Therapeutic mechanism of subthalamic nucleus stimulation for refractory epilepsy involved in melanocortin-4 receptor signaling

Abstract

Despite there exist obvious metabolic changes within brain after subthalamic nucleus stimulation for refractory epilepsy, our understanding about the neuroanatomical and neurochemical mechanisms of subthalamic nucleus stimulation is still limited. Melanocortin receptor subtype 4 (MC4R) has been shown to mediate melanocortin effects on cerebral glucose metabolism, and, recently, to modulate astrocyte functions. This review described that subthalamic nucleus stimulation involved in the changes in regional cerebral glucose metabolism, and MC4R signaling in the brain. We discussed the possible therapeutic mechanism of subthalamic nucleus stimulation for refractory epilepsy. It is highlighted that improvement of epileptic signs associated with subthalamic nucleus stimulation might involve in melanocortin-4 receptor signaling on neurons and astrocytes, not only in the target, but also in surrounding and remote connecting regions.