We show in the present study in an optogenetic mouse model that blue light evoked early life pain (ELP) causes cortical hyperexcitability and reduced expression of synaptic genes suggesting refinement of synaptic connectivity [59, 60, 68]. Post-ELP in adult life manifested in nociceptive hypersensitivity and repetitive, compulsive behavior in the IntelliCage. Nociceptive hypersensitivity tended to normalize towards the end of the observation (one year) but DRG neurons of aged mice were still hypersensitive upon stimulation with capsaicin, and behavioral features were associated with low long-chain sphingomyelin species in brain and plasma pointing to abnormal activity of sphingomyelin metabolism which has be suggested a key mechanism in psychiatric disorders [38, 40, 41, 69, 70]. The data are a strong argument for measures against ELP.
It is of note that Avil-ChR2 mice were not impaired in daily mouse life. They behaved comparable to controls, in classical maze tests of anxiety, curiosity, spatial cognition, social cognition and memory. IntelliCage behavioral parameters of activity, circadian rhythms, social structure, and learning & memory were also equal to controls. Hence, differences between genotypes were more subtle. Avil-ChR2 mice showed a high rate of nosepokes per visit and high frequency of repetitive returns to the same corner irrespective of the success within this corner, plus compulsive licking behavior. One may interpret this behavior as compulsive repetitiveness i.e. insistence on sameness and cognitive inflexibility [71–73] considered as features of reward deficiency syndrome [74, 75]. One would expect difficulties in reversal learning [76–78], but accuracy in preference learning or reversal learning was not affected. We even noticed a paradoxical higher accuracy in the final reversal period likely reflecting strong spontaneous habits. IntelliCage designs strive to minimize biases of spontaneous preferences, but it cannot be completely avoided. In this final task, reward was assigned to one corner, which had been highly preferred during adaptation. This was true for all mice, but obviously Avil-ChR2 mice adhered more strongly.
An alternative explanation for outperformance of Avil-ChR2 is suggested by a study that revealed a paradoxical enhancement of reversal learning under mild stress [79], which would imply that ELP mice were under mild stress. In support of this hypothesis, adolescent to young adult mice had temporarily lower body weights as compared to controls, and aged Avil-ChR2 mice engaged less in rewarding voluntary running. The performance in motor function tests was normal. Therefore, low VWR indeed points to lower reward. ELP might have reduced suckling, so that weaning body weights were lower than of the controls but they caught up with the controls' body weights and were as healthy as the controls. During the IntelliCage experiments, body weights were equal in both groups, and we did not observe social structures suggestive of inferiority of Avil-ChR2 mice. Still, it is possible from a human perspective that ELP might cause persistent mild stress in adulthood.
Previous studies have employed repeated pin prick [18], skin incision [16, 19, 21, 80] or nerve injury [6] of neonatal mice or rats to assess the impact of ELP. The results mostly show that such neonatal injuries increase nociceptive sensitivity in adult life and cause a more serious course of a second injury in adult life [7, 20, 21]. The resulting neuroimmune activation [6, 7] and low endocannabinoid tone [5] may predispose to metabolic disease or reward deficiency syndromes [75]. In our optogenetic ELP model we did not observe an immune activation (RNAseq) but stimulated nociceptive withdrawal thresholds were lower than in controls, showing nociceptive sensitization. There was no evidence for spontaneous heat or cold intolerances as assessed with a TGR, in which mice can freely choose the preferred temperature zone [42, 81]. Avil-ChR2 mice were equal to controls in the TGR. Hence, the sensation of warmth and cold was not affected. In particular, the settings would have revealed cold intolerance [81, 82]. Importantly, normal TGR behavior shows that blue light evoked excitation of ChR2 in neonatal Avil-ChR2 mice did not damage sensory neurons or skin that would have manifested in some kind of sensory neuropathy and loss of thermal sensation [83]. The viability of primary DRG neurons as assessed as proportion of high K+ responsive neurons did not differ between genotypes. Instead, capsaicin evoked calcium influx was stronger in DRG neurons of Avil-ChR2 mice suggesting hypersensitivity of transient receptor potential TRPV1 channels, which is a biological correlate of heat pain [84, 85]. Calcium imaging results thus agree with the behavioral tests of nociception and reveal the peripheral nociceptive sensitization at a biological level.
Pain sensitization may arise in the periphery at the level of the primary sensory nerve or nerve terminal [86, 87] and/or may involve hyperexcitability of the central nociceptive system [88], referred to as "pain matrix" in functional magnet resonance imaging (fMRI) studies [89–91]. We used electrophysiological MEAchip recordings from cortical slice preparations to address the central sensitization evoked by ELP. These multi-electrode recordings were done after completion of blue light stimulation with a free interval of 3–4 days. Hence, the observed higher frequency of spontaneous action potentials suggests that ELP elicits cortical hyperactivity that outlasts sensory stimulations. Owing to our mouse model of Advillin-driven [30, 32] ChR2 expression primarily in IB4 positive nociceptors during the stimulation period, we assume that blue light penetrated the skin to activate sensory nerve terminals [29, 34] but did not directly activate cortical neurons, also prevented by the skull.
It has been shown previously that somatosensory touch or whisker evoked stimulation of the cortex in the early days of life leads to an increased rate of neuronal apoptosis by P7 hence matching the time of our transcriptomic and electrophysiology studies [9, 10, 92]. We did not observe differences between genotypes of active caspase 3 immunofluorescence or neurogenesis or activation of apoptosis associated genes, but RNAseq showed a reduced expression of synaptic genes in Avil-ChR2 mice including Grin2b, neurexins, piccolo and voltage gate calcium and sodium channel subunits. Transcriptomic changes would agree with fewer synaptic contacts possibly owing to a refinement of neuronal networks that were highly in use upon nociceptive stimulation [9]. In the context of early life injuries such as skin incision, such priming was shown to increase the response to injuries in later life [20, 21], a phenomenon that is believed to involve central sensitization and immune activation. It is important to note, that our mice had no skin or tissue injury, and transcriptomics reveal that blue light exposure did not elicit neuroinflammation that was described in neonatal injury models [6, 7].
We have shown previously using adult Avil-ChR2 mice that blue light evokes paw withdrawal and active avoidance in a chamber [29]. Hence, we assume that blue light elicits an unpleasant feeling interpreted as "pain". Originally, advillin expression was proposed to occur in all somatosensory neurons which was based on studies in embryonic mice [30, 31]. However, later, a very detailed analysis in postnatal mice revealed that advillin is enriched in IB4 positive non-peptidergic nociceptors in postnatal DRGs and not equally expressed in all DRG neurons [33]. Hence, blue light stimulation in our mice likely mostly activated non-peptidergic nociceptors which agrees with blue light avoidance in adult mice. Nevertheless, it cannot be excluded that blue light also activated some Merkel cells in the skin, which were shown to express advillin [33]. Merkel cells are mainly found in glabrous skin of the paws and involved in sense of pressure. Advillin expression also occurs in autonomous nerves and ganglia, but expression in the autonomous nervous system only emerges beyond P7, i.e. when the blue light stimulation was already finished. Hence, considering advillin expression after birth and the stimulation protocol in our study, we believe that blue light mildly activated non-peptidergic nociceptors and was unpleasant but not harmful. This notion is supported by the observed high spontaneous cortical firing activity that outlasted sensory stimulation, and is reminiscent of cortical hyperactivity after nerve injury [93], neuroinflammation [94] or traumatic injury [95, 96]. Different from early life stress models imposed by intermittent maternal deprivation [75, 97–99], perinatal immune activation [100, 101] or perinatal valproic acid treatment [72, 102, 103] our mice did not show behavior of autism like social deficits, depression or anxiety or features of schizophrenia or cognitive impairment. Indeed, Avil-ChR2 mice behaved astonishingly equal to controls in all standard maze tests showing that the blue light exposure was not harmful. Differences revealed only upon detailed analyses of IntelliCage behavior. Key parameters that were consistently altered in successive tasks were the frequency of rapid returns to the same corner, quantified as "repetitiveness", and the numbers and durations of lickings. In addition, Avil-ChR2 made more nosepokes per visit (NP-per Visit ratio) in some tasks. NP/visit ratios are normally high in young mice showing strong exploration and are low in mice with dementia-associated hyperactivity [55, 104]. Together with the repetitiveness and "over-licking", high NP/visit ratios of Avil-ChR2 mice suggest compulsive behavior and insistence on sameness rather than youthful exploration. From a human perspective, one is inclined to interpret the behavior of Avil-ChR2 as subtle but still important psychopathology which might be a consequence of persistent nociceptive hypersensitivity or develop independently in consequence of ELP.
At the biological level, psychopathology of ELP mice was associated with low brain and plasma levels of sphingomyelin species, pointing to alterations of sphingomyelin metabolism, that have been suggested to contribute to neuropsychiatric diseases, but mechanistically, the pathology is still poorly understood [41]. It has been shown that the activity of sphingomyelin degrading enzymes, neutral or acidic sphingomyelinase, is increased in psychiatric diseases including depression, anxiety and addiction [38, 40, 41, 69]. Some antidepressants work as functional inhibitors of acidic sphingomyelinase. It is therefore believed that raising SM is part of their mood stabilizing effects [70, 105]. Our results show low SM 38, 40 and 41 species in brain and plasma. The characterization of SM species is a recent advancement in lipidomic analyses and it is not known yet how specific SM species work in the context of psychic health. Based on previous reports and our results it is tempting to speculate that the late ELP-psychopathology of Avil-ChR2 mice is caused / contributed by changes of sphingomyelin homeostasis.