WO2021173564A1 - Predicting successful generation and inhibition of seizure-like afterdischarges and mapping their seizure networks using fmri - Google Patents
Predicting successful generation and inhibition of seizure-like afterdischarges and mapping their seizure networks using fmri Download PDFInfo
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Definitions
- Methods are also provided for generating a seizure network map, which can find use in identification of targets for intervention.
- ADs that can be suppressed locally show similar but less widespread seizure networks compared with those that could not be inhibited. It is shown that success in generating or curtailing seizures is related to their onset time, with inhibition proving less effective on earlier- onset afterdischarges.
- simultaneous fMRI and LFP can be used to map the seizure network of afterdischarges initiated from the dorsal and ventral hippocampus.
- a seizure induction and inhibition model is provided that can be analyzed with simultaneous electrophysiology, including local field potential (LFP) and functional MRI (fMRI).
- specific neurons or overlapping sets of neurons comprise both an inhibitory and excitatory light-reactive polypeptides.
- the model provides a means mapping seizure induction and inhibition. For example, whole-brain fMRI imaging can be used to determine which regions are involved in ADs that could not be curtailed using local inhibition. Imaging of induced seizures events can be analyzed in fine detail. For example, distinct networks were identified for ADs originating from the VH compared with those generated from the DH. Models include an animal brain, e.g. a live animal, which may be a mammal, e.g. a rodent such as a rat, mouse, etc., non-human primate, and the like.
- a seizure is generated by depolarizing neurons of interest in an individual.
- Neurons that find use in the invention include but is not limited to, neurons in the ventral hippocampus, dorsal hippocampus, medial pre-frontal cortex, medial temporal lobe, etc. including, for example, CaMKII-positive excitatory neurons in the dorsal and ventral hippocampus.
- Neurons may be depolarized using a variety of methods, which include but are not limited to, optogenetic stimulation, chemical treatment, electrical stimulation, etc.
- optogenetic stimulation is used to induce seizure networks
- a number of light-reactive polypeptides may be used.
- the light-activated polypeptide for stimulation may be, for example, a channelrhodopsin, including without limitation ChR2, ChR1, VChR1, etc.
- the light-reactive polypeptide may be operably linked to a promoter expressed in excitatory hippocampal neurons. Promoters that find use in this method, include without limitation, a hSyn promoter, CAMKII promoter, a thy1 promoter, etc.
- a second light-reactive polypeptide is used to hyperpolarize neurons of interest after they have been depolarized, in order inhibit seizures, i.e. inhibit ADs.
- optogenetics is used to hyperpolarize neurons.
- a number of light-reactive proteins may be used.
- Light-reactive polypeptides of interest include but are not limited to, NpHr, eNpHr2.0, eNpHr3.0, eNpHr3.1, GtR3, etc.
- the second light-reactive polypeptide may be operably linked to a promoter expressed in excitatory hippocampal neurons.
- Promoters that find use in this method include without limitation, a hSyn promoter, CaMKII promoter, a thy1 promoter, etc.
- the first light-reactive polynucleotide is operably linked to a promoter that is different from the second light-reactive polynucleotide.
- both excitatory light-reactive polypeptides and inhibitory light- reactive polypeptides are co-expressed in cells, or in overlapping cell populations.
- ChR2 and eNpHR3.0 can be expressed in a cell from the same or different promoters.
- the promoter is hSyn.
- inhibiting ADs generated by optogenetic stimulation requires a minimum light intensity. For instance, a minimum of 10mW may be required in order to inhibit ADs generated by optogenetic stimulation.
- the light intensity may be, including without limitation, 1000-1500mW/mm 2 , 1500-2000mW/mm 2 , 2000-2500mW/mm 2 , 2500- 3000mW/mm 2 , or greater than 3000mW/mm 2 .
- light is applied to neurons in an individual. Any suitable method may be used to deliver light to a region of interest, including without limitation, transdermally, through an implanted device, etc.
- fMRI activation maps for ADs originating from the ventral hippocampus indicate that ADs that did not progress were limited to the hypothalamus, amygdala, and prefrontal cortex.
- fMRI activation maps with dorsal hippocampus stimulation and inhibition show that ADs did not progress and were limited to the anterior dorsal hippocampus.
- Optogenetic inhibition applied during optogenetic stimulation dramatically attenuates the fMRI response, while applied by itself, optogenetic inhibition does not alter the cbv-weighted fMRI signal.
- ADs were largely similar for ADs that could be curtailed compared with those that could not be curtailed, while activity spread more extensively in those that could not be curtailed.
- the effectiveness of local optogenetic inhibition to curtail ADs is related to their progression, with earlier-onset ADs being less sensitive to local inhibition.
- ADs could not be curtailed, they did not necessarily involve extrahippocampal regions but rather spread farther toward the temporal pole.
- ADs elicited from the VH that could be optogenetically disrupted frequently involved limited ipsilateral activation of the septum, amygdala, PFC, and hypothalamus.
- CBV-weighted fMRI typically improves detection sensitivity and the contrast-to-noise ratio by at least a factor of 2 over BOLD fMRI and confers more confidence that the activation maps are representative of the true extent of ictal activity.
- ADs with Earlier Ictal Onset Time are More Likely to Be Sustained
- A Optrodes were implanted into the VH for electrophysiology and optogenetic excitation.
- B Example LFP traces from a single subject and session, illustrating that ADs are not induced at lower light intensities, e.g., 2 and 3 mW(top and middle panels, respectively) but stimulating ChR2-positive neurons with more intense light, e.g., 3.5mWcan induce ADs (bottom panel).
- the AD that was sustained had an earlier estimated ictal onset time.
- the bottom sub- panels illustrate how onset time is calculated by subtracting the sliding window evoked potential.
- (C) AD probability versus ictal onset time as modeled using a hierarchical Bayesian logistic regression model, in which intercepts were allowed to vary across subjects, excluding trials from sessions in which the seizure threshold was already known (i.e., fMRI sessions, n 13; AD, 206 trials; no AD, 192 trials).
- the solid line and shaded region indicate the mean ⁇ 95% quantile credible intervals of the posterior predictive distribution, and the individual points show the observed data.
- Example LFP traces from rats expressing hSyn-eNpHR3.0 illustrating examples in which optogenetic inhibition was considered to have failed to curtail ADs (top panels) and in which optogenetic inhibition was considered to have succeeded in curtailing ADs (bottom panels).
- the traces on the left and right panels are from the same recording sessions.
- the left panels are from stimulations consisting of the control condition (ChR2 only), and the right panels are from cases in which the optogenetic inhibition was applied immediately following the ChR2 blue light stimulation.
- FIG. 1 Examples LFP traces indicating stimulation condition and ictal onset time from a single session.
- Top panel ChR2-only and late-onset ictal activity with a sustained AD.
- Middle panel ChR2 + eNpHR3.0 and early-onset ictal activity with a sustained AD.
- Bottom panel ChR2 + eNpHR3.0 and late-onset ictal activity without AD.
- C Modeling using a Bayesian hierarchical (random intercept) logistic regression; i.e., the log odds of the AD probability logit(p) was explained by a linear combination of the stimulation condition and ictal onset time, along with a subject-specific intercept term.
- FIG. 1 Voxel-wise Activation Time Maps Comparing the Spread of Seizure Activity between ADs Originating in the DH and VH.
- A A logistic function was fit to each trials (blue dots) that progressed to AD, and the inflection point was used as an estimate of the AD duration at which 50% of trials displayed activation for each voxel.
- B and C Voxel-wise relationship between AD duration and fMRI activation for (B) focal VH ADs and (C) focal DH ADs. Distinct patterns were observed for seizures originating from the VH compared with the DH.
- Activation is present in the ipsilateral PFC for short-duration ADs, whereas the inflection point is slightly later for the contralateral VH and PFC.
- both the ipsilateral and the contralateral DH are only activated in longer-duration ADs.
- seizures originating from the DH both the ipsilateral and the contralateral DH and VH are activated in short-duration ADs, whereas longer-duration ADs may start to involve cortical regions.
- D ROI-wise analysis. Regions were considered activated if their volume of activation exceeded 10% of the maximum volume within each subject. Observed data are represented as a binary response variable, with 1 representing the region as active and 0 representing not active.
- Figure 6. fMRI Activation Maps with DH Stimulation and Inhibition Show that ADs Did Not Progress and Were Limited to the Anterior DH (A) Optrodes were implanted into the DH for electrophysiology and optogenetic excitation and inhibition.
- C and D Simultaneously acquired LFP and fMRI signals from different ROIs.
- G Fraction of region activated with and without successful optogenetic inhibition of ADs. The t statistic maps are thresholded at p ⁇ 0.0001, uncorrected. Data are represented as mean ⁇ SEM.
- Figure 8 Expression of CaMKII-ChR2-YFP and eNpHR3.0-mCherry in the dorsal and ventral hippocampus following co-injection of 2 separate viral vectors.
- Fig.1 and Fig. 2. A and (B) Widefield fluorescence images of the ipsilateral dorsal and ventral hippocampi respectively.
- C Confocal images within the ventral hippocampus show that expression of ChR2- YFP is localized in the soma and dendrites whereas eNPHR3.0 is predominantly localized in the soma.
- NpHR3.0-mCherry cells co-localize with CaMKII positive cells as well as CaMKII-negative cells.
- Each example shows 4 rows which consist of (from top-to-bottom): (i) the raw LFP data, (ii) the LFP during the stimulation period after mean centering each epoch, (iii) the sliding-window mean evoked potential averaged over 8 epochs and (iv) the LFP after subtracting the sliding-window average evoked potential.
- the final row indicates the threshold for detection of spiking events (dashedline) calculated as 4.5 ⁇ the standard deviation of the baseline, where the baseline period is indicated by the shaded purple area and defined to be between 500-2500 ms from the stimulation onset.
- (A)-(D) Indicate examples of trials that were classified as true negative, false positive, false negative and true positive respectively.
- Figure 10 hSyn-eNpHR3.0 optogenetic inhibition suppresses local spiking activity and prevents afterdischarges if applied simultaneously during optogenetic stimulation.
- CAMKII- eNpHR3.0 was not effective at inhibiting spontaneous firing and curtailing ADs.
- FIG.2 and Fig.3. (A) Optrodes were implanted into the ventral hippocampus for electrophysiology and optogenetic excitation and inhibition.
- (C) Multiunit firing rate during the stimulation period as a fraction of the baseline firing rate for hSyn-eNpHR3.0 expressing rats (n 2 animals, 21-30 trials for each light power). Data are plotted as the mean ⁇ standard deviation across trials.
- (G) Multiunit firing rate during the stimulation period as a fraction of the baseline firing rate for CAMKII rats (n 2 animals, 15-30 trials for each light power, except for 0.5, 6 and 20 mW which only include data from a single animal). Data are plotted as the mean ⁇ SD across trials.
- the left panels are from stimulations consisting of the control condition (ChR2 only) and the right panels are from where the optogenetic inhibition has been applied immediately following the ChR2 blue light stimulation.
- (J) Proportion of ADs exceeding 2.5 in duration for the two different conditions. p ⁇ 0.05 based on paired t-tests for n 7 subjects.
- Figure 11 Local optogenetic inhibition is able to curtail afterdischarges in the dorsal hippocampus for 5 s duration stimuli but not for longer duration stimuli.
- FIG.2 and Fig. 3. (A) Optrodes were implanted into the dorsal hippocampus for electrophysiology and optogenetic excitation and inhibition.
- B LFP traces from hSyn-eNpHR3.0 rats illustrating the generation of an AD from 5 sec stimulation without inhibition (upper) and a failed attempt at AD attenuation with optogenetic inhibition (lower).
- C Representative LFP traces from hSyneNpHR3.0 rats illustrating the generation of an AD from 6-7.5 s stimulation without inhibition (upper) and successful AD attenuation with optogenetic inhibition (lower).
- D Histogram of AD duration for 5 seconds of stimulation only (blue) and stimulation with subsequent inhibition (orange).
- FIG. 13 Examples of optogenetic fMRI activation maps for individual trials in the ventral and dorsal hippocampus. Related to Fig.5 and Fig.6. Activation maps correspond to the same trials as the time series in Fig. 4c,d and Fig. 5c,d.
- Dorsal Hippocampus (A) single-trial fMRI activation map (t-statistic) of short duration AD that was curtailed by optogenetic inhibition.
- D single-trial fMRI activation map (t-statistic) of a short duration AD that was not curtailed by optogenetic inhibition. T-statistic maps are thresholded at p ⁇ 0.001, uncorrected.
- Figure 14 CBV-weighted fMRI response to optogenetic stimulation in the dorsal hippocampus may be more appropriately described using a gamma distribution function with custom parameters compared to the canonical HRF or a more flexible 5th order gamma basis set as it has a faster onset and slower decay.
- a gamma distribution function with custom parameters compared to the canonical HRF or a more flexible 5th order gamma basis set as it has a faster onset and slower decay.
- Fig.4-7 (A) Example of gamma function with the best fitting parameters in comparison to the canonical HRF and SPM 1st order gamma.
- B 5th order gamma basis set. The higher order functions are able to account for significantly slower responses compared to the functions shown in (A).
- (C) Mean sum of squared errors in the fit across all voxels in the ipsilateral dorsal hippocampus for different gamma shape and scale parameters, indicating the estimated optimal fit results from using shape and scale parameters of 1.3 and 0.09 respectively.
- (D) Example of fitted HRFs to block-design stimulation data. Here the measured and fitted responses are shown for 9 periods, where each period consisted of a 5 s stimulation block at 40 Hz and 55 s rest block. The data were collected from least 3 six cycle acquisitions per subject in 3 subjects. Activation volumes expressed as a fraction of the total ROI volume in the contralateral (E) and ipsilateral (F) dorsal hippocampus respectively.
- Amyg – Amygdala Cpu – Caudate Putamen, DH – Dorsal Hippocampus, Ent – Entorhinal Cortex, Hypothal – Hypothalamus, PFC – Prefrontal Cortex, RSG – Retrosplenial Cortex, S1 – Primary Somatosensory Cortex, Thal Ant – Anterior thalamus.
- Thal DL – Thalamus Dorsal Lateral Thal MD – Thalamus Medial Dorsal, Thal VM – Thalamus Ventral Medial, VH – Ventral Hippocampus.
- active agent refers to a chemical material or compound which, when administered to an organism (human or animal) induces a desired pharmacologic and/or physiologic effect by local and/or systemic action.
- treatment refers to obtaining a desired pharmacologic and/or physiologic effect.
- the effect may be prophylactic in terms of completely or partially preventing a disease or symptom thereof and/or may be therapeutic in terms of a partial or complete cure for a disease and/or adverse effect attributable to the disease.
- Treatment covers any treatment of a disease in a mammal, particularly in a human, and includes: (a) preventing the disease or a symptom of a disease from occurring in a subject which may be predisposed to the disease but has not yet been diagnosed as having it (e.g., including diseases that may be associated with or caused by a primary disease; (b) inhibiting the disease, i.e., arresting its development; and (c) relieving the disease, i.e., causing regression of the disease.
- a “therapeutically effective amount” or “efficacious amount” means the amount of a compound that, when administered to a mammal or other subject for treating a disease, condition, or disorder, is sufficient to effect such treatment for the disease, condition, or disorder.
- the “therapeutically effective amount” will vary depending on the compound, the disease and its severity and the age, weight, etc., of the subject to be treated.
- the term “unit dosage form,” as used herein, refers to physically discrete units suitable as unitary dosages for human and animal subjects, each unit containing a predetermined quantity of a compound calculated in an amount sufficient to produce the desired effect in association with a pharmaceutically acceptable diluent, carrier or vehicle.
- a "pharmaceutically acceptable excipient,” “pharmaceutically acceptable diluent,” “pharmaceutically acceptable carrier,” and “pharmaceutically acceptable adjuvant” means an excipient, diluent, carrier, and adjuvant that are useful in preparing a pharmaceutical composition that are generally safe, non-toxic and neither biologically nor otherwise undesirable, and include an excipient, diluent, carrier, and adjuvant that are acceptable for veterinary use as well as human pharmaceutical use.
- a pharmaceutically acceptable excipient, diluent, carrier and adjuvant includes both one and more than one such excipient, diluent, carrier, and adjuvant.
- a “pharmaceutical composition” is meant to encompass a composition suitable for administration to a subject, such as a mammal, especially a human.
- a “pharmaceutical composition” is sterile, and preferably free of contaminants that are capable of eliciting an undesirable response within the subject (e.g., the compound(s) in the pharmaceutical composition is pharmaceutical grade).
- compositions can be designed for administration to subjects or patients in need thereof via a number of different routes of administration including oral, buccal, rectal, parenteral, intraperitoneal, intradermal, intracheal, intramuscular, subcutaneous, and the like.
- routes of administration including oral, buccal, rectal, parenteral, intraperitoneal, intradermal, intracheal, intramuscular, subcutaneous, and the like.
- the terms “individual,” “host,” “subject,” and “patient” are used interchangeably herein, and refer to an animal, including, but not limited to, human and non-human primates, including simians and humans; rodents, including rats and mice; bovines; equines; ovines; felines; canines; avians, and the like.
- “Mammal” means a member or members of any mammalian species, and includes, by way of example, canines; felines; equines; bovines; ovines; rodentia, etc. and primates, e.g., non-human primates, and humans.
- Non-human animal models e.g., mammals, e.g. non-human primates, murines, lagomorpha, etc. may be used for experimental investigations. Suitable animal models include particularly rodents, e.g. rats and mice.
- the terms “determining,” “measuring,” “assessing,” and “assaying” are used interchangeably and include both quantitative and qualitative determinations.
- the method is a compressed sensing (CS) high-resolution fMRI method.
- Compressed sensing refers to a signal processing method where an image can be reconstructed from a series of sampling measurements obtained with a sampling rate below the Nyquist sampling rate.
- the method may include obtaining one or more fMRI images of a target area in a subject.
- the method may include applying with an MRI system (e.g., a permanent magnet or electromagnet of the MRI system) a magnetic field to a target area in a subject.
- an MRI system e.g., a permanent magnet or electromagnet of the MRI system
- the method also includes applying with the MRI system (e.g., an RF coil of the MRI system) an excitation waveform (e.g., an RF excitation waveform) to the target area in the subject to produce detectable image data (e.g., magnetic resonance (MR) signals) of the target area in the subject.
- an excitation waveform e.g., an RF excitation waveform
- detectable image data e.g., magnetic resonance (MR) signals
- One or more additional fields may also be applied by the MRI system, such as, but not limited to, one or more shim fields using one or more shim coils, one or more gradient fields using one or more gradient coils, and the like.
- the method includes acquiring the image data (e.g., with a receiver of the MRI system) and producing an image of the target area in the subject based on the acquired image data.
- the acquired image data may be saved in a computer-readable memory and analyzed at a subsequent time (also referred to herein as "offline” processing or “offline” MRI).
- the acquired image data may be analyzed in real-time to produce the image of the target area in the subject.
- real-time is meant that the acquired signals are analyzed by the MRI system (e.g., by a processor in the MRI system) immediately after signal acquisition and/or during signal acquisition.
- the method may include applying an excitation waveform to the target area in the subject.
- the method includes applying a pulse sequence to the target area in the subject.
- the pulse sequence may be a balanced steady state free precession (b-SSFP) sequence that is applied to the target area in the subject.
- the method includes acquiring image data (MR signals) of the target area in the subject.
- the method includes using a sampling trajectory.
- the sampling trajectory may be a randomized sampling trajectory.
- the method may include acquiring image data of the target area in the subject using a randomly undersampled trajectory, such as a randomly undersampled variable density spiral (VDS) trajectory.
- VDS variable density spiral
- the method includes producing an image of the target area in the subject based on the acquired image data.
- the method may include analyzing (also referred to herein as processing) the image data to produce the image of the target area.
- the method includes reconstructing an image from the acquired image data.
- the method includes reconstructing the image using a cost function, such as an L1 regularized cost function.
- LFP Local Field Potential
- the LFP signal in the mammalian cortex reflects the activity of thousands of neurons and is commonly used to study the network dynamics underlying e.g., sensory processing, motor planning, attention, memory, and perception.
- the LFP signal has further increased in importance in recent decades because of the development of high-density silicon-based microelectrodes, allowing simultaneous recording of the LFP at thousands of positions spanning entire brain regions.
- LFP can be used for steering neuroprosthetic devices as it is easier and more stably recorded in chronic settings than single-unit spiking activity.
- Magnetic resonance imaging is used to analyze neurophysical events.
- MRI can be used to analyze functionally correlated regions of the brain (anatomical neural networks) in relation to neurophysical events.
- the correlation patterns can denote a temporal and/or spatial correlation of neurophysical events.
- An MRI technique of interest is functional MRI (fMRI). With fMRI, temporal changes in image contrast are displayed by suitable MR imaging scanning sequences.
- Functional MRI (fMRI) measures signal changes in the brain that are due to changing neural activity. The brain is scanned at low resolution but at a rapid rate (typically once every 2-3 seconds). Increases in neural activity cause changes in the MR signal via T*.sub.2 changes. This mechanism is referred to as the blood-oxygen-level dependent (BOLD) effect. Increased neural activity causes an increased demand for oxygen, and the vascular system actually overcompensates for this, increasing the amount of oxygenated hemoglobin relative to deoxygenated hemoglobin.
- BOLD blood-oxygen-level dependent
- MR imaging provides means to sensitize the signal to other aspects of the blood supply.
- Alternative techniques employ arterial spin labeling (ASL) or weight the MRI signal by cerebral blood flow (CBF) and cerebral blood volume (CBV).
- ASL arterial spin labeling
- CBF cerebral blood flow
- CBV cerebral blood volume
- Epilepsy is a brain disorder characterized by repeated seizures over time. Types of epilepsy can include, but are not limited to generalized epilepsy, e.g., childhood absence epilepsy, juvenile myoclonic epilepsy, epilepsy with grand-mal seizures on awakening, West syndrome, Lennox-Gastaut syndrome, partial epilepsy, e.g., temporal lobe epilepsy, frontal lobe epilepsy, benign focal epilepsy of childhood.
- generalized epilepsy e.g., childhood absence epilepsy, juvenile myoclonic epilepsy, epilepsy with grand-mal seizures on awakening, West syndrome, Lennox-Gastaut syndrome
- partial epilepsy e.g., temporal lobe epilepsy, frontal lobe epilepsy, benign focal epilepsy of childhood.
- Status Epilepticus can include, e.g., convulsive status epilepticus, e.g., early status epilepticus, established status epilepticus, refractory status epilepticus, super-refractory status epilepticus; non-convulsive status epilepticus, e.g., generalized status epilepticus, complex partial status epilepticus; generalized periodic epileptiform discharges; and periodic lateralized epileptiform discharges.
- convulsive status epilepticus e.g., early status epilepticus, established status epilepticus, refractory status epilepticus, super-refractory status epilepticus
- non-convulsive status epilepticus e.g., generalized status epilepticus, complex partial status epilepticus
- generalized periodic epileptiform discharges e.g., periodic epileptiform discharges.
- Convulsive status epilepticus is characterized by the presence of convulsive status epileptic seizures, and can include early status epilepticus, established status epilepticus, refractory status epilepticus, super-refractory status epilepticus. Early status epilepticus is treated with a first line therapy. Established status epilepticus is characterized by status epileptic seizures which persist despite treatment with a first line therapy, and a second line therapy is administered. Refractory status epilepticus is characterized by status epileptic seizures which persist despite treatment with a first line and a second line therapy, and a general anesthetic is generally administered.
- Non-convulsive status epilepticus can include, e.g., focal non-convulsive status epilepticus, e.g., complex partial non-convulsive status epilepticus, simple partial non-convulsive status epilepticus, subtle non-convulsive status epilepticus; generalized non-convulsive status epilepticus, e.g., late onset absence non-convulsive status epilepticus, atypical absence non- convulsive status epilepticus, or typical absence non-convulsive status epilepticus.
- focal non-convulsive status epilepticus e.g., complex partial non-convulsive status epilepticus, simple partial non-convulsive status epilepticus, subtle non-convulsive status epilepticus
- generalized non-convulsive status epilepticus e.g., late onset absence non-convulsive status epilepticus, atypical absence non- convulsive
- seizure A seizure is the physical findings or changes in behavior that occur after an episode of abnormal electrical activity in the brain.
- the term "seizure” is often used interchangeably with “convulsion.” Convulsions are when a person's body shakes rapidly and uncontrollably. During convulsions, the person's muscles contract and relax repeatedly. Based on the type of behavior and brain activity, seizures are divided into two broad categories: generalized and partial (also called local or focal). Classifying the type of seizure helps doctors diagnose whether or not a patient has epilepsy. [0058] Generalized seizures are produced by electrical impulses from throughout the entire brain, whereas partial seizures are produced (at least initially) by electrical impulses in a relatively small part of the brain.
- Absence seizures cause a short loss of consciousness (just a few seconds) with few or no symptoms.
- the patient most often a child, typically interrupts an activity and stares blankly. These seizures begin and end abruptly and may occur several times a day. Patients are usually not aware that they are having a seizure, except that they may be aware of "losing time.”
- Myoclonic seizures consist of sporadic jerks, usually on both sides of the body. Patients sometimes describe the jerks as brief electrical shocks. When violent, these seizures may result in dropping or involuntarily throwing objects.
- Clonic seizures are repetitive, rhythmic jerks that involve both sides of the body at the same time.
- Tonic seizures are characterized by stiffening of the muscles.
- Atonic seizures consist of a sudden and general loss of muscle tone, particularly in the arms and legs, which often results in a fall.
- Focal to bilateral tonic-clonic (FBTC) seizures start in one area of the brain, then spreads to both sides of the brain as a tonic-clonic seizure.
- FBTC bilateral tonic-clonic
- a scale is often used to categorize seizure-related behaviors.
- the Racine scale has been the scale most widely used to describe these behaviors.
- the method is a method for functional MRI (fMRI) to generate a seizure map in an individual.
- fMRI functional MRI
- the present disclosure provides a method for monitoring seizure activity and response in an individual (also referred to as "a subject" herein).
- the target organ or tissue is an excitable organ or tissue in the subject.
- Excitable refers to electrically excitable cells in an organ or tissue, such as neurons and muscle cells. Excitable cells typically use changes in their membrane potential to transmit signals within the cell. Thus, an excitable cell may be characterized in having a resting state, where the membrane potential is at the resting membrane potential, and an excited state, where rapid depolarization of the membrane potential is transmitted across the cell as an action potential.
- the "cellular electrical activity" of an excitable cell may refer to the changes in the membrane potential or may refer to any indirect measure of the changes in membrane potential, such as the changes in intracellular calcium concentration or any other biochemical changes that is a functional measure of the change in the membrane potential.
- the method includes surgically implanting a device of the present disclosure into or adjacent to an organ or tissue of an individual, and monitoring the activity of the organ or tissue using fMRI.
- surgically implanting the device includes opening an access in the subject and inserting at least a portion of the device through the access.
- the access may be an access through the skin, bone, muscle, and/or other tissues of the subject.
- an access may include an access through bone (e.g., skull) of the subject to allow placement of at least a portion of a device (e.g., an optrode) adjacent to target neurons in the subject.
- monitoring the activity of the organ or tissue includes conducting functional magnetic resonance imaging (fMRI) on the organ or tissue.
- the organ or tissue includes excitable cells (e.g., cells that express one or more light-responsive polypeptides).
- excitable cells e.g., cells that express one or more light-responsive polypeptides.
- Such light-responsive proteins may have a depolarizing or hyperpolarizing effect on the cell on whose plasma membrane the protein is expressed depending on the ion permeability of the activated protein, and the electrochemical gradients present across the plasma membrane.
- a specific region of a brain of an individual is stimulated, in conjunction with combined electrophysiology, e.g.
- LFP local field potentials
- fMRI functional magnetic resonance imaging
- Suitable protocols for analysis include electrophysiology; light-induced modulation of neural activity; electroencephalography (EEG) recordings; functional imaging and behavioral analysis.
- Electrophysiology may include single electrode, multi electrode, and/or field potential recordings.
- Light-induced modulation of neural activity may include any suitable optogenetic method, as described further herein.
- Functional imaging may include fMRI, and any functional imaging protocols using genetically encoded indicators (e.g., calcium indicators, voltage indicators, etc.).
- Behavioral analysis may include any suitable behavioral assays, such as behavioral assays for arousal, memory (such as a water maze assay), conditioning (such as fear conditioning), sensory responses (responses to e.g., visual, somatosensory, auditory, gustatory, and/or olfactory cues).
- Some protocols such as fMRI, provide a non-invasive, brain-wide measure representative of neural activity.
- Some protocols such as electrophysiology, provide cellular resolution and rapid measures of neural activity as well as cellular resolution and rapid control of neural activity.
- Some protocols, such as optogenetics provide spatially-targeted and temporally-defined control of action potential firing in defined groups of neurons.
- the one or more light-responsive polypeptides include a hyperpolarizing light-responsive polypeptide. In some cases, the one or more light-responsive polypeptides include a depolarizing light-responsive polypeptide.
- the method includes producing an image of the target organ or tissue using fMRI. In some cases, fMRI may be used to image the organ or tissue prior to delivering light to the target organ or tissue using the optrode. In some cases, fMRI may be used to image the organ or tissue during delivery of light to the target organ or tissue using the optrode. In some cases, fMRI may be used to image the organ or tissue after delivering light to the target organ or tissue using the optrode.
- the method may further include detecting and/or recording a detectable parameter of the organ or tissue using the device (e.g., optrode).
- the optrode may be configured to detect electrical signals, such as local field potentials produced by changes in the membrane potential of the excitable cells.
- the method includes detecting and/or recording a detectable parameter of the organ or tissue using a carbon fiber electrode of the optrode.
- the device e.g., optrode
- the device may include a light source.
- the method includes delivering light to the target organ or tissue using the light source.
- the method may include stimulating the excitable cells in the target organ or tissue with light from the light source.
- the light source includes an optical fiber as described herein.
- the method includes delivering light to the target organ or tissue using the optical fiber (e.g., stimulating the excitable cells with light delivered by the optical fiber).
- the light source includes a laser.
- the method includes delivering light to the target organ or tissue using the laser.
- the method may include generating light using the laser and directing the light from the laser to the target organ or tissue using the optical fiber (e.g., for stimulating the excitable cells in the target organ or tissue with light from the laser).
- the light source includes a light-emitting diode (LED).
- the method includes delivering light to the target organ or tissue using the LED.
- the method may include generating light using the LED and directing the light from the LED to the target organ or tissue using the optical fiber (e.g., for stimulating the excitable cells in the target organ or tissue with light from the LED).
- the detectable parameter of the target organ or tissue includes local field potentials, e.g., local field potentials produced by changes in the membrane potential of the excitable cells. The local field potentials may be produced by stimulating the excitable cells with light from the light source.
- the detectable parameter is a single-unit activity, e.g., detectable activity from a single target area (i.e., a uniplex assay). In some cases, the detectable parameter is a multi-unit activity, e.g., detectable activity from two or more target areas (i.e., a multiplex assay). [0076] In some instances, monitoring the activity of the organ or tissue is performed once. In other cases, monitoring the activity of the organ or tissue is performed two or more times. In some cases, monitoring the activity of the organ or tissue is performed several times over a period of time, e.g., the method includes chronically monitoring the activity of the organ or tissue.
- monitoring the activity of the organ or tissue may be performed over an extended period of time, such as 1 day or more, 2 days or more, 3 days or more, 4 days or more, 5 days or more, 6 days or more, 7 days or more, 8 days or more, 9 days or more, 10 days or more, such as, for example, 1 week or more, 2 weeks or more, 3 weeks or more, 1 month or more, 2 months or more, 3 months or more, 4 months or more, 5 months or more, 6 months or more, 7 months or more, 8 months or more, 9 months or more, 10 months or more, 11 months or more, 1 year or more, or ever longer periods of time.
- the individual is a human. In some cases, the individual is a non-human primate.
- the individual is a rodent (e.g., a rat, a mouse, etc.).
- the tissue or organ e.g., "target tissue” or “target organ”
- the in vivo neuronal tissue may be neuronal tissue of an animal that is anesthetized or non-anesthetized, and is restrained or non-restrained.
- the target tissue of interest includes, but is not limited to, the neocortex, the hypothalamus, entorhinal and hippocampal formation cortex, mammillary bodies, septum, bed nucleus of stria terminalis, dorsal and ventral striatum, thalamus, amygdala, accumbens, brainstem, subcortical structures in general, muscle, spinal cord, cardiac tissue, etc.
- the excitable cells e.g., neurons
- a target tissue or organ are genetically modified to express a light-responsive polypeptide that, when stimulated by an appropriate light stimulus, hyperpolarizes or depolarizes the stimulated excitable cell.
- genetic modification refers to a permanent or transient genetic change induced in a cell following introduction into the cell of a heterologous nucleic acid (i.e., nucleic acid exogenous to the cell). Genetic change (“modification”) can be accomplished by incorporation of the heterologous nucleic acid into the genome of the host cell, or by transient or stable maintenance of the heterologous nucleic acid as an extrachromosomal element. Where the cell is a eukaryotic cell, a permanent genetic change can be achieved by introduction of the nucleic acid into the genome of the cell. Suitable methods of genetic modification include viral infection, transfection, conjugation, protoplast fusion, electroporation, particle gun technology, calcium phosphate precipitation, direct microinjection, and the like.
- a subject polypeptide comprises an amino acid sequence that encodes a light-reactive polypeptide.
- a light-reactive polypeptide is a light-reactive cation channel.
- a target cell that expresses a light-reactive polypeptide can be activated or inhibited upon exposure to light of varying wavelengths.
- a target cell that expresses a light-reactive polypeptide is a neuronal cell that expresses a light-reactive polypeptide, and upon exposure to light of varying wavelengths, results in depolarization or polarization of the neuron.
- the light-responsive polypeptide is a light-activated ion channel polypeptide.
- the light-activated ion channel polypeptides are adapted to allow one or more ions to pass through the plasma membrane of a target cell when the polypeptide is illuminated with light of an activating wavelength.
- Light-activated proteins may be characterized as ion pump proteins, which facilitate the passage of a small number of ions through the plasma membrane per photon of light, or as ion channel proteins, which allow a stream of ions to freely flow through the plasma membrane when the channel is open.
- the light-responsive polypeptide depolarizes the excitable cell when activated by light of an activating wavelength.
- the light-responsive polypeptide hyperpolarizes the excitable cell when activated by light of an activating wavelength.
- a light-responsive polypeptide mediates a hyperpolarizing current in the target cell it is expressed in when the cell is illuminated with light.
- Non-limiting examples of light- reactive polypeptides capable of mediating a hyperpolarizing current can be found, e.g., in International Patent Application No. PCT/US2011/028893; U.S. Patent No. 9,175,095.
- Non- limiting examples of hyperpolarizing light-reactive polypeptides include NpHr, eNpHr2.0, eNpHr3.0, eNpHr3.1 or GtR3.
- a light-reactive polypeptide mediates a depolarizing current in the target cell it is expressed in when the cell is illuminated with light.
- depolarizing light-reactive polypeptides include “C1V1”, ChR1, VChR1, ChR2. Additional information regarding other light-activated cation channels, anion pumps, and proton pumps can be found in U.S. Patent Application Publication Nos: 2009/0093403; and International Patent Application No: PCT/US2011/028893.
- the light-reactive polypeptide can be activated by light having a wavelength of about 560 nm. In one embodiment, the light-reactive polypeptide can be activated by red light.
- the light-reactive polypeptide can be activated by light having a wavelength of about 630 nm. In other embodiments, the light-reactive polypeptide can be activated by violet light. In one embodiment, light-reactive polypeptide can be activated by light having a wavelength of about 405 nm. In other embodiments, the light-reactive polypeptide can be activated by green light. A person of skill in the art would recognize that each light-reactive polypeptide will have its own range of activating wavelengths. [0083] In some embodiments, the light-responsive polypeptides are activated by blue light. In some embodiments, the light-responsive polypeptides are activated by green light.
- the light-responsive polypeptides are activated by yellow light. In some embodiments, the light-responsive polypeptides are activated by orange light. In some embodiments, the light-responsive polypeptides are activated by red light.
- the regions of the brain with neurons containing a light-responsive peptide is illuminated using one or more optical fibers.
- the optical fiber may be configured in any suitable manner to direct a light emitted from suitable source of light, e.g., a laser or light-emitting diode (LED) light source, to the region of the brain.
- the optical fiber may be any suitable optical fiber. In some cases, the optical fiber is a multimode optical fiber.
- the optical fiber may include a core defining a core diameter, where light from the light source passes through the core.
- the optical fiber may have any suitable core diameter.
- the core diameter of the optical fiber is 10 mm or more, e.g., 20 mm or more, 30 mm or more, 40 mm or more, 50 mm or more, 60 mm or more, including 80 mm or more, and is 1,000 mm or less, e.g., 500 mm or less, 200 mm or less, 100 mm or less, including 70 mm or less.
- the core diameter of the optical fiber is in the range of 10 to 1,000 mm, e.g., 20 to 500 mm, 30 to 200 mm, including 40 to 100 mm.
- the optical fiber end that is implanted into the target region of the brain may have any suitable configuration suitable for illuminating a region of the brain with a light stimulus delivered through the optical fiber.
- the optical fiber includes an attachment device at or near the distal end of the optical fiber, where the distal end of the optical fiber corresponds to the end inserted into the subject.
- the attachment device is configured to connect to the optical fiber and facilitate attachment of the optical fiber to the subject, such as to the skull of the subject. Any suitable attachment device may be used.
- the attachment device includes a ferrule, e.g., a metal, ceramic or plastic ferrule. The ferrule may have any suitable dimensions for holding and attaching the optical fiber.
- methods of the present disclosure may be performed using any suitable electronic components to control and/or coordinate the various optical components used to illuminate the regions of the brain.
- the optical components e.g., light source, optical fiber, lens, objective, mirror, and the like
- the controller may include a driver for the light source that controls one or more parameters associated with the light pulses, such as, but not limited to the frequency, pulse width, duty cycle, wavelength, intensity, etc. of the light pulses.
- the controllers may be in communication with components of the light source (e.g., collimators, shutters, filter wheels, moveable mirrors, lenses, etc.).
- the light-reactive polypeptides are activated by light pulses that can have a duration for any of about 1 millisecond (ms), about 2 ms, about 3, ms, about 4, ms, about 5 ms, about 6 ms, about 7 ms, about 8 ms, about 9 ms, about 10 ms, about 15 ms, about 20 ms, about 25 ms, about 30 ms, about 35 ms, about 40 ms, about 45 ms, about 50 ms, about 60 ms, about 70 ms, about 80 ms, about 90 ms, about 100 ms, about 200 ms, about 300 ms, about 400 ms, about 500 ms, about 600 ms, about 700 ms, about 800 ms, about 900 ms, about 1 sec, about 1.25 sec, about 1.5 sec, or about 2 sec, inclusive, including any times in between these numbers.
- ms millisecond
- the light-reactive polypeptides are activated by light pulses that can have a light power density of any of about 0.05 mW/mm 2 , about 0.1 mW/mm 2 , about 0.25 mW/mm 2 , about 0.5 mW/mm 2 , about 0.75 mW/mm 2 , about 1 mW/mm 2 , about 2 mW/mm 2 , about 3 mW/mm 2 , about 4 mW/mm 2 , about 5 mW/mm 2 , about 6 mW/mm 2 , about 7 mW/mm 2 , about 8 mW/mm 2 , about 9 mW/mm 2 , about 10 mW/mm 2 , about 20 mW/mm 2 , about 50 mW/mm 2 , about 100 mW/mm 2 , about 250 mW/mm 2 , about 500 mW/mm 2 , about 750 mW/mm 2 , about 1000 mW/mm
- the light stimulus used to activate the light-responsive polypeptide may include light pulses characterized by, e.g., frequency, pulse width, duty cycle, wavelength, intensity, etc.
- the light stimulus includes two or more different sets of light pulses, where each set of light pulses is characterized by different temporal patterns of light pulses.
- the temporal pattern may be characterized by any suitable parameter, including, but not limited to, frequency, period (i.e., total duration of the light stimulus), pulse width, duty cycle, etc.
- the light pulses may have any suitable frequency.
- the set of light pulses contains a single pulse of light that is sustained throughout the duration of the light stimulus.
- the light pulses of a set have a frequency of 0.1 Hz or more, e.g., 0.5 Hz or more, 1 Hz or more, 5 Hz or more, 10 Hz or more, 20 Hz or more, 30 Hz or more, 40 H or more, including 50 Hz or more, or 60 Hz or more, or 70 Hz or more, or 80 Hz or more, or 90 Hz or more, or 100 Hz or more, and have a frequency of 100,000 Hz or less, e.g., 10,000 Hz or less, 1,000 Hz or less, 500 Hz or less, 400 Hz or less, 300 Hz or less, 200 Hz or less, including 100 Hz or less.
- the light pulses have a frequency in the range of 0.1 to 100,000 Hz, e.g., 1 to 10,000 Hz, 1 to 1,000 Hz, including 5 to 500 Hz, or 10 to 100 Hz.
- the two sets of light pulses are characterized by having different parameter values, such as different pulse widths, e.g. short or long.
- the light pulses may have any suitable pulse width.
- the pulse width is 0.1 ms or longer, e.g., 0.5 ms or longer, 1 ms or longer, 3 ms or longer, 5 ms or longer, 7.5 ms or longer, 10 ms or longer, including 15 ms or longer, or 20 ms or longer, or 25 ms or longer, or 30 ms or longer, or 35 ms or longer, or 40 ms or longer, or 45 ms or longer, or 50 ms or longer, and is 500 ms or shorter, e.g., 100 ms or shorter, 90 ms or shorter, 80 ms or shorter, 70 ms or shorter, 60 ms or shorter, 50 ms or shorter, 45 ms or shorter, 40 ms or shorter, 35 ms or shorter, 30 ms or shorter, 25 ms or shorter, including 20 ms or shorter.
- 500 ms or shorter e.g., 100 ms or shorter, 90 ms or shorter,
- the pulse width is in the range of 0.1 to 500 ms, e.g., 0.5 to 100 ms, 1 to 80 ms, including 1 to 60 ms, or 1 to 50 ms, or 1 to 30 ms.
- the average power of the light pulse, measured at the tip of an optical fiber delivering the light pulse to regions of the brain, may be any suitable power.
- the power is 0.1 mW or more, e.g., 0.5 mW or more, 1 mW or more, 1.5 mW or more, including 2 mW or more, or 2.5 mW or more, or 3 mW or more, or 3.5 mW or more, or 4 mW or more, or 4.5 mW or more, or 5 mW or more, and may be 1,000 mW or less, e.g., 500 mW or less, 250 mW or less, 100 mW or less, 50 mW or less, 40 mW or less, 30 mW or less, 20 mW or less, 15 mW or less, including 10 mW or less, or 5 mW or less.
- the power is in the range of 0.1 to 1,000 mW, e.g., 0.5 to 100 mW, 0.5 to 50 mW, 1 to 20 mW, including 1 to 10 mW, or 1 to 5 mW.
- the wavelength and intensity of the light pulses may vary and may depend on the activation wavelength of the light-responsive polypeptide, optical transparency of the region of the brain, the desired volume of the brain to be illuminated, etc.
- the volume of a brain region illuminated by the light pulses may be any suitable volume.
- the illuminated volume is 0.001 mm 3 or more, e.g., 0.005 mm 3 or more, 0.001 mm 3 or more, 0.005 mm 3 or more, 0.01 mm 3 or more, 0.05 mm 3 or more, including 0.1 mm 3 or more, and is 100 mm 3 or less, e.g., 50 mm 3 or less, 20 mm 3 or less, 10 mm 3 or less, 5 mm 3 or less, 1 mm 3 or less, including 0.1 mm 3 or less.
- the illuminated volume is in the range of 0.001 to 100 mm 3 , e.g., 0.005 to 20 mm 3 , 0.01 to 10 mm 3 , 0.01 to 5 mm 3 , including 0.05 to 1 mm 3 .
- the light-responsive polypeptide expressed in a cell can be fused to one or more amino acid sequence motifs selected from the group consisting of a signal peptide, an endoplasmic reticulum (ER) export signal, a membrane trafficking signal, and/or an N-terminal golgi export signal.
- the one or more amino acid sequence motifs which enhance light-responsive protein transport to the plasma membranes of mammalian cells can be fused to the N-terminus, the C-terminus, or to both the N- and C-terminal ends of the light-responsive polypeptide.
- the one or more amino acid sequence motifs which enhance light-responsive polypeptide transport to the plasma membranes of mammalian cells is fused internally within a light- responsive polypeptide.
- the light-responsive polypeptide and the one or more amino acid sequence motifs may be separated by a linker.
- the light-responsive polypeptide can be modified by the addition of a trafficking signal (ts) which enhances transport of the protein to the cell plasma membrane.
- the trafficking signal can be derived from the amino acid sequence of the human inward rectifier potassium channel Kir2.1.
- the signal peptide sequence in the protein can be deleted or substituted with a signal peptide sequence from a different protein.
- Exemplary light-responsive polypeptides and amino acid sequence motifs that find use in the present system and method are disclosed in, e.g., PCT App. Nos. PCT/US2011/028893 and PCT/US2015/23087.
- Light-responsive polypeptides of interest include, for example, a step function opsin (SFO)6 protein or a stabilized step function opsin (SSFO) protein that can have specific amino acid substitutions at key positions in the retinal binding pocket of the protein.
- SFO step function opsin
- SSFO stabilized step function opsin
- the polypeptide may be a cation channel derived from Volvox carteri (VChR1), optionally comprising one or more amino acid substitutions, e.g. C123A; C123S; D151A, etc.
- a light-responsive cation channel protein can be a C1V1 chimeric protein derived from the VChR1 protein of Volvox carteri and the ChR1 protein from Chlamydomonas reinhardti, wherein the protein comprises the amino acid sequence of VChR1 having at least the first and second transmembrane helices replaced by the first and second transmembrane helices of ChR1, optionally having an amino acid substitution at amino acid residue E122 or E162.
- the light-responsive cation channel protein is a C1C2 chimeric protein derived from the ChR1 and the ChR2 proteins from Chlamydomonas reinhardti, wherein the protein is responsive to light and is capable of mediating a depolarizing current in the cell when the cell is illuminated with light.
- a depolarizing light-responsive polypeptide is a red shifted variant of a depolarizing light- responsive polypeptide derived from Chlamydomonas reinhardtii; referred to as a "ReaChR polypeptide” or “ReaChR protein” or “ReaChR.”
- a depolarizing light- responsive polypeptide is a SdChR polypeptide derived from Scherffelia dubia, wherein the SdChR polypeptide is capable of transporting cations across a cell membrane when the cell is illuminated with light.
- a depolarizing light-responsive polypeptide is CnChR1, derived from Chlamydomonas noctigama, wherein the CnChR1 polypeptide is capable of transporting cations across a cell membrane when the cell is illuminated with light.
- the light-responsive cation channel protein is a CsChrimson chimeric protein derived from a CsChR protein of Chloromonas subdivisa and CnChR1 protein from Chlamydomonas noctigama, wherein the N terminus of the protein comprises the amino acid sequence of residues 1-73 of CsChR followed by residues 79-350 of the amino acid sequence of CnChR1; is responsive to light; and is capable of mediating a depolarizing current in the cell when the cell is illuminated with light.
- a depolarizing light-responsive polypeptide can be, e.g.
- a depolarizing light-responsive polypeptide is derived from Chlamydomonas reinhardtii (CHR1, and particularly CHR2) wherein the polypeptide is capable of transporting cations across a cell membrane when the cell is illuminated with light; and is capable of mediating a depolarizing current in the cell when the cell is illuminated with light.
- CHR1 Chlamydomonas reinhardtii
- CaMKIIa-driven, humanized channelrhodopsin CHR2 H134R mutant fused to EYFP is used for optogenetic activation.
- the light used to activate the light-responsive cation channel protein derived from Chlamydomonas reinhardtii can have a wavelength between about 460 and about 495 nm or can have a wavelength of about 480 nm.
- the light-responsive cation channel protein can additionally comprise substitutions, deletions, and/or insertions introduced into a native amino acid sequence to increase or decrease sensitivity to light, increase or decrease sensitivity to particular wavelengths of light, and/or increase or decrease the ability of the light- responsive cation channel protein to regulate the polarization state of the plasma membrane of the cell. Additionally, the light-responsive cation channel protein can comprise one or more conservative amino acid substitutions and/or one or more non-conservative amino acid substitutions.
- the light-responsive proton pump protein containing substitutions, deletions, and/or insertions introduced into the native amino acid sequence suitably retains the ability to transport cations across a cell membrane.
- the protein may comprise various amino acid substitutions, e.g. one or more of H134R; T159C; L132C ; E123A; etc.
- the protein may further comprise a fluorescent protein, for example, but not limited to, a yellow fluorescent protein, a red fluorescent protein, a green fluorescent protein, or a cyan fluorescent protein.
- the individual may be any suitable individual for analyzing the individual's brain functional activity data. In some cases, the individual is a human individual. In some cases the human is a healthy human, or a human having a neurological disorder.
- the neurological disorder may be any suitable neurological disorder.
- the neurological disorder is caused by a disease, e.g., a neurological disease.
- the neurological disease may be any suitable disease associated with pathological activity of a network of neurons. Suitable neurological diseases include, without limitation, Parkinson's disease, Alzheimer's disease, dementia, epilepsy, autism, bipolar disorder, schizophrenia, Tourette's syndrome, obsessive compulsive disorder, attention deficit hyperactivity disorder, Huntington's disease, multiple sclerosis, or migraine.
- the neurological disorder is an age-related disorder of brain function.
- the methods may be used to treat a disease or condition (e.g., a neurological disorder) in the subject that is amenable to treatment using the subject methods.
- the terms “treat,” “treatment,” “treating,” and the like refer to obtaining a desired pharmacologic and/or physiologic effect.
- the effect may be prophylactic in terms of completely or partially preventing a disease or symptom thereof and/or may be therapeutic in terms of a partial or complete cure for a disease and/or adverse effect attributable to the disease.
- Treatment covers any treatment of a disease in a mammal, particularly in a human, and includes: (a) preventing the disease from occurring in a subject which may be predisposed to the disease but has not yet been diagnosed as having it; (b) inhibiting the disease, i.e., arresting its development; and (c) relieving the disease, e.g., causing regression of the disease, e.g., to completely or partially remove symptoms of the disease.
- Selective activation of neurons in order to measure subtype-specific functional activity may be done using any suitable method. Suitable methods of selective neuron activation include, without limitation, optogenetic stimulation, single unit electrophysiology, etc.
- a light-activated polypeptide for use in the present disclosure may be any suitable light- activated polypeptide for selectively activating neurons of a subtype by illuminating the neurons with an activating light stimulus.
- the light-activated polypeptide is a light- activated ion channel polypeptide.
- the light-activated ion channel polypeptides are adapted to allow one or more ions to pass through the plasma membrane of a target cell when the polypeptide is illuminated with light of an activating wavelength.
- Light-activated proteins may be characterized as ion pump proteins, which facilitate the passage of a small number of ions through the plasma membrane per photon of light, or as ion channel proteins, which allow a stream of ions to freely flow through the plasma membrane when the channel is open.
- the light-activated polypeptide depolarizes the cell when activated by light of an activating wavelength. In some embodiments, the light-activated polypeptide hyperpolarizes the cell when activated by light of an activating wavelength.
- Suitable hyperpolarizing and depolarizing polypeptides include, e.g., a channelrhodopsin (e.g., ChR2), variants of ChR2 (e.g., C128S, D156A, C128S+D156A, E123A, E123T), iC1C2, C1C2, GtACR2, NpHR, eNpHR3.0, C1V1, VChR1, VChR2, SwiChR, Arch, ArchT, KR2, ReaChR, ChiEF, Chronos, ChRGR, CsChrimson, and the like.
- a channelrhodopsin e.g., ChR2
- variants of ChR2 e.g., C128S, D156A, C128S+D156A, E123A, E123T
- iC1C2, C1C2, GtACR2 e.g., NpHR, eNpHR3.0, C1V1,
- the light-activated polypeptide includes bReaCh-ES, as described herein and described further in, e.g., Rajasethupathy et al., Nature. 2015 Oct. 29;526(7575):653, which is incorporated by reference.
- Hyperpolarizing and depolarizing opsins have been described in various publications; see, e.g., Berndt and Deisseroth (2015) Science 349:590; Berndt et al. (2014) Science 344:420; and Guru et al. (Jul.25, 2015) Intl. J. Neuropsychopharmacol. pp.1-8 (PMID 26209858).
- the light-activated polypeptide may be introduced into the neurons using any suitable method.
- the neurons of a subtype of interest are genetically modified to express a light-activated polypeptide.
- the neurons may be genetically modified using a viral vector, e.g., an adeno-associated viral vector, containing a nucleic acid having a nucleotide sequence that encodes the light-activated polypeptide.
- the viral vector may include any suitable control elements (e.g., promoters, enhancers, recombination sites, etc.) to control expression of the light-activated polypeptide according to neuronal subtype, timing, presence of an inducer, etc.
- "Operably linked" refers to a juxtaposition wherein the components so described are in a relationship permitting them to function in their intended manner.
- a promoter is operably linked to a nucleotide sequence (e.g., a protein coding sequence, e.g., a sequence encoding an mRNA; a non-protein coding sequence, e.g., a sequence encoding a light-reactive protein; and the like) if the promoter affects its transcription and/or expression.
- a nucleotide sequence e.g., a protein coding sequence, e.g., a sequence encoding an mRNA; a non-protein coding sequence, e.g., a sequence encoding a light-reactive protein; and the like.
- Neuron-specific promoters and other control elements e.g., enhancers are known in the art.
- Suitable neuron-specific control sequences include, but are not limited to, a neuron-specific enolase (NSE) promoter (see, e.g., EMBL HSENO2, X51956; see also, e.g., U.S. Pat. No. 6,649,811, U.S. Pat. No.5,387,742); an aromatic amino acid decarboxylase (AADC) promoter; a neurofilament promoter (see, e.g., GenBank HUMNFL, L04147); a synapsin promoter (see, e.g., GenBank HUMSYNIB, M55301); a thy-1 promoter (see, e.g., Chen et al.
- NSE neuron-specific enolase
- EMBL HSENO2 see also, e.g., U.S. Pat. No. 6,649,811, U.S. Pat. No.5,387,742
- AADC
- an L7 promoter see, e.g., Oberdick et al., Science 248:223-226 (1990)
- a DNMT promoter see, e.g., Bartge et al., Proc. Natl. Acad. Sci. USA 85:3648-3652 (1988)
- an enkephalin promoter see, e.g., Comb et al., EMBO J.17:3793-3805 (1988)
- MBP myelin basic protein
- CMV enhancer/platelet-derived growth factor-.beta. promoter see, e.g., Liu et al.
- neuronal subtype-specific expression of the light-activated polypeptide may be achieved by using recombination systems, e.g., Cre-Lox recombination, Flp-FRT recombination, etc.
- Cell type-specific expression of genes using recombination has been described in, e.g., Fenno et al., Nat Methods, 2014 July; 11(7):763; and Gompf et al., Front Behav Neurosci.2015 Jul.2;9:152, which are incorporated by reference herein.
- the vector is a recombinant adeno-associated virus (AAV) vector.
- AAV adeno-associated virus
- AAV vectors are DNA viruses of relatively small size that can integrate, in a stable and sitespecific manner, into the genome of the cells that they infect. They are able to infect a wide spectrum of cells without inducing any effects on cellular growth, morphology or differentiation, and they do not appear to be involved in human pathologies.
- the AAV genome has been cloned, sequenced and characterized. It encompasses approximately 4700 bases and contains an inverted terminal repeat (ITR) region of approximately 145 bases at each end, which serves as an origin of replication for the virus.
- ITR inverted terminal repeat
- the remainder of the genome is divided into two essential regions that carry the encapsidation functions: the left-hand part of the genome, that contains the rep gene involved in viral replication and expression of the viral genes; and the right-hand part of the genome, that contains the cap gene encoding the capsid proteins of the virus.
- AAV as a vector for gene therapy has been rapidly developed in recent years. Wild-type AAV could infect, with a comparatively high titer, dividing or non-dividing cells, or tissues of mammal, including human, and also can integrate into in human cells at specific site (on the long arm of chromosome 19) (Kotin et al, Proc. Natl. Acad. Sci.
- AAV vector without the rep and cap genes loses specificity of site-specific integration, but may still mediate long-term stable expression of exogenous genes.
- AAV vector exists in cells in two forms, wherein one is episomic outside of the chromosome; another is integrated into the chromosome, with the former as the major form.
- AAV has not hitherto been found to be associated with any human disease, nor any change of biological characteristics arising from the integration has been observed.
- AAV vectors may be prepared using any convenient methods.
- Adeno-associated viruses of any serotype are suitable (See, e.g., Blacklow, pp. 165-174 of "Parvoviruses and Human Disease” J. R. Pattison, ed. (1988); Rose, Comprehensive Virology 3:1, 1974; P. Tattersall "The Evolution of Parvovirus Taxonomy” In Parvoviruses (J R Kerr, S F Cotmore. M E Bloom, R M Linden, C R Parrish, Eds.) p 5-14, Hudder Arnold, London, UK (2006); and D E Bowles, J E Rabinowitz, R J Samulski "The Genus Dependovirus” (J R Kerr, S F Cotmore.
- the replication defective recombinant AAVs according to the invention can be prepared by co-transfecting a plasmid containing the nucleic acid sequence of interest flanked by two AAV inverted terminal repeat (ITR) regions, and a plasmid carrying the AAV encapsidation genes (rep and cap genes), into a cell line that is infected with a human helper virus (for example an adenovirus).
- ITR inverted terminal repeat
- the vector(s) for use in the methods of the invention are encapsidated into a virus particle (e.g. AAV virus particle including, but not limited to, AAV1, AAV2, AAV3, AAV4, AAV5, AAV6, AAV7, AAV8, AAV9, AAV10, AAV11, AAV12, AAV13, AAV14, AAV15, and AAV16).
- a virus particle e.g. AAV virus particle including, but not limited to, AAV1, AAV2, AAV3, AAV4, AAV5, AAV6, AAV7, AAV8, AAV9, AAV10, AAV11, AAV12, AAV13, AAV14, AAV15, and AAV16.
- the invention includes a recombinant virus particle (recombinant because it contains a recombinant polynucleotide) comprising any of the vectors described herein.
- Embodiments of the methods and systems described herein find use in a variety of MRI applications, such as MRI methods and systems where high-resolution MRI images are desired. In some cases, the subject methods and systems find use in producing high-resolution functional MRI (fMRI) images of a target area in an individual.
- fMRI functional MRI
- the subject methods and systems find use in fMRI techniques for measuring the brain activity of an individual, such as by detecting changes associated with blood flow in one or more target areas in the brain of the individual.
- the subject methods and systems find use in producing high-resolution functional MRI (fMRI) images of a target area in an individual, where the activity in excitable cells in a target organ or tissue in the individual is assessed.
- fMRI functional MRI
- the subject methods and systems may find use in detecting the activity of light-responsive polypeptides (e.g., light- activated ion channels) in excitable cells (e.g., neurons) in the individual.
- the subject methods and systems find use in global and/or regional brain function studies, such as where the activity of one or more target regions of the brain is mapped in high-resolution.
- the subject methods and systems find use in producing high- resolution fMRI images of a target area in an individual, including high-resolution fMRI images that are produced offline (i.e., where processing of the image data is performed at a time after the image data is acquired), and also high-resolution fMRI images that are produced in real-time (i.e., where processing of the image data occurs immediately following acquisition of the image data and/or during acquisition of the image data).
- the present methods and systems find use in screening in vitro and/or in vivo animal models of disease for neuronal circuit elements diagnostic of or causative for neuropsychiatric disease.
- the present methods and systems find use in pre- surgical brain function diagnosis.
- Embodiments of the present methods and systems also find use in planning brain machine interface, such as by mapping the neuronal activity in areas of the brain to determine appropriate locations in the brain for brain machine interface.
- the present methods and systems find use in methods for identifying a treatment, e.g., a therapeutic treatment, with a desired activity on a group of neurons.
- the present methods and systems may be used to screen for treatments, including, but not limited to, optogenetic treatment, pharmacological agents, nonchemical based therapeutic treatment; behavioral treatment; electrical, magnetic, or optical based neural-modulation treatment; etc., that will bring about the desired neuronal activity pattern.
- the screening may be performed in any suitable animal model, either normal, or a model for a neurological disorder, such as Alzheimer's and Parkinson's disease, mild cognitive impairment, other dementias, and Down's Syndrome, as well as schizophrenia, autism, mood, affective, anxiety, and personality/developmental disorders, or other disease models described herein.
- the present methods and systems find use in the treatment of a condition or disorder, such as a neurological or psychiatric condition using optogenetic control.
- a controller or processor may be configured to modulate the activity of neurons in response to the imaged activity signals in such a way as to treat or reduce symptoms of the condition or disorder, at the behavioral and/or physiological levels.
- Seizure Models Provided herein are methods and models for analyzing in vivo the brain circuits and regional relationships involved in seizures, particularly by imaging of single seizures for fine discrimination of effects.
- Methods of the present disclosure may use any number of combinations of suitable neuronal stimulation and neuronal activity measurement protocols, as necessary, to image the effects of seizures.
- the methods and models may include, for example, one or more of analysis of single seizures, analysis of focal to bilateral tonic-clonic (FBTC) seizures, analysis of excitatory ventral hippocampal (VH) networks, and the like.
- FBTC focal to bilateral tonic-clonic
- VH excitatory ventral hippocampal
- exemplary agents for this purpose include, without limitation, dexmedetomidine sedation and vecuronium. Seizures may be induced with optogenetic stimulation, with electrical stimulation, e.g.
- electroshock whole-brain stimulation protocols single- evoked epileptic afterdischarges; with chemoconvulsants, e.g. pilocarpine, tetanus toxin, PTZ, kainic acid, flurothyl, etc., fluid percussion injury, high-intensity acoustic stimulation.
- chemoconvulsants e.g. pilocarpine, tetanus toxin, PTZ, kainic acid, flurothyl, etc.
- fluid percussion injury high-intensity acoustic stimulation.
- optogenetic stimulation is preferred.
- a specific region of a brain of an individual is stimulated, in conjunction with combined electrophysiology, e.g. local field potentials (LFP) and functional magnetic resonance imaging (fMRI) scanning of different regions of the brain to determine functional connections between the seizure propagation zone and other regions of the brain and to image movement of a seizure.
- LFP local field potential
- Suitable protocols for analysis include electrophysiology; light-induced modulation of neural activity; electroencephalography (EEG) recordings; functional imaging and behavioral analysis.
- Electrophysiology may include single electrode, multi electrode, and/or field potential recordings.
- Light-induced modulation of neural activity may include any suitable optogenetic method, as described further herein.
- Functional imaging may include fMRI, and any functional imaging protocols using genetically encoded indicators (e.g., calcium indicators, voltage indicators, etc.).
- Behavioral analysis may include any suitable behavioral assays, such as behavioral assays for arousal, memory (such as a water maze assay), conditioning (such as fear conditioning), sensory responses (responses to e.g., visual, somatosensory, auditory, gustatory, and/or olfactory cues).
- Some protocols such as fMRI, provide a non-invasive, brain-wide measure representative of neural activity.
- Some protocols such as electrophysiology, provide cellular resolution and rapid measures of neural activity as well as cellular resolution and rapid control of neural activity.
- Some protocols, such as optogenetics provide spatially-targeted and temporally-defined control of action potential firing in defined groups of neurons.
- an optogenetic model for seizures wherein electrographic seizures are induced in an animal model by cell-type specific, optogenetic stimulations. Simultaneous electrophysiology and fMRI can be used to determine the effect of inhibition of targeted neurons.
- the animal model is useful in the design and testing of therapeutic interventions, e.g. surgery, pharmacologic therapy, and the like, where the effect of a therapeutic intervention on seizure propagation can be determined.
- an agent is determined to be effective for targeted intervention of seizures if the duration or severity of seizure is reduced.
- the severity of a seizure is determined using the Racine scale.
- an agent is determined to be effective for targeted intervention if seizure severity is reduced by at least 1 stage on the Racine scale. For example, reducing seizure severity from Racine stage 5 to stage 4. In some embodiments, seizure severity is reduced by 2 stages, 3 stages, 4 stages or seizures are stopped all together.
- Drug Design Methods are provided for optimizing therapy, by analyzing the effects of seizures across brain regions, and based on that information, selecting appropriate drug candidates and therapeutic modalities that are optimal for addressing seizure induction and propagation, while minimizing undesirable toxicity. The treatment is optimized by selection for a treatment that minimizes undesirable toxicity, while providing for effective activity. [00123] The models provided herein are useful in the design and testing of therapeutic interventions, e.g.
- Parameters are quantifiable characteristics of cells, tissues and organisms, particularly components that can be accurately measured.
- a parameter can be, for example, the site or sites, strength, duration, speed, etc. of an electrophysiological discharge, and can be imaged by fMRI, LFP, etc.
- Readouts may include a single determined value, or may include mean, median value or the variance, etc. Characteristically a range of parameter readout values will be obtained for a parameter from a multiplicity of measurements. Variability is expected and a range of values for each of the set of test parameters will be obtained using standard statistical methods with a common statistical method used to provide single values.
- Candidate agents of interest are for drug design are biologically active agents that encompass numerous chemical classes, primarily organic molecules, which may include organometallic molecules, inorganic molecules, genetic sequences, etc. Also of interest are therapeutic interventions, such as surgery, deep brain stimulation, optogenetics, and the like. An important aspect of the invention is to evaluate candidate therapies with preferred biological response functions. [00126] Included are pharmacologically active drugs, genetically active molecules, etc. Compounds of interest include chemotherapeutic agents, anti-inflammatory agents, hormones or hormone antagonists, ion channel modifiers, and neuroactive agents.
- Test compounds include all of the classes of molecules described above, and may further comprise samples of unknown content. Of interest are complex mixtures of naturally occurring compounds derived from natural sources such as plants. While many samples will comprise compounds in solution, solid samples that can be dissolved in a suitable solvent may also be assayed.
- Samples of interest include environmental samples, e.g. ground water, sea water, mining waste, etc.; biological samples, e.g. lysates prepared from crops, tissue samples, etc.; manufacturing samples, e.g. time course during preparation of pharmaceuticals; as well as libraries of compounds prepared for analysis; and the like. Samples of interest include compounds being assessed for potential therapeutic value, i.e. drug candidates. [00128] The term samples also includes the fluids described above to which additional components have been added, for example components that affect the ionic strength, pH, total protein concentration, etc. In addition, the samples may be treated to achieve at least partial fractionation or concentration. Biological samples may be stored if care is taken to reduce degradation of the compound, e.g. under nitrogen, frozen, or a combination thereof.
- Compounds, including candidate 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, including 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.
- pharmacological agents may be subjected to directed or random chemical modifications, such as acylation, alkylation, esterification, amidification, etc. to produce structural analogs.
- the term "genetic agent” refers to polynucleotides and analogs thereof, which-agents are tested in the screening assays of the invention by addition of the genetic agent, to a cell. The introduction of the genetic agent results in an alteration of the total genetic composition of the cell. As employed herein, the genetic agent results in the expression of a protein and is being evaluated as to its effect on one or more target pathways.
- the genetic agents such as DNA result in an experimentally introduced change in the genome of a cell, generally through the integration of the sequence into a chromosome.
- Genetic changes can also be transient, where the exogenous sequence is not integrated but is maintained as an episomal agent.
- RNA viruses may be employed that comprise the gene of interest and are reverse transcribed and inserted into the genome of the host cell.
- Genetic agents polypeptides or polynucleotides
- a moiety e.g antennapedia 16-amino acid "Penetratin-1 peptide, available from Qbiogene
- the effect of a genetic agent is to increase expression of a particular gene product in the cell with the potential for the increase and/or decrease of other products in the cell.
- chemical agents of known or unknown activity are administered to an animal and the effect on seizure induction, propagation and movement assessed. These chemical agents may serve to activate a pathway, inhibit a pathway, etc., where there is interest in having a pathway other than the pathway of interest modulated and rather than using a natural factor, a chemical agent may be more convenient.
- the chemical agents are conveniently added in solution, or readily soluble form, and may be administered to the animal in various ways, e.g. oral, sub- cutaneous, by cannula, etc. as known in the art.
- Preferred chemical agent formulations consist essentially of a biologically active compound and a physiologically acceptable carrier, e.g. water, normal saline, etc.
- a specific region of a brain of an individual is stimulated, in conjunction with combined electrophysiology, e.g. local field potentials (LFP) and functional magnetic resonance imaging (fMRI) scanning with respect to induction and inhibition of AD.
- the animal may be sedated, e.g. with dexmedetomidine; and treated with a short-acting neuromuscular blocker, e.g. vecuronium, to abolish motion during imaging of seizures with simultaneous LFP- fMRI.
- Suitable protocols for analysis include electrophysiology; light-induced modulation of neural activity; electroencephalography (EEG) recordings; functional imaging and behavioral analysis.
- Electrophysiology may include single electrode, multi electrode, and/or field potential recordings.
- Light-induced modulation of neural activity may include any suitable optogenetic method, as described further herein.
- Functional imaging may include fMRI, and any functional imaging protocols using genetically encoded indicators (e.g., calcium indicators, voltage indicators, etc.).
- Behavioral analysis may include any suitable behavioral assays, such as behavioral assays for arousal, memory (such as a water maze assay), conditioning (such as fear conditioning), sensory responses (responses to e.g., visual, somatosensory, auditory, gustatory, and/or olfactory cues).
- the models provided herein are useful in the design and testing of therapeutic interventions, e.g.
- Comparisons can be made to known antiepileptic drugs, for example gabapentin, topiramate, lamotrigine, levetiracetam, stiripentol, and rufinamide, oxcarbazepine, lacosamide, perampanel, etc.
- the comparison of measurements obtained from a test agent, and a reference agent can be accomplished by the use of suitable deduction protocols, AI systems, statistical comparisons, etc.
- the data is compared with a database of reference results.
- a database of reference results can be compiled.
- a data matrix is generated, where each point of the data matrix corresponds to a readout from a parameter, where data for each parameter may come from replicate determinations, e.g. multiple individual seizures of the same type, etc.
- a data point may be quantitative, semi-quantitative, or qualitative, depending on the nature of the parameter.
- the readout may be a mean, average, median or the variance or other statistically or mathematically derived value associated with the measurement.
- the parameter readout information may be further refined by direct comparison with the corresponding reference readout.
- the absolute values obtained for each parameter under identical conditions will display a variability that is inherent in live biological systems and also reflects individual cellular variability as well as the variability inherent between individuals.
- Classification rules are constructed from sets of training data (i.e. data matrices) obtained from multiple repeated experiments. Classification rules are selected as correctly identifying repeated reference patterns and successfully distinguishing distinct reference patterns. Classification rule-learning algorithms may include decision tree methods, statistical methods, naive Bayesian algorithms, and the like. A knowledge database will be of sufficient complexity to permit novel test agents to be effectively identified and classified. Several approaches for generating a sufficiently encompassing set of classification patterns and sufficiently powerful mathematical/statistical methods for discriminating between them can accomplish this. Computer aspects [00137] A computational system (e.g., a computer) may be used in the methods of the present disclosure to control and/or coordinate stimulus through the one or more controllers, and to analyze data from scanning of the regions of the brain.
- a computational system e.g., a computer
- a computational unit may include any suitable components to analyze the measured images.
- the computational unit may include one or more of the following: a processor; a non-transient, computer-readable memory, such as a computer-readable medium; an input device, such as a keyboard, mouse, touchscreen, etc.; an output device, such as a monitor, screen, speaker, etc.; a network interface, such as a wired or wireless network interface; and the like.
- the raw data from measurements such as fMRI, LFP, and the like, can be analyzed and stored on a computer-based system.
- a computer-based system refers to the hardware means, software means, and data storage means used to analyze the information of the present invention.
- the minimum hardware of the computer-based systems of the present invention comprises a central processing unit (CPU), input means, output means, and data storage means.
- CPU central processing unit
- the data storage means may comprise any manufacture comprising a recording of the present information as described above, or a memory access means that can access such a manufacture.
- a variety of structural formats for the input and output means can be used to input and output the information in the computer-based systems. Such presentation provides a skilled artisan with a ranking of similarities and identifies the degree of similarity contained in the test data.
- the analysis may be implemented in hardware or software, or a combination of both.
- a machine-readable storage medium comprising a data storage material encoded with machine readable data which, when using a machine programmed with instructions for using said data, is capable of displaying a any of the datasets and data comparisons of this invention.
- data may be used for a variety of purposes, such as drug discovery, analysis of interactions between cellular components, and the like.
- the invention is implemented in computer programs executing on programmable computers, comprising a processor, a data storage system (including volatile and non-volatile memory and/or storage elements), at least one input device, and at least one output device.
- Program code is applied to input data to perform the functions described above and generate output information.
- the output information is applied to one or more output devices, in known fashion.
- the computer may be, for example, a personal computer, microcomputer, or workstation of conventional design.
- Each program can be implemented in a high level procedural or object oriented programming language to communicate with a computer system. However, the programs can be implemented in assembly or machine language, if desired. In any case, the language may be a compiled or interpreted language.
- Each such computer program can be stored on a storage media or device (e.g., ROM or magnetic diskette) readable by a general or special purpose programmable computer, for configuring and operating the computer when the storage media or device is read by the computer to perform the procedures described herein.
- the system may also be considered to be implemented as a computer-readable storage medium, configured with a computer program, where the storage medium so configured causes a computer to operate in a specific and predefined manner to perform the functions described herein.
- a variety of structural formats for the input and output means can be used to input and output the information in the computer-based systems of the present invention.
- Any computer or computer accessory including, but not limited to software and storage devices, can be utilized to practice the present invention. Sequence or other data (e.g., immune repertoire analysis results), can be input into a computer by a user either directly or indirectly.
- any of the devices which can be used to sequence DNA or analyze DNA or analyze immune repertoire data can be linked to a computer, such that the data is transferred to a computer and/or computer-compatible storage device.
- Data can be stored on a computer or suitable storage device (e.g., CD).
- Data can also be sent from a computer to another computer or data collection point via methods well known in the art (e.g., the internet, ground mail, air mail).
- methods well known in the art e.g., the internet, ground mail, air mail.
- Standard abbreviations may be used, e.g., bp, base pair(s); kb, kilobase(s); pl, picoliter(s); s or sec, second(s); min, minute(s); h or hr, hour(s); aa, amino acid(s); kb, kilobase(s); bp, base pair(s); nt, nucleotide(s); i.m., intramuscular(ly); i.p., intraperitoneal(ly); s.c., subcutaneous(ly); and the like.
- Example 1 Predicting Successful Generation and Inhibition of Seizure-like Afterdischarges and Mapping Their Seizure Networks Using fMRI
- LFP local field potential
- fMRI fMRI
- optogenetic inhibition During after discharge induction using optogenetics, LFP recordings show that stimulations with earlier ictal onset times are more likely to result in afterdischarges and are more difficult to curtail with optogenetic inhibition. These results are generalizable across two initiation sites, the dorsal and ventral hippocampus.
- fMRI shows that afterdischarges initiated from the dorsal or ventral hippocampus exhibit distinct networks.
- Short-duration seizures initiated in the dorsal and ventral hippocampus are unilateral and bilateral, respectively, while longer-duration afterdischarges recruit broader, bilateral networks.
- optogenetic inhibition is ineffective at stopping seizures, the network activity spreads more extensively but largely overlaps with the network activity associated with seizures that could be curtailed.
- the AD probability was modeled using a hierarchical Bayesian model with ictal onset time as the explanatory variable and the intercepts (b 0 ) allowed to vary across subjects ( Figures 1C and 1D).
- Figure 1C shows the observed data for individual subjects alongside the mean ⁇ 95% credible intervals of the posterior predictive distribution. The data generated from the model reproduce the pattern of the observed data well, suggesting a good model fit. Earlier onset significantly predicted the occurrence of ADs, indicated by the ictal onset regression coefficient and their 95% highest- posterior density (HPD) uncertainty intervals being greater than zero.
- HPD highest- posterior density
- Propagation patterns were explored by mapped the relationship between seizure network activity on fMRI and AD duration.
- a binary variable was used to describe voxels as either active (if they exceeded the p ⁇ 0.001 statistical threshold) or not active, and a logistic function fit across all subjects and trials as a function of the AD duration, as illustrated in Figure 4A.
- the inflection point of this fitted curve provided an estimation of the average activation time at each voxel during an AD and thus was used to visualize the spread of seizure activity over the course of ADs originating in different regions.
- ADs originating from the VH displayed early activation in short-duration ADs in the ipsilateral VH, septum, and ipsilateral prefrontal cortex (PFC) ( Figure 4B).
- the average activation time in the contralateral VH was 17 ⁇ 2 s later than in the ipsilateral hippocampus, while the contralateral PFC was 18 ⁇ 6 s later than the VH.
- the DH was significantly later (27 ⁇ 5 s), demonstrating that the DH was only active during long-duration ADs.
- Distinct networks were identified for ADs originating from the VH compared with those generated from the DH. Interestingly, these networks were largely similar for ADs that could be curtailed compared with those that could not be curtailed, while activity spread more extensively in those that could not be curtailed. [00163]
- Our statistical model based on the ictal onset time suggests that the effectiveness of local optogenetic inhibition to curtail ADs is related to their progression, with earlier-onset ADs being less sensitive to local inhibition.
- ADs could not be curtailed, they did not necessarily involve extrahippocampal regions but rather spread farther toward the temporal pole.
- the network activity involved in ADs that could and could not be curtailed was therefore largely similar but different in extent, while ADs initiated from the DH were dramatically different from those initiated from the VH.
- Our results provide important insights for future investigations into targeted epilepsy therapies and further our understanding of the spread of seizure activity from the DH and VH.
- Methods [00171] Surgical procedure for virus injection and implantation of optrodes. The surgical procedure was designed to drive expression of both eNpHR3.0 and ChR2 in the ventral hippocampus in overlapping neuronal populations by administering via co-injection of 2 viruses of the same serotype. For AD induction, CAMKII neurons were targeted for ChR2 expression.
- eNpHR3.0 For the inhibitory opsin, eNpHR3.0, we tested both the human synapsin (hSyn) promoter and also the CAMKII promoter for their capacities to interrupt ADs.
- hSyn human synapsin
- CAMKII CAMKII promoter
- hSyn-eNpHR3.0 was more effective at curtailing ADs than CAMKII-eNpHR3.0, therefore only the hSyn group data was analyzed, except for in Figure 1, where both groups were included as only ChR2 stimulations (without optogenetic inhibition) were examined. Both groups also received viruses encoding for ChR2 under the CAMKII promoter.
- a syringe pump (Micro 4, World Precision Instruments, FL) was used to ensure a constant rate (150 nl/min) of administration.
- MRI compatible carbon fiber optrodes constructed with 0.22 numerical aperture, 105 mm diameter step-index multimodal optical fiber (ThorLabs, Newton, NJ) as described previously (Duffy et al., 2015), were inserted so that the tip of the electrode and fiber resided just above the injection site. Before implantation, the optrodes were checked to ensure that the percentage of light transmission was greater than 70% and light transmission to the brain was estimated to be 70% of the input intensity. Two brass screws were inserted above the cerebellum to anchor the dental cement and to serve as ground and reference electrodes. Finally, the electrode wires were soldered to a DF13 connector (Hirose, Japan) and all components were secured to the skull using light-curable dental cement.
- Sustained release buprenorphine (1 mg/kg, s.c.) was given pre-operatively to alleviate pain and discomfort due to the procedure.
- Local administration of lidocaine (4%) and bupivacaine (0.25%) was also administered pre- and post-operatively. To allow time for viral-induced protein expression, experiments were performed at least 6 weeks following the surgical procedure.
- Multiunit recordings were performed using the OpenEphys system and a sharpened tungsten electrode (0.5 kOhm impedance, 120 mm diameter, AM systems) attached to a 105 mm diameter optical fiber.
- Anesthesia regimen for induction of seizure-like afterdischarges Rats were sedated using a bolus (0.05 mg/kg), followed by a continuous intravenous (i.v.) infusion (0.1 mg/kg/h) of dexmedetomidine via a 24-gauge catheter inserted into one of the lateral tail veins.
- i.v. intravenous infusion
- atipamazole (0.5 mg/kg, s.c.) was given to partially reverse the effects of dexmedetomidine.
- Induction of seizure-like afterdischarges For selectively stimulating ChR2 expressing cells to induce ADs, we used a 473 nm (blue light) diode-pumped solid-state laser (Laserglow Technologies, Toronto, Canada). A train of 200 pulses (7.5 ms in duration) with a frequency of 40 Hz was generated using a Master-9 (AMPI, Israel) pulse stimulator. The duration of the pulse train was 5 s.
- a 589 nm (orange light) diode-pumped solid-state laser (Laserglow Technologies, Toronto, Canada) was used.
- the orange light was delivered continuously for 5 s to the same location as the blue light (through the same optical fiber).
- the light was switched on and off using a mechanical shutter (Uniblitz, Vincent Associates, NY) triggered with the Master-9 to enable stable light intensity and precise timing.
- the orange light was applied immediately after the blue light was switched off. This condition was compared to a control condition in which no orange light was applied.
- a random permutation of the set containing 5 orange light stimulations and 5 control conditions was used to generate equal numbers of each condition within sessions.
- rats were sedated using a bolus (0.05 mg/kg, s.c.) of dexmedetomidine followed by a continuous infusion (0.1 mg/kg, i.v.) via a cannula inserted into a lateral tail vein.
- a single bolus of Feraheme (15 mg/kg, i.v.) was used for cerebral blood volume (CBV) weighted imaging for the enhanced contrast to noise ratio (Mandeville et al., 1998) and microvascular sensitivity (Zhao et al., 2006) that this technique offers in comparison to BOLD fMRI.
- CBV cerebral blood volume
- Ictal onset time was estimated during the ChR2 stimulation period by subtracting the averaged evoked potential to produce an estimate of the underlying stimulation independent LFP ( Figure 9). First, each 25 ms stimulation epoch was zero centered and an average evoked potential at each epoch was generated using the sliding-window mean evoked potential averaged over 8 consecutive epochs. This average evoked potential was subtracted from the initial mean centered data and this was used to detect underlying ictal activity using a simple thresholding approach.
- fMRI data analysis and statistics fMRI data was analyzed using SPM12. The data were first smoothed using a Gaussian kernel of 0.5 mm at full-width at half-maximum. This was followed by motion correction using a 6-parameter rigid registration.
- the images first underwent manual brain masking and then were aligned to a common space using a 12-parameter affine registration as implemented in the NiftyReg software package.
- This common template was segmented into regions of interest by registration to an atlas followed by manual correction.
- a general linear model (GLM) was used to generate activation maps. This entailed searching for optimal parameters for a custom gamma distribution function.
- the fMRI data used for estimating gamma parameters was collected from the same animals from the block- design trials. This custom gamma distribution was convolved with the stimulation period together with the afterdischarge period to model the activation across both periods as a single rectangle function.
- the high-pass cut-off value was set to 400 s, while serial correlations were modeled using an autoregressive AR(1) model and estimation was performed using the restricted maximum likelihood method.
- Single subject, single trial t-statistic activation maps were thresholded at a level of p ⁇ 0.001, uncorrected for multiple comparisons. For the fixed-effects group level analysis, a stricter threshold of p ⁇ 0.0001 (uncorrected for multiple comparisons) was applied.
- This threshold was chosen to allow time for optogenetic inhibition to take effect and because conditioning on ADs that exceeded the 5 s period of optogenetic inhibition, the AD duration was not significantly shorter for trials that included optogenetic inhibition, suggesting that inhibition had little effect if ADs were severe or progressed enough to exceed the period of optogenetic inhibition.
- the median AD duration without inhibition was 11 s, more than 4 3 greater than the duration threshold.
- Figure 1 which displays data from ChR2 stimulation only, the input matrix (X) included ictal onset time as the only explanatory variable.
- Figure 3 also included trials with optogenetic inhibition, therefore X was expanded to include activation of eNpHR3.0 as a binary variable.
- Weakly informative priors were used (Gelman etal., 2008) as these are typically preferred over non informative priors which can lead to improper posterior distributions .
- the No-U-Turn Sampler Adaptively Setting Path Lengths in Hamiltonian Monte Carlo. J. Mach. Learn. Res 15, 1593–1623.
- Exogenous contrast agent improves sensitivity of gradient-echo functional magnetic resonance imaging at 9.4 T.
- Nonlinear hemodynamic responses in human epilepsy a multimodal analysis with fNIRS-EEG and fMRIEEG. J. Neurosci. Methods 204, 326–340. [00223] Rungta, R.L., Osmanski, B.-F., Boido, D., Tanter, M., and Charpak, S. (2017). Light controls cerebral blood flow in naive animals. Nat. Commun.8, 14191. [00224] Salvatier, J., Wiecki, T.V., and Fonnesbeck, C. (2016). Probabilistic Programming in Python using PyMC. PeerJ Comput. Sci 2, e55.
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