The 6-hydroxydopamine (6-OHDA) model has been used for decades to advance the understanding of Parkinson’s Disease. In this protocol, we demonstrate how to perform unilateral nigrostriatal lesions in the rat by injecting 6-OHDA in the medial forebrain bundle, assess motor deficits, and predict lesions using the stepping test.
Motor symptoms of Parkinson’s disease (PD)-bradykinesia, akinesia, and tremor at rest-are consequences of the neurodegeneration of dopaminergic neurons in the substantia nigra pars compacta (SNc) and dopaminergic striatal deficit. Animal models have been widely used to simulate human pathology in the laboratory. Rodents are the most used animal models for PD due to their ease of handling and maintenance. Moreover, the anatomy and molecular, cellular, and pharmacological mechanisms of PD are similar in rodents and humans. The infusion of the neurotoxin, 6-hydroxydopamine (6-OHDA), into a medial forebrain bundle (MFB) of rats reproduces the severe destruction of dopaminergic neurons and simulates PD symptoms. This protocol demonstrates how to perform the unilateral microinjection of 6-OHDA in the MFB in a rat model of PD and shows the motor deficits induced by 6-OHDA and predicted dopaminergic lesions through the stepping test. The 6-OHDA causes significant impairment in the number of steps performed with the contralateral forelimb.
The main neuropathological characteristics of PD are the chronic progressive neurodegeneration of dopaminergic neurons in the substantia nigra pars compacta (SNc) and the presence of Lewy bodies containing α-synuclein protein1. As SNc dopaminergic neurons project their axons into the striatum through the nigrostriatal pathway, neurodegeneration of neurons in SNc results in a dopaminergic deficit in the striatum2. The absence of dopamine in the striatum causes an imbalance in the activities of the direct and indirect motor control pathways, which is responsible for the main motor symptoms of PD: akinesia (slow movement), bradykinesia (difficulty in starting movements), muscle stiffness, and tremor at rest3,4,5.
As the molecular and physiological mechanisms involved in the onset of PD are still not fully understood, currently available principal treatments seek to alleviate the motor symptoms through pharmacotherapies, deep brain stimulation6,7, genetic therapies8, and cell transplantation9. Therefore, preclinical research is fundamental to elucidate the mechanisms involved in the onset of PD and discover new methodologies for the early diagnosis and new therapies to prevent or stop the degeneration of neurons affected by PD10.
Animal models have been widely used to simulate human pathology in the laboratory, contributing to the advancement of medicine and science11,12,13,14. However, it is essential to emphasize that the correct choice of the animal model is fundamental for the success of the study. Therefore, the animal model must be validated in three main aspects: i) face validity, in which the animal model must have the characteristics of human pathology; ii) constructive validity, in which the animal model must have a solid theoretical basis; and iii) predictive validity, in which animal models must respond to treatments in a similar way to clinical treatment.
Currently, several animals are used as animal models for PD. The main groups include mammals, such as rodents, primates, minipigs, dogs, and cats, and other groups such as drosophila and zebrafish. Rodents are the most classic animal model for PD and the most used due to their ease of handling and maintenance. In addition, the anatomy and molecular, cellular, and pharmacological mechanisms of PD are similar in rodents and humans15.
A review published by Kin and colleagues in 2019 analyzed the principal animal model methodologies used for PD in the 2000s and found that the most used animal model involved neurotoxins such as 6-hydroxydopamine (6-OHDA) and 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP). Both neurotoxins cause mitochondrial dysregulation in dopaminergic neurons in the nigrostriatal pathway, leading to cell death16. Another widely used model involves genetic manipulation through mutation in specific genes involved in the onset of PD, causing mitochondrial dysregulation17. Neurotoxin models are commonly used to evaluate and compare therapeutics, whereas genetic models are used to study the development of preventive therapies and idiopathic PD15.
The neurotoxin MPTP was discovered to cause parkinsonism in the mid-1980s after seven patients used the substance and exhibited severe PD symptoms. In addition to the symptoms, the patients responded to treatment with L-DOPA, which made the researchers link the molecule directly to PD. After the case was published in 1986, several researchers began using MPTP in preclinical PD research18. Researchers have found that being a lipophilic molecule, MPTP can cross the blood-brain barrier (BBB) and be converted to MPP+19. This toxic substance accumulates inside neurons and causes damage to complex 1 of the mitochondrial respiratory chain, leading to the death of dopaminergic neurons20.
The 6-OHDA neurotoxin model was first used to induce the degeneration of monoamine neurons of the nigrostriatal pathway in 196821. The 6-OHDA model is commonly used to cause neurodegeneration in the nigrostriatal pathway as it is a dopamine analog and toxic for catecholamine-containing cells. After 6-OHDA enters the brain, it may be taken up by the dopamine transporter (DAT) in dopaminergic neurons, leading to degeneration of the nigrostriatal pathway22. Because 6-OHDA does not penetrate the BBB, it must be administered directly through intracerebral stereotaxic injection23. A noradrenaline reuptake inhibitor is often combined with 6-OHDA microinjection to preserve noradrenergic fibers and provide a more selective degeneration of dopaminergic neurons24.
After DAT takes up 6-OHDA, it will accumulate in the cytosol of neurons, producing reactive oxygen species (ROS) and leading to cell death15. Three different lesions models of 6-OHDA are frequently used: i) lesions to the SNc25,26; ii) lesions to the striatum27,28; iii) lesions to the MFB29,30. Lesions caused in the striatum result in a slow and retrograde degeneration of dopaminergic neurons in SNpc. In contrast, lesions caused in SNpc and MFB result in rapid and total degeneration of neurons, leading to more advanced parkinsonian symptoms31.
Unilateral or bilateral injection of 6-OHDA can cause neurodegeneration in dopaminergic neurons. 6-OHDA does not always cause severe damage to the neurons; sometimes, the injection results in partial damage, which is also used to simulate the early stages of PD32. The unilateral injection is more commonly used due to the model's ability to assess the animal's motor deficits and predict cell loss through tests such as amphetamine/apomorphine-induced rotation and the stepping test29. Bilateral injections are most used to evaluate spatial memory and recognition33.
The amphetamine/apomorphine-induced rotation test is a behavioral test commonly used to predict cell loss in the nigrostriatal pathway. It is defined as a process in which repeated administration of dopamine agonists leads to an intensification of rotational behavior in 6-OHDA-lesioned animals34. Rotational behavior consists of quantifying amphetamine-induced ipsilateral rotation or apomorphine-induced contralateral turns in unilaterally lesioned rodents. Drug-induced rotational behavior has been criticized because rotation does not correspond to PD symptoms in humans and can be affected by variables such as tolerance, sensitization, and "priming"35.
Priming is one of the most critical factors in these behavioral tests. Some cases have been reported wherein a single dose of L-DOPA led to a failure in rotational behaviors36. Additionally, another critical factor related to the combined application of the amphetamine-induced test and apomorphine-induced test for parallel use is that they measure different endpoints because of different mechanisms of action, reflecting the inactivation of different signaling mechanisms and pathways. Furthermore, the amphetamine-induced test is more accurate to measure nigrostriatal lesions above 50-60%, whereas the apomorphine-induced test is more accurate for lesions above 80%37.
The stepping test has emerged as a behavioral test that indicates deficits related to dopaminergic neuron degeneration and therapeutic effects. It enables the analysis of akinesia caused by a 6-OHDA lesion in dopaminergic neurons without a drug-induced procedure. Furthermore, the test has been well established and commonly used since 1995, when it was first described by Olsson et al.35. In 1999, Chang et al.38 also analyzed and compared the performance of rats in the stepping test with the level of degeneration caused by 6-OHDA and found that animals that performed worse in the stepping test also had a more significant degeneration of dopaminergic neurons.
The stepping test is an excellent method to predict severe dopaminergic nigrostriatal damage in 6-OHDA-lesioned rats. Evidence suggests that motor deficits appear in the contralateral forelimb of the 6-OHDA infusion during the stepping test when the degree of dopaminergic loss in SNc is >90%39. This paper describes the protocols, methodologies, and materials used to perform stereotaxic surgery for the unilateral infusion of 6-OHDA into the MFB of rats and how to predict the dopaminergic lesions caused by the toxin through the stepping test.
All procedures involving animals followed the ethical principles of the National Council for the Control of Animal Experimentation (CONCEA) and the Arouca Law (Law 11.794/2008) and were approved by the local ethics committee (CEUA-FFCLRP/USP (18.5.35.59.5).
1. Preparation of drugs
2. Preparation of materials
NOTE: Always follow instructions provided with the material safety data sheet when handling chemicals.
3. Surgical procedure
NOTE: In this protocol, adult male Sprague-Dawley rats (200-250 g) were kept under controlled conditions of temperature (22 ± 2 °C), air exchange (15-20 exchanges/hour), and light-dark cycles (12 h/12 h), grouped in boxes with 3 or 4 animals, with free access to food and water.
4. Postoperative procedures
5. Stepping test
Dopaminergic lesion assessment
The stepping test enables the assessment of the akinesia of the anterior limb contralateral to the lesion and the selection of animals with a possible lesion of the nigrostriatal pathway induced by 6-OHDA infusion (Figure 1). The comparison of the performance of the contralateral forelimb stepping test presurgery and 2 weeks and 4 weeks after surgery revealed interaction (F2,74 = 93.63; p < 0.0001; two-way repeated-measures ANOVA) between time (pre, 2, and 4 weeks after surgery) and treatment (sham-operated and 6-OHDA-lesioned). Bonferroni's post-hoc test showed a significant decrease in the number of steps contralateral to the lesion in animals receiving 6-OHDA in the right MFB compared to the sham-operated animals at the second and fourth week after surgery (p < 0.0001) (Figure 1). The results were consistent with those of previous studies35.
It is important to note that when the dopaminergic lesion is not complete, the results of the stepping test will not reach the degree of success of the results presented in this study. A previously published study performed the stepping test and immunohistochemistry of tyrosine hydroxylase (TH) with animals with a partial dopaminergic lesion after performing surgery for microinjection of 6-OHDA following the same protocol used in this study. Their finding of a partial deficit in the stepping test (4-8 steps) is the result of a partial dopaminergic lesion of ~60% of the neurons39.
Figure 1: Assessment of contralateral stepping test pre- and postsurgery for unilateral infusion of 6-OHDA or vehicle into the right MFB. Data show that animals receiving 6-OHDA had a significant decrease in the number of steps with the anterior forelimb contralateral to the lesion at the second and fourth weeks after surgery (****p < 0.0001 vs. sham postsurgery; two-way repeated-measures ANOVA, Bonferroni post-hoc). Data expressed as mean ± standard error of the mean. Vehicle is 0.9% saline solution containing 0.1% ascorbic acid. Results are based on 14 animals in the sham group and 25 animals in the 6-OHDA group. Abbreviations: P = presurgery. 2 = two weeks after surgery. 4 = four weeks after surgery; 6-OHDA = 6-hydroxydopamine; MFB = medial forebrain bundle. Please click here to view a larger version of this figure.
The comparison of the performance of the ipsilateral forelimb stepping test presurgery and 2 weeks and 4 weeks after surgery did not reveal any interaction (F2,74 = 0.4492; p = 0.6399; two-way repeated-measures ANOVA) between time (pre, 2, and 4 weeks after surgery) and treatment (sham-operated and 6-OHDA-lesioned). Bonferroni's post-hoc test did not show any significant difference in the number of steps ipsilateral to the lesion in animals receiving 6-OHDA in the right MFB compared to sham animals (Figure 2).
Figure 2: Assessment of ipsilateral stepping test pre- and postsurgery for unilateral infusion of 6-OHDA or vehicle into the right MFB. Data show that animals receiving 6-OHDA did not significantly decrease the number of steps with the anterior forelimb ipsilateral to the lesion at the second and fourth weeks after surgery (p > 0.05 vs. sham postsurgery; two-way repeated-measures ANOVA, Bonferroni post-hoc). Data expressed as mean ± standard error of the mean. Vehicle is 0.9% saline solution containing 0.1% ascorbic acid. Results are based on 14 animals in the sham group and 25 animals in the 6-OHDA group. Abbreviations: P = presurgery. 2 = two weeks after surgery. 4 = four weeks after surgery; 6-OHDA = 6-hydroxydopamine; MFB = medial forebrain bundle. Please click here to view a larger version of this figure.
Consistent with previous studies on 6-OHDA-lesioned animals42, histological analysis (Figure 3) comparing TH of the striatum of both hemispheres allows a reliable assessment of the DA deficit in the striatum. Therefore, this behavioral protocol can be used in combination with immunohistochemical methods in studies involving experimental models of PD.
Figure 3: Representative images of TH labeling in the 6-OHDA experimental model of PD, including anterior striatum and substantia nigra compacta. The panoramic image demonstrates the extension of the lesion, and inset zooms depict innervation e cell bodies immunostained. (A) Image of the striatal coronal section showing a partial injury induced by 6-OHDA in the right hemisphere. (B) Image of substantia nigra and ventral tegmental area coronal section from the same animal also showing the lesion extension. (C) Image of the striatal coronal section showing a complete induced injury by 6-OHDA in the right hemisphere. (D) Image of substantia nigra and ventral tegmental area coronal section from the same animal also showing the lesion extension. Scale bar = 1.3 mm in panoramic view and 65 µm in inset zooms. Abbreviations: 6-OHDA = 6-hydroxydopamine; TH = tyrosine hydroxylase; PD = Parkinson's disease; NL = non-lesioned; L = lesioned. Please click here to view a larger version of this figure.
This paper describes a protocol for performing surgery for unilateral microinfusion of 6-OHDA in the MFB, capable of causing robust lesions in the neurons of the nigrostriatal pathway and generating akinesia in the animal. Also described is the protocol for performing the stepping test, an easily applicable and noninvasive test that can be used to prove the success of the lesions and assess forelimb akinesia. As presented in the representative results, animals receiving 6-OHDA showed a reduction in the number of adjusting steps contralateral to injury, which means that 6-OHDA-injured animals exhibit strong akinesia from 2 weeks after infusion surgery. Akinesia-the focus of several treatments for the disease-is one of the main motor symptoms of PD. The development of akinesia in an animal model is significant for preclinical studies of PD. Moreover, these results resemble those reported by Chang et al.37, who confirmed that animals presenting a lower number of steps had a higher percentage of dopaminergic neuron death by immunohistochemistry. Therefore, animals that presented a lower number of contralateral adjusting steps are more likely to have a dopaminergic injury.
Assessment of the success of the surgery and the lesions can also be confirmed by other behavioral tests such as amphetamine/apomorphine-induced rotation43, elevated body swing test (EBST), corridor test, cylinder test, tissue labeling techniques such as TH immunohistochemistry, or even quantification of dopamine in the striatum by HPLC42. Other methodologies differ in the injected dose of 6-OHDA and postsurgery time interval for behavioral assessment. A recent review43 summarizes the most recent articles using this methodology and the difference in dose, behavioral testing, and postsurgery interval between them. The model of PD induced by 6-OHDA does not mimic all the pathological processes related to the disease, such as the accumulation of Lewy bodies, but simulates the death of dopaminergic neurons of the striatal-nigral pathway. This enables the study of new therapies for the symptoms of the disease, which could lead to an improvement in the quality of life of patients affected by this disease.
Despite being the most widely used model, the 6-OHDA model has its limitations like all current PD models. The model has the disadvantage of not fully representing the molecular mechanisms involved in the pathology of the disease, such as the accumulation of alfa-synuclein proteins and the formation of Lewy bodies. The model simulates the death of dopaminergic neurons of the nigrostriatal pathway, corresponding to a late stage of the disease and leading to the onset of motor symptoms only. This makes it unsuitable for studying its natural development15,32. The 6-OHDA model described in this article is usually characterized by low mortality rates. Postsurgery recovery is crucial to prevent high mortality rates due to the union of an invasive procedure and the neurodegenerative lesion44. It is possible to reduce mortality by taking extra care during the postsurgery recovery period with nutritional supplementation, rehydration, and external temperature control45. The combination of such measures has been shown to reduce or even eliminate the mortality rate drastically30,46. A common cause of death is the insertion of the needle at the wrong coordinate in the brain. It is crucial to carefully check the coordinates during this delicate surgical procedure. This will avoid damage to other brain structures (e.g., the hypothalamus) by the needle, which can impair the animal's eating and drinking actions, leading to malnutrition and dehydration47.
Finally, it is essential to highlight that although the ketamine-xylazine anesthesia protocol is well established and used in rodent experiments48, some evidence suggests that the combination of these anesthetics may be insufficient for an extended period of surgery. Additionally, ketamine-xylazine sensitivity might vary according to different strains of mice and rats49,50. An alternative may be to induce anesthesia by isoflurane inhalation. One study demonstrated faster loss of the righting reflex with isoflurane-induced anesthesia than with ketamine-xylazine. Moreover, 60% of the rats anesthetized with ketamine-xylazine presented consecutive toe pinch reflexes during the surgical procedure, even with dose supplementation. In contrast, animals anesthetized with isoflurane presented isolated cases of tail pinch reflexes that disappeared after volume adjustment51.
The authors have nothing to disclose.
This work was supported by São Paulo Research Foundation (FAPESP, grant 2017/00003-0). We are grateful for the Coordination for the Improvement of Higher Education Personnel (CAPES). We thank Dr. Anthony R. West, Dr. Heinz Steiner, and Dr. Kuei Y. Tseng for support and mentoring.
6-OHDA | Sigma Aldrich | H4381 | https://www.sigmaaldrich.com/catalog/product/sigma/h4381?lang=pt®ion=BR&cm_sp=Insite-_-caSrpResults_srpRecs_srpModel _6-ohda-_-srpRecs3-1 |
70% Alcohol | |||
Ascorbic acid | Sigma Aldrich | 795437 | https://www.sigmaaldrich.com/catalog/product/sial/795437?lang=pt®ion=BR&gclid= Cj0KCQjw4cOEBhDMARIsAA3XD RipyOnxOxkKAm3J1PxvIsvw09 _kfaS2jYcD9E5OyuHYr4n89kO 6yicaAot6EALw_wcB |
Cotton | |||
Drill or tap | |||
Gauze | |||
Hamilton syringe 50 uL | Hamilton | 80539 | https://www.hamiltoncompany.com/laboratory-products/syringes/80539 |
Imipramine | Alfa Aeser | J63723 | https://www.alfa.com/pt/catalog/J63723/ |
Infusion pump | Insight | EFF-311 | https://insightltda.com.br/produto/eff-311-bomba-de-infusao-2-seringas/ |
Ketamine (Dopalen) | Ceva | https://www.ceva.com.br/Produtos/Lista-de-Produtos/DOPALEN | |
Machine for trichotomy | |||
Meloxicam (Maxicam 2% Ourofino) | Ourofino | https://terrazoo.com.br/produto/maxicam-injetavel-2-50ml-ouro-fino/ | |
Metal Disposal | |||
Paper towels | |||
Pentabiotic | Zoetis | https://www.zoetis.com.br/pentabiotico-veterinario.aspx | |
Plastic waste garbage can | |||
Poly-antibiotic | Pentabiotic (Wealth) | ||
Povidone-iodine | |||
Scalpel and blades | |||
Scissors | |||
Scraper | |||
Stereotaxic apparatus | Insight | EFF-331 | https://insightltda.com.br/produto/eff-331-estereotaxico-1-torre/ |
Sterile saline solution | |||
Swabs | |||
Temperature probe | |||
Timer | |||
Tweezers | |||
Xylazine (Anasedan) | Ceva | https://www.ceva.com.br/Produtos/Lista-de-Produtos/ANASEDAN |