTP-treated and non-MPTP-treated monkeys had no STN alteration (intact animals; A series). Animals were treated with MPTP either after (B1, C1) or before (B2, C2) STN alteration. We also explored the long-term ( approximately 7 months) effect of DBS in non-MPTP-treated monkeys (D series). Brains were aldehyde-fixed and processed for routine Nissl staining and tyrosine hydroxylase immunocytochemistry. Our results showed that there were significantly more (20-24%) dopaminergic cells in the substantia nigra pars compacta (SNc) of the MPTP-treated monkeys that had STN alteration, either with kainic acid lesion or DBS, compared to the non-MPTP-treated monkeys (intact animals). We suggest that this saving or neuroprotection was due to a reduction in glutamate excitotoxicity, as a result of the loss or reduction of the STN input to the SNc. Our results also showed that SNc cell number in the B1 and C1 series were very similar to those in the B2 and C2 series. In the cases that had long-term DBS of the STN (D series), there was no adverse impact on SNc cell number. In summary, these results indicated that STN alteration offered neuroprotection to dopaminergic cells that would normally die as part of the disease process.

We conclude that treatment with anti-sFlt-1 mAb preserves lung structure and function and prevents right ventricular hypertrophy in two rat models of BPD of antenatal stress and speculate that early mAb therapy may provide a novel strategy for the prevention of BPD.

The electrical effects on the nervous system have been known for long. The excitatory effect has been used for diagnostic purposes or even for therapeutic applications, like in pain using low-frequency stimulation of the spinal cord or of the thalamus. The discovery that High-Frequency Stimulation (HFS) mimics the effect of lesioning has opened a new field of therapeutic application of electrical stimulation in all places where lesion of neuronal structures, such as nuclei of the basal ganglia, had proven some therapeutic efficiency. This was first applied to the thalamus to mimic thalamotomy for the treatment of tremor, then to the subthalamic nucleus and the pallidum to treat some advanced forms of Parkinson's disease and control not only the tremor but also akinesia, rigidity and dyskinesias. The field of application is increasingly growing, currently encompassing dystonias, epilepsy, obsessive compulsive disease, cluster headaches, and experimental approaches are being made in the field of obesity and food intake control. Although the effects of stimulation are clear-cut and the therapeutic benefit is clearly recognized, the mechanism of action of HFS is not yet understood. The similarity between HFS and the effect of lesions in several places of the brain suggests that this might induce an inhibition-like process, which is difficult to explain with the classical concept of physiology where electrical stimulation means excitation of neural elements. The current data coming from either clinical or experimental observations are providing elements to shape a beginning of an understanding. Intra-cerebral recordings in human patients with artefact suppression tend to show the arrest of electrical firing in the recorded places. Animal experiments, either in vitro or in vivo, show complex patterns mixing inhibitory effects and frequency stimulation induced bursting activity, which would suggest that the mechanism is based upon the jamming of the neuronal message, which is by this way functionally suppressed. More recent data from in vitro biological studies show that HFS profoundly affects the cellular functioning and particularly the protein synthesis, suggesting that it could alter the synaptic transmission by reducing the production of neurotransmitters. It is now clear that this method has a larger field of application than currently known and that its therapeutical applications will benefit to several diseases of the nervous system. The understanding of the mechanism has opened a new field of research, which will call for reappraisal of the basic effects of electricity on the living tissues. RésuméLa stimulation électrique thérapeutique du système nerveux central. Les effets de l'électricité sur le système nerveux sont connus depuis longtemps. Les effets excitateurs ont été utilisés dans un but diagnostique et même pour des applications thérapeutiques, telles que le traitement de la douleur, en utilisant une stimulation à basse fréquence de la moelle épinière ou du thalamus. La découverte que la stimu...

Since its advent in 1993, high frequency stimulation (HFS) of the subthalamic nucleus (STN) has rapidly developed into the most commonly practiced surgical procedure for the treatment of Parkinson's Disease (PD). Although its exact mechanism of action, be it through an inhibitory depolarization block, desynchronization of neuronal circuits or other means, is not clear, the efficacy and safety of the technique are now well established. HFS of the STN improves the motor function by at least 60%, drastically reduces the levodopa requirement and significantly improves the quality of life in PD. This review updates the recent concepts on the pathophysiology of PD and analyses the basic science principles underlying the clinical practice of the STN HFS. The evolution of the surgical technique and long-term patients' outcome are further discussed.

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In view of the recent focus on the zona incerta (and surrounding regions) as a target for deep brain stimulation in patients with Parkinson Disease, we have explored incertal cyto and chemoarchitecture in normal and MPTP (methyl-4-phenyl-1,2,3,6tetrahydropyridine)-treated macaque monkeys. Brains were processed for routine tyrosine hydroxylase (TH), nitric oxide synthase (NOs), parvalbumin (Pv) and calbindin D 28k (Cal) immunocytochemistry, as well as for Nissl staining. We show four main sectors in the zona incerta, namely rostral, dorsal, ventral and caudal, each with a largely distinct cytoarchitecture. Each of the antibodies screened had signature distribution patterns across the zona incerta; TH + cells were localised within the rostral sector, NOs + cells were concentrated in the dorsal sector, Pv + cells were found mainly in the ventral sector and Cal + cells were distributed uniformly across all sectors. These patterns match closely those reported in non primates. We found no major differences in the distribution and shape of labelled cells in the zona incerta of MPTP-treated monkeys when compared to control. In conclusion, we report that the primate zona incerta shows considerable cyto and chemoarchitectonic heterogeneity; that it forms a nucleus with distinct sectors presumably associated with diverse functions-from generating arousal to shifting attention, and from controlling visceral activity to influencing posture and locomotion. These functions have been proposed for the zona incerta of non primates. Our results have clinical implications, in that deep brain stimulation of the zona incerta (or parts thereof) could manifest in signs and symptoms other than those associated with the motor system. Such clinical stimulations could well involve other systems, including those of arousal, attention and visceral control.

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