Epilepsy and the Cortex Anatomy. In: Peters A, Jones EG, editors. Normal and Altered States of Function. Boston: Springer US; 1991. pp. 427-83. [DOI: 10.1007/978-1-4615-6622-9_10]

Ketamine prevents seizures and reverses changes in muscarinic receptor induced by bicuculline in rats

The cholinergic system has been implicated in several experimental epilepsy models. In a previous study bicuculline (BIC), known to antagonize GABA-A postsynaptic receptor subtype, was administered to rats at subconvulsant (1mg/kg) and convulsant (7.5mg/kg) doses and quinuclidinyl benzilate ([(3)H]-QNB) binding to CNS membranes was determined. It was observed that ligand binding to cerebellum increases while it decreases in the case of hippocampus. Saturation binding curves showed that changes were due to the modification of receptor affinity for the ligand without alteration of binding site number. The purpose of this study was to assay muscarinic receptors employing other BIC dose (5mg/kg), which induces seizures and allows the analysis of a postseizure stage as well. To study further muscarinic receptor involvement in BIC induced seizures, KET was also employed since it is a well known anticonvulsant in some experimental models. The administration of BIC at 5mg/kg to rats produced a similar pattern of changes in [(3)H]-QNB binding to those recorded with 1.0 and 7.5mg/kg doses. Here again, changes were observed in receptor binding affinity without alteration in binding site number for cerebellum or hippocampus membranes. Pretreatment with KET (40 mg/kg) prevented BIC seizures and reverted [(3)H]-QNB binding changes induced by BIC administration. The single administration of KET invariably resulted in [(3)H]-QNB binding decrease to either cerebellar or hippocampal membranes. KET added in vitro decreased ligand binding likewise. Results of combined treatment with KET plus BIC are hardly attributable to the single reversion of BIC effect since KET alone invariably decreased ligand binding. It is suggested that besides alteration of cholinergic muscarinic receptor other(s) neurotransmitter system(s) may well also be involved.

The integrated nature of motor cortical function

Recent studies on the functional organization and operational principles of motor cortical function, taken together, strongly support the notion that the motor cortex controls the muscle activities subserving movements in an integrated manner. For example, during pointing the shoulder, elbow and wrist muscles appear to be controlled as a coupled functional system, rather than individually and separately. The pattern of intrinsic connections between motor cortical points is likely part of the explanation of this operational principle. So too is the manner in which muscles and muscle synergies are represented in the motor cortex. However, selection of movement-related muscle synergies is likely a dynamic process involving the functional linking of a variety of motor cortical points, rather than the selection of fixed patterns embedded in the motor cortical circuitry. One of the mechanisms that may be involved in the functional linking of motor cortical points is disinhibition. Thus, motor cortical points are recruited into action by selected excitation as well as by selected release from inhibition. The incoordination of limb movements in patients after a stroke may be understood, at least in part, as a disruption of the connections between motor cortical points and of the neural mechanisms involved in their functional linking.

Microtubule-associated protein 2 phosphorylation is decreased in the human epileptic temporal lobe cortex

Microtubule-associated protein 2 (MAP2) is an abundant component of the neuronal cytoskeleton whose function is related to the outgrowth and stability of neuronal processes, to synaptic plasticity and neuronal cell death. We have sought to study whether abnormal patterns of neuronal activity which are characteristic of epileptic patients are associated to alterations of MAP2 phosphorylation. An antibody (305) that selectively recognizes a phosphorylated epitope in a proline-rich region of the MAP2 molecule has been used to analyze neocortical biopsy samples from temporal lobe epileptic patients, whose electrocorticogram activity had been previously monitored. Immunoblot analysis showed that samples with greater spiking activity displayed significantly diminished MAP2 phosphorylation. Immunocytochemical analysis revealed the occurrence of discrete areas in the neocortex with highly decreased or no immunostaining for antibody 305, which showed a clear, although non-significant, tendency to appear more frequently in areas with greater spiking activity. To further support an association between epileptiform activity and MAP2 dephosphorylation an experimental model of epileptiform activity in cultures of rat hippocampal neurons was used. Neurons were cultured during 15 days in the presence of kynurenic acid, an antagonist of glutamate receptors. At this time, kynurenic acid was removed from the culture medium and neurons developed seizure-like activity. Using antibody 305, we found a decrease of MAP2 phosphorylation that was already visible after 15 min of kynurenic acid withdrawal. We therefore propose that MAP2 phosphorylation is decreased in the neocortex of epileptic patients and that this decrease is a likely consequence of seizure activity. Also, MAP2 dephosphorylation may lead to alterations of the neuronal cytoskeleton and eventually to neuronal damage and loss, which is typical of epileptic patients.

Chandelier cells and epilepsy

The main goal of this article is to review certain aspects of the circuitry of the human cerebral cortex that may be particularly relevant for the development, maintenance or spread of seizures. There are a number of different structural abnormalities that are commonly found in the cortex of epileptic patients, but these abnormalities do not appear to be intrinsically epileptogenic, since some patients displaying them are epileptic (after variable delays) whereas others are not. Therefore, cortical circuits in an affected brain may undergo a series of changes that finally cause epilepsy. In this article, it is proposed that the chandelier cell, which is considered to be the most powerful cortical GABAergic inhibitory interneuron, is probably a key component of cortical circuits in the establishment of human intractable temporal lobe epilepsy. These cells (among other types) have been found to be lost or reduced at epileptic foci in both experimental animals and epileptic patients. A hypothesis is presented by which the normal variability in the number of interneurons might explain the predisposition of some individuals to develop epilepsy more than others as a result of a lesion or other precipitating factors that lead to loss of neurons. The sources of GABAergic input on dendrites and somata of cortical pyramidal cells originate from many and diverse types of interneurons but, at the level of the axon initial segment of these cells, all synapses come from a few chandelier cells (five or less). Loss of one class of interneurons ending on soma and dendrites might have relatively little impact on the inhibitory control of the pyramidal cell. However, if chandelier cells were affected, it would have serious consequences for the inhibitory control of the pyramidal cells. Evidence suggests that the loss of chandelier cells may be non-specific and that when this occurs epilepsy may develop. Therefore, these cells might represent a key component in the aetiology of human temporal lobe epilepsy.

Parvalbumin-immunoreactive cortical neurons in Creutzfeldt-Jakob disease

Massive abnormalities of parvalbumin-immunoreactive cortical neurons were observed in the cerebral biopsy samples of 3 patients with Creutzfeldt-Jakob disease. Immunoreactive cells had reduced and short, often fragmented, dendrites, and large numbers of dendritic varicosities were observed. Since parvalbumin-immunoreactive neurons are the most important inhibitory cells in the cerebral cortex, the damage to these neurons may account, in part, for the impaired cortical function, and may play a role in the appearance of myoclonus and electroencephalographic patterns in patients with Creutzfeldt-Jakob disease.