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Abstract
The noninvasive localization of the epileptogenic zone continues to be a challenge in many patients that present as candidates for possible epilepsy surgery. Magnetic resonance imaging (MRI) techniques provide accurate anatomical definition, but despite their high resolution, these techniques fail to visualize the pathological neocortical and hippocampal changes in a sizable number of patients with focal pathologies. Further, visualized lesions on MRI may not all produce seizures. One of the keys to the understanding of the epileptogenic zone lies in the recognition of the metabolic alterations that occur in the setting of epileptic seizures. Magnetic resonance spectroscopy (MRS) is a valuable tool that can be used to study the metabolic changes seen in both acute and chronic animal models of epilepsy. Such study allows for the identification of epileptic tissue with high sensitivity and specificity. We present here a review of the use of MRS in animal models of epilepsy.
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Affiliation(s)
- Girish K Hiremath
- Department of Neurosurgery, Cleveland Clinic Epilepsy Center, Neurological Institute, Cleveland, Ohio 44195, USA
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2
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Avery RA, Zubal IG, Stokking R, Studholme C, Corsi M, Seibyl JP, Spencer SS. Decreased cerebral blood flow during seizures with ictal SPECT injections. Epilepsy Res 2000; 40:53-61. [PMID: 10771258 DOI: 10.1016/s0920-1211(00)00109-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Increased regional cerebral blood flow (rCBF) at the epileptogenic site has been consistently reported for single photon emission computed tomography (SPECT) injections made during seizure activity, and the increased rCBF has been shown to remain elevated at the epileptogenic site in some cases, even when SPECT injections are made after seizure termination (postictal). A sustained increase in rCBF after seizure cessation was recently confirmed, but for no more than 100 s from seizure onset [Avery, R.A., Spencer, S.S., Spanaki, M.V., Corsi, M., Seibyl, J.P., Zubal, I.G., 1999. Effect of injection time on postictal SPET perfusion changes in medically refractory epilepsy. Eur. J. Nucl. Med. 26, 830-836]. In the current study, it is examined whether ictal SPECT injections demonstrate a similar change in rCBF around 100 s from seizure onset. Twenty-one patients with medically refractory epilepsy and a known area of seizure onset receiving ictal and interictal 99mTc-Hexamethyl-propyleneamineoxime (HMPAO) SPECT scans were studied. The results of SPECT subtraction analysis which visualize increased and decreased rCBF were compared to seizure duration and HMPAO injection time. Five patients received ictal SPECT injections (during ongoing seizure activity) more than 90 s after seizure onset and demonstrated decreased rCBF. Two of these patients also demonstrated areas of increased rCBF. Decreased rCBF was localized to the epileptogenic lobe in four of the five patients. By examining ictal SPECT injections made 90 s after seizure onset, evidence was found that reduced rCBF may exist during ictus. The change in rCBF around 90 s is also observed in postictal injections, suggesting a common metabolic mechanism may be responsible.
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Affiliation(s)
- R A Avery
- Departments of Diagnostic Radiology, Yale University School of Medicine, Box 208042, New Haven, CT, USA
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3
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Meir A, Ginsburg S, Butkevich A, Kachalsky SG, Kaiserman I, Ahdut R, Demirgoren S, Rahamimoff R. Ion channels in presynaptic nerve terminals and control of transmitter release. Physiol Rev 1999; 79:1019-88. [PMID: 10390521 DOI: 10.1152/physrev.1999.79.3.1019] [Citation(s) in RCA: 220] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The primary function of the presynaptic nerve terminal is to release transmitter quanta and thus activate the postsynaptic target cell. In almost every step leading to the release of transmitter quanta, there is a substantial involvement of ion channels. In this review, the multitude of ion channels in the presynaptic terminal are surveyed. There are at least 12 different major categories of ion channels representing several tens of different ion channel types; the number of different ion channel molecules at presynaptic nerve terminals is many hundreds. We describe the different ion channel molecules at the surface membrane and inside the nerve terminal in the context of their possible role in the process of transmitter release. Frequently, a number of different ion channel molecules, with the same basic function, are present at the same nerve terminal. This is especially evident in the cases of calcium channels and potassium channels. This abundance of ion channels allows for a physiological and pharmacological fine tuning of the process of transmitter release and thus of synaptic transmission.
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Affiliation(s)
- A Meir
- Department of Physiology and the Bernard Katz Minerva Centre for Cell Biophysics, Hebrew University Hadassah Medical School, Jerusalem, Israel
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4
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Abstract
Magnetic resonance spectroscopy (MRS) can be used for noninvasive measurement of more than two dozen small metabolites in the brains of living animals and humans. In the first decade of its use for study of seizure phenomena in animals, MRS successfully detected in vivo seizure-induced cerebral acidosis and reduction of phosphocreatine concentration, changes that had been described previously by techniques requiring destruction of tissue. Thus validated, MRS was used to reveal new aspects of epileptic pathophysiology in animals: (a) dissociation of brain lactate and pH during experimental status epilepticus of low and intermediate intensity, reflecting metabolic compartmentation; and (b) long persistence of metabolically active elevated brain lactate after brief cortical electroshock. The latter phenomenon may be an extreme form of a mechanism by which lactate production primes synaptic terminals for maximal sustained firing rates during normal brain activation. Diffusion-weighted imaging of rat brain has shown that status epilepticus apparently shortens the mean path length of water diffusion, a novel finding that provides new insight concerning the physical conditions under which the seizure-related chemical changes detected by MRS occur. MRS study of epileptic patients has been undertaken more recently as instruments large enough for observations on humans have become available. Acidosis, reduction of phosphocreatine, and elevation of lactate have all been demonstrated in the human brain during seizure discharge. Chronic reduction of N-acetylaspartate in limbic regions probably reflects neuronal loss and may correlate with mesial temporal sclerosis.
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Affiliation(s)
- J W Prichard
- Department of Neurology, Yale University, New Haven, Connecticut 06510
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5
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Abstract
Nuclear magnetic resonance (NMR) methods allow a wide variety of noninvasive measurements to be made on living animals and humans. The most extensively developed application of such methods is magnetic resonance imaging (MRI) of the brain and other organs, which has already come to the attention of most biomedical scholars, many physicians, and even much of the lay public because of its widespread use in neurological research and medical diagnosis.
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Affiliation(s)
- J W Prichard
- Department of Neurology, School of Medicine, Yale University, New Haven, Connecticut 06510
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Prichard J, Rothman D, Novotny E, Petroff O, Kuwabara T, Avison M, Howseman A, Hanstock C, Shulman R. Lactate rise detected by 1H NMR in human visual cortex during physiologic stimulation. Proc Natl Acad Sci U S A 1991; 88:5829-31. [PMID: 2062861 PMCID: PMC51971 DOI: 10.1073/pnas.88.13.5829] [Citation(s) in RCA: 413] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Brain lactate concentration is usually assumed to be stable except when pathologic conditions cause a mismatch between glycolysis and respiration. Using newly developed 1H NMR spectroscopic techniques that allow measurement of lactate in vivo, we detected lactate elevations of 0.3-0.9 mM in human visual cortex during physiologic photic stimulation. The maximum rise appeared in the first few minutes; thereafter lactate concentration declined while stimulation continued. The results are consistent with a transient excess of glycolysis over respiration in the visual cortex, occurring as a normal response to stimulation in the physiologic range.
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Affiliation(s)
- J Prichard
- Department of Neurology, Yale Medical School, New Haven, CT 06510
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7
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Boakye P, White EJ, Clark JB. Protection of ischaemic synaptosomes from calcium overload by addition of exogenous lactate. J Neurochem 1991; 57:88-94. [PMID: 2051174 DOI: 10.1111/j.1471-4159.1991.tb02103.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
In depolarised anoxic synaptosomes, in which lactate production was significantly raised compared with normoxic conditions, calcium uptake, net acetylcholine release, and the intrasynaptosomal calcium concentration were all significantly lowered. In contrast, lactate production in synaptosomes incubated under aglycaemic- and ischaemic-type conditions was significantly lower and basal calcium uptake, acetylcholine release, and intrasynaptosomal calcium concentration were elevated compared with normoxia. In addition, the increase in intrasynaptosomal calcium concentration under the ischaemic-type condition appeared to be greater than could be accounted for by the rise in calcium uptake alone. Intrasynaptosomal pH reflected the lactate production under each condition investigated. Addition of exogenous lactate to normoxic synaptosomes mimicked the effects observed in anoxia, suggesting that lactate itself may have blocked the calcium uptake, inhibiting the rise in intrasynaptosomal calcium and acetylcholine release occurring in depolarised anoxic synaptosomes. When lactate was added to ischaemic synaptosomes, the large rise in intrasynaptosomal calcium concentration, calcium uptake, and acetylcholine release were decreased, suggesting that lactate may have a protective role in preventing cell death by calcium overload under ischaemic-type conditions. Evidence is presented to suggest that the effect of L-lactate was due to the lactate moiety itself rather than the associated acidosis.
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Affiliation(s)
- P Boakye
- Department of Biochemistry, St. Bartholomew's Hospital Medical College, University of London, England
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White EJ, Clark JB. Involvement of lactic acidosis in anoxia-induced perturbations of synaptosomal function. J Neurochem 1990; 55:321-7. [PMID: 2355225 DOI: 10.1111/j.1471-4159.1990.tb08854.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
L-Lactate (4-32 mM) added exogenously to resting or depolarised rat forebrain synaptosomes led to a significant decrease in intrasynaptosomal pH. Similarly depolarisation-induced increases in intrasynaptosomal calcium, calcium uptake, and acetylcholine release were all inhibited. These effects mimicked those previously observed in synaptosomes under anoxic conditions and suggest that lactate may be involved in limiting the damage due to calcium accumulation occurring during ischaemia. D-Lactate (added exogenously up to 32 mM) did not produce similar effects on these parameters even though the concentrations of intrasynaptosomal D-lactate reached levels comparable to those obtained with L-lactate (at 8-16 mM exogenous concentration). The results suggest that the mechanism of action of lactate on these parameters is stereospecific for the L-enantiomer. The effect of glucose availability on lactate production was assessed to explore the role of substrate availability on ischaemia/anoxic events. When exogenous glucose was increased (10-60 mM), there was no further increase in lactate production in normoxic synaptosomes, which suggests that glucose is not limiting under these conditions. When glucose was removed, as may occur in complete ischaemia, there was a significant decrease in lactate production after 60 min under anoxic or normoxic conditions. It would seem likely therefore that the mechanism underlying the changes observed in synaptosomes incubated under conditions reflecting complete ischaemia does not involve lactate.
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Affiliation(s)
- E J White
- Department of Biochemistry, St. Bartholomew's Hospital Medical College, University of London, England
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Gibson GE, Manger T, Toral-Barza L, Freeman G. Cytosolic-free calcium and neurotransmitter release with decreased availability of glucose or oxygen. Neurochem Res 1989; 14:437-43. [PMID: 2568593 DOI: 10.1007/bf00964858] [Citation(s) in RCA: 44] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Exposing brain slices to reduced oxygen tensions or impairing their ability to utilize oxygen with KCN decreases acetylcholine (ACh) but increases dopamine (DA) and glutamate in the medium at the end of a release incubation. To determine if these changes are due to alterations in the presynaptic terminals, release from isolated nerve endings (i.e. synaptosomes) was determined during histotoxic hypoxia (KCN). KCN reduced potassium-stimulated synaptosomal ACh release and increased dopamine and glutamate release. Since several lines of evidence suggest that altered calcium homeostasis underlies these changes in release, the effects of reducing medium calcium concentrations from 2.3 to 0.1-mM were determined. In low calcium medium, KCN still increased dopamine and glutamate release, but had no effect on ACh release. Hypoxia increased cytosolic-free calcium in both the normal and low calcium medium, although the elevation was less in the low calcium medium. Thus, the effects of histotoxic hypoxia on cytosolic free calcium concentration paralleled those on glutamate and dopamine release. Reducing the glucose concentration of the medium also increased cytosolic-free calcium. The data are consistent with the hypothesis that hypoxia and hypoglycemia increase cytosolic-free calcium, which stimulates the release of dopamine and glutamate, whose excessive release may lead to subsequent cellular damage postsynaptically.
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Affiliation(s)
- G E Gibson
- Cornell University Medical College, Burke Rehabilitation Center, White Plains, New York 10605
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White EJ, Juchniewicz HJ, Clark JB. Effects of lactic acidosis on the function of cerebral cortical synaptosomes. J Neurochem 1989; 52:154-61. [PMID: 2908886 DOI: 10.1111/j.1471-4159.1989.tb10910.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Synaptosomes exposed to anoxic insult produce lactate at a slow rate (measured over 60 min). No measurable damaging effects were produced by prolonged depolarisation, anoxic insult, or exogenous lactate (2-32 mM) either on the synaptic plasma membrane (as judged by release of lactate dehydrogenase and soluble proteins), or on synaptosomal phospholipases (as judged by choline release from membrane phospholipids). Potassium-stimulated acetylcholine release was decreased by incubation in the presence of lactate (2-32 mM), as was potassium- and veratrine-stimulated calcium uptake and the calcium content of depolarised synaptosomes. The intrasynaptosomal pH was also reduced but there was no stimulation of oxygen radical production (as judged by H2O2 generation) by exogenous lactate. The role that lactic acidosis may play in giving rise to the altered calcium homeostasis and decreased acetylcholine release from synaptosomes exposed to anoxic insult is discussed.
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Affiliation(s)
- E J White
- Department of Biochemistry, St. Bartholomew's Hospital Medical College, University of London, England, U.K
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Busija DW, Wagerle LC, Pourcyrous M, Leffler CW. Acetylcholine dramatically increases prostanoid synthesis in piglet parietal cortex. Brain Res 1988; 439:122-6. [PMID: 3359178 DOI: 10.1016/0006-8993(88)91468-0] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
We investigated effects of exogenous acetylcholine on prostanoid synthesis by parietal cortex in neonatal pigs. Cerebrospinal fluid (CSF) with no drug, and CSF containing acetylcholine at 10(-6) to 10(-3) M was injected under a 'closed' cranial window, and after 5 min the CSF was collected and analyzed by radioimmunoassay for prostaglandin (PG) E2, PGF2 alpha, PGD2, 6-keto-PGF1 alpha (the hydrolysis product of prostacyclin), and thromboxane (TX) B2 (the hydrolysis product of TXA2). PGE2 and PGF2 alpha were the predominant prostanoids in CSF under control conditions. Levels of all CSF prostanoids increased after topical application of acetylcholine, with the largest increases being for PGE2 and PGF2 alpha. During control conditions, levels were 1294 +/- 170 (mean +/- S.E.M.) pg/ml for PGE2 (n = 16), 1032 +/- 143 pg/ml for PGF2 alpha (n = 3), 659 +/- 92 pg/ml for 6-keto-PGF1 alpha (n = 15), 141 +/- 44 pg/ml for TXB2 (n = 12), and were below detectable levels for PGD2. Following application of 10(-3) M acetylcholine, levels were 34,535 +/- 5438 pg/ml for PGE2, 15,539 +/- 2772 pg/ml for PGF2 alpha, 2967 +/- 547 pg/ml for 6-keto-PGF1 alpha, 580 +/- 105 pg/ml for TXB2, and 556 +/- 221 pg/ml for PGD2. These results suggest that prostanoids could play a role in mediating effects of acetylcholine in the brain, or in modulating acetylcholine release via a negative feedback mechanism.
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Affiliation(s)
- D W Busija
- Department of Physiology and Biophysics, University of Tennessee, Memphis 38163
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