Adrenalin

The surgery was conducted as earlier described,²⁵ where two guides (stainless steel, length 10 mm, with an o.d./i.d. of 0.6/0.45 mm) targeting the NAc shell were implanted 2 days prior to the drug challenge. During surgery, the rats were kept on a heating pad to prevent hypothermia. The rats were anaesthetized with isoflurane (Isofluran Baxter, Kronans Apotek) and a local anaesthetic mixture [Xylocain (10 mg/ml) together with adrenalin (5 μg/ml), Astra Zeneca, Kronans Apotek] was applied on the skull surface. After incision, the skull bone was exposed, and three holes were drilled: two for the guides³⁵(Table S2) and one for the anchoring screw. The tips of the guides were inserted 1 mm below the skull bone. The guides were anchored to the screw and the skull bone with dental cement (DENTALON®plus; Agntho's AB, Lidingö, Sweden). Carprofen (5 mg/kg, SC, Rimadyl®; Zoetis, Kronans Apotek) was used to relieve pain following surgery.
At the experimental day, a dummy cannula was carefully inserted and retracted into the guide to remove clotted blood and hamper spreading depression within NAc shell. One hour later, a cannula delivered the drug into the NAc shell (Table S2), the drug was delivered over 1 min, and after an additional minute, the cannula was retracted.

The same anesthetic and surgical techniques were used for all patients using a predefined study protocol, as described earlier (14 (link)). Local anesthetic was administered (20 ml of Marcain^® and adrenalin 5 mg/ml, AstraZeneca, London, UK) in the dermis, subcutis and peritendinous space prior to surgery. The patients were subsequently placed in the prone position and a medial incision was made through the skin, fascia cruris and paratenon. From the ruptured area, the surgeon retrieved Achilles tendon biopsies. The tendon ends were sutured together using a modified Kessler suture with two 1–0 polydioxanone (Ethicon, Somerville, New Jersey, USA) sutures. The paratenon and fascia cruris were then closed with 3–0 Vicryl (Ethicon, Somerville, New Jersey, USA) and the skin was sutured with 3–0 Ethilon (Ethicon, Somerville, New Jersey, USA).