Hippocampal interictal spikes induced by kindling: relations to behavior and EEG

Spatiotemporal dynamics between interictal epileptiform discharges and ripples during associative memory processing

We describe the spatiotemporal course of cortical high-gamma activity, hippocampal ripple activity and interictal epileptiform discharges during an associative memory task in 15 epilepsy patients undergoing invasive EEG. Successful encoding trials manifested significantly greater high-gamma activity in hippocampus and frontal regions. Successful cued recall trials manifested sustained high-gamma activity in hippocampus compared to failed responses. Hippocampal ripple rates were greater during successful encoding and retrieval trials. Interictal epileptiform discharges during encoding were associated with 15% decreased odds of remembering in hippocampus (95% confidence interval 6-23%). Hippocampal interictal epileptiform discharges during retrieval predicted 25% decreased odds of remembering (15-33%). Odds of remembering were reduced by 25-52% if interictal epileptiform discharges occurred during the 500-2000 ms window of encoding or by 41% during retrieval. During encoding and retrieval, hippocampal interictal epileptiform discharges were followed by a transient decrease in ripple rate. We hypothesize that interictal epileptiform discharges impair associative memory in a regionally and temporally specific manner by decreasing physiological hippocampal ripples necessary for effective encoding and recall. Because dynamic memory impairment arises from pathological interictal epileptiform discharge events competing with physiological ripples, interictal epileptiform discharges represent a promising therapeutic target for memory remediation in patients with epilepsy.

Interictal epileptiform discharges impair word recall in multiple brain areas

OBJECTIVES

Interictal epileptiform discharges (IEDs) have been linked to memory impairment, but the spatial and temporal dynamics of this relationship remain elusive. In the present study, we aim to systematically characterize the brain areas and times at which IEDs affect memory.

METHODS

Eighty epilepsy patients participated in a delayed free recall task while undergoing intracranial electroencephalography (EEG) monitoring. We analyzed the locations and timing of IEDs relative to the behavioral data in order to measure their effects on memory.

RESULTS

Overall IED rates did not correlate with task performance across subjects (r = 0.03, p = 0.8). However, at a finer temporal scale, within-subject memory was negatively affected by IEDs during the encoding and recall periods of the task but not during the rest and distractor periods (p < 0.01, p < 0.001, p = 0.3, and p = 0.8, respectively). The effects of IEDs during encoding and recall were stronger in the left hemisphere than in the right (p < 0.05). Of six brain areas analyzed, IEDs in the inferior-temporal, medial-temporal, and parietal areas significantly affected memory (false discovery rate < 0.05).

SIGNIFICANCE

These findings reveal a network of brain areas sensitive to IEDs with key nodes in temporal as well as parietal lobes. They also demonstrate the time-dependent effects of IEDs in this network on memory.

Regulating hippocampal hyperexcitability through GABAB Receptors

Disturbances of GABAergic inhibition are a major cause of epileptic seizures. GABA exerts its actions via ionotropic GABAA receptors and metabotropic G protein‐coupled GABAB receptors. Malfunction of GABAA inhibition has long been recognized in seizure genesis but the role of GABAB receptors in controlling seizure activity is still not well understood. Here, we examined the anticonvulsive, or inhibitory effects, of GABAB receptors in a mouse model of hippocampal kindling as well as mouse hippocampal slices through the use of GS 39783, a positive allosteric GABAB receptor modulator, and CGP 55845, a selective GABAB receptor antagonist. When administered via intraperitoneal injections in kindled mice, GS 39783 (5 mg/kg) did not attenuate hippocampal EEG discharges, but did reduce aberrant hippocampal spikes, whereas CGP 55845 (10 mg/kg) prolonged hippocampal discharges and increased spike incidences. When examined in hippocampal slices, neither GS 39783 at 5 μmol/L nor the GABAB receptor agonist baclofen at 0.1 μmol/L alone significantly altered repetitive excitatory field potentials, but GS 39783 and baclofen together reversibly abolished these field potentials. In contrast, CGP 55845 at 1 μmol/L facilitated induction and incidence of these field potentials. In addition, CGP 55845 attenuated the paired pulse depression of CA3 population spikes and increased the frequency of EPSCs in individual CA3 pyramidal neurons. Collectively, these data suggest that GABABB receptors regulate hippocampal hyperexcitability by inhibiting CA3 glutamatergic synapses. We postulate that positive allosteric modulation of GABAB receptors may be effective in reducing seizure‐related hyperexcitability.

GABAB positive modulator GS 39783 attenuated, whereas GABAB antagonist CGP55845 facilitated hippocampal EEG spikes in kindled mice and excitatory field potentials in hippocampal slices. We postulate that GABAB receptors may inhibit CA3 glutamate synapses and hence regulate hippocampal hyperexcitability.

A reliable method for intracranial electrode implantation and chronic electrical stimulation in the mouse brain

BACKGROUND

Electrical stimulation of brain structures has been widely used in rodent models for kindling or modeling deep brain stimulation used clinically. This requires surgical implantation of intracranial electrodes and subsequent chronic stimulation in individual animals for several weeks. Anchoring screws and dental acrylic have long been used to secure implanted intracranial electrodes in rats. However, such an approach is limited when carried out in mouse models as the thin mouse skull may not be strong enough to accommodate the anchoring screws. We describe here a screw-free, glue-based method for implanting bipolar stimulating electrodes in the mouse brain and validate this method in a mouse model of hippocampal electrical kindling.

METHODS

Male C57 black mice (initial ages of 6-8 months) were used in the present experiments. Bipolar electrodes were implanted bilaterally in the hippocampal CA3 area for electrical stimulation and electroencephalographic recordings. The electrodes were secured onto the skull via glue and dental acrylic but without anchoring screws. A daily stimulation protocol was used to induce electrographic discharges and motor seizures. The locations of implanted electrodes were verified by hippocampal electrographic activities and later histological assessments.

RESULTS

Using the glue-based implantation method, we implanted bilateral bipolar electrodes in 25 mice. Electrographic discharges and motor seizures were successfully induced via hippocampal electrical kindling. Importantly, no animal encountered infection in the implanted area or a loss of implanted electrodes after 4-6 months of repetitive stimulation/recording.

CONCLUSION

We suggest that the glue-based, screw-free method is reliable for chronic brain stimulation and high-quality electroencephalographic recordings in mice. The technical aspects described this study may help future studies in mouse models.

Phase shift in the 24-hour rhythm of hippocampal EEG spiking activity in a rat model of temporal lobe epilepsy

For over a century epileptic seizures have been known to cluster at specific times of the day. Recent studies have suggested that the circadian regulatory system may become permanently altered in epilepsy, but little is known about how this affects neural activity and the daily pattern of seizures. To investigate, we tracked long-term changes in the rate of spontaneous hippocampal EEG spikes (SPKs) in a rat model of temporal lobe epilepsy. In healthy animals, SPKs oscillated with near 24-h period; however, after injury by status epilepticus, a persistent phase shift of ∼12 h emerged in animals that later went on to develop chronic spontaneous seizures. Additional measurements showed that global 24-h rhythms, including core body temperature and theta state transitions, did not phase shift. Instead, we hypothesized that locally impaired circadian input to the hippocampus might be responsible for the SPK phase shift. This was investigated with a biophysical computer model in which we showed that subtle changes in the relative strengths of circadian input could produce a phase shift in hippocampal neural activity. MRI provided evidence that the medial septum, a putative circadian relay center for the hippocampus, exhibits signs of damage and therefore could contribute to local circadian impairment. Our results suggest that balanced circadian input is critical to maintaining natural circadian phase in the hippocampus and that damage to circadian relay centers, such as the medial septum, may disrupt this balance. We conclude by discussing how abnormal circadian regulation may contribute to the daily rhythms of epileptic seizures and related cognitive dysfunction.

Hippocampal interictal spikes disrupt cognition in rats

OBJECTIVE

Cognitive impairment is common in epilepsy, particularly in memory function. Interictal spikes (IISs) are thought to disrupt cognition, but it is difficult to delineate their contribution from general impairments in memory produced by etiology and seizures. We investigated the transient impact of focal IISs on the hippocampus, a structure crucial for learning and memory and yet highly prone to IISs in temporal lobe epilepsy (TLE).

METHODS

Bilateral hippocampal depth electrodes were implanted into 14 Sprague-Dawley rats, followed by intrahippocampal pilocarpine or saline infusion unilaterally. Rats that developed chronic spikes were trained in a hippocampal-dependent operant behavior task, delayed-match-to-sample. Depth-electroencephalogram (EEG) was recorded during 5,562 trials among five rats, and within-subject analyses evaluated the impact of hippocampal spikes on short-term memory operations.

RESULTS

Hippocampal spikes that occurred during memory retrieval strongly impaired performance (p < 0.001). However, spikes that occurred during memory encoding or memory maintenance did not affect performance in those trials. Hippocampal spikes also affected response latency, adding approximately 0.48 seconds to the time taken to respond (p < 0.001).

INTERPRETATION

We found that focal IIS-related interference in cognition extends to structures in the limbic system, which required intrahippocampal recordings. Hippocampal spikes seem most harmful if they occur when hippocampal function is critical, extending human studies showing that cortical spikes are most disruptive during active cortical functioning. The cumulative effects of spikes could therefore impact general cognitive functioning. These results strengthen the argument that suppression of IISs may improve memory and cognitive performance in patients with epilepsy.

Effects of repeated seizure induction on seizure activity, post-ictal and interictal behavior

Individual variability and numerous interactions between pharmacokinetics, pharmacodynamics, and homeostatic factors complicate the study of the anticonvulsant effect in animal models of seizure activity. In theory, both individual variability and the contribution of these factors to the anticonvulsant effect can be determined by following the time course of the pharmacological response and the corresponding plasma concentrations in individual animals. Currently, there are several formal pharmacokinetic-pharmacodynamic models available for the analysis of such data, which yield accurate estimates of drug intrinsic activity and potency. However, most models of seizure activity are not suited for such an approach, either because they can be applied only once, or because the expression of seizures is not constant over time. In addition, the induction of seizures constitutes repeated jeopardy to the animals, which may profoundly change behavior and interfere in the anticonvulsant response as well as in different physiological processes. In this paper, we compare ictal, post-ictal, and interictal behavior in three different models of seizure activity in rats, namely, the electroconvulsive shock, amygdala kindling and the cortical stimulation model (CSM). The methods were compared in the same way as they are currently in use for the assessment of antiepileptic drug effect. Our results show that repeated seizure activity induced by cortical stimulation does not exacerbate ictal activity (eye closure, jerk, gasp, forelimb clonus, and hind-limb tonus) nor post-ictal behavior (chewing and freezing), while producing less serious changes in interictal behavior (walk, lean, upright rearing, exploratory, grooming, and rest) than kindling or electroconvulsive shock. We conclude that seizures induced by cortical stimulation are reproducible and qualitatively similar to kindling seizures. Our results also suggest that the electroconvulsive shock model is not suited for pharmacokinetic-pharmacodynamic studies and that the assessment of interictal behavior may contribute to the evaluation of overall antiepileptic drug effect in seizure disorders.

NMDA receptor activation during status epilepticus is required for the development of epilepsy

NMDA receptor activation has been implicated in modulating seizure activity; however, its complete role in the development of epilepsy is unknown. The pilocarpine model of limbic epilepsy involves inducing status epilepticus (SE) with the subsequent development of spontaneous recurrent seizures (SRSs) and is widely accepted as a model of limbic epilepsy in humans. The pilocarpine model of epilepsy provides a tool for looking at the molecular signals triggered by SE that are responsible for the development of epilepsy. In this study, we wanted to examine the role of NMDA receptor activation on the development of epilepsy using the pilocarpine model. Pretreatment with the NMDA receptor antagonist MK-801 does not block the onset of SE in the pilocarpine model. Thus, we could compare animals that experience similar lengths of SE in the presence or absence of NMDA receptor activation. Animals treated with MK-801 (4 mg/kg) 20 min prior to pilocarpine (350 mg/kg) (MK-Pilo) were compared to the pilocarpine treated epileptic animals 3-8 weeks after the initial episode of SE. The pilocarpine-treated animals displayed both ictal activity and interictal spikes on EEG analysis, whereas MK-801-pilocarpine and control animals only exhibited normal background EEG patterns. In addition, MK-801-pilocarpine animals did not exhibit any SRSs, while pilocarpine-treated animals exhibited 4.8 +/- 1 seizures per 40 h. MK-801-pilocarpine animals did not demonstrate any decrease in pyramidal cell number in the CA1 subfield of the hippocampus, while pilocarpine animals averaged 15% decrease in cell number. In summary, the MK-801-pilocarpine animals exhibited a number of characteristics similar to control animals and were statistically significantly different from pilocarpine-treated animals. Thus, NMDA receptor inhibition by MK-801 prevented the development of epilepsy and interictal activity following SE. These results indicate that NMDA receptor activation is required for epileptogenesis following SE in this model of limbic epilepsy.

Properties of interictal discharges induced by hippocampal kindling

The present experiment was designed to reveal the characteristics of interictal discharges (IIDs) induced by kindling of the rabbit hippocampus. Out of 21 animals, 13 developed stage 5 convulsions with a mean of 18 stimulations (Kindled (K) group), whereas the remaining eight animals did not (incomplete kindling (IK) group). A correlation between the duration of the afterdischarge and the behavioral stages was found in the K group. However, changes in frequency of total IIDs during kindling did not differ between the two groups. In the acute experiments performed after kindling, IIDs were classified into two types: simple and complex IIDs. The former was further classified into two subtypes (A and B) according to the laminar profile in the CA1 region. The A type of simple IIDs showed a negative polarity in the apical dendritic layer, while the B type showed a negative polarity in the basal dendritic layer. Complex IIDs basically consisted of two to three simple IIDs and were often followed by large irregular activity. Retrospective analysis was done, based on the classification of IIDs in the acute experiments (n = 12). Consequently, in the K group (n = 7), the frequency of complex IIDs rather than that of simple ones was closely related to the enhancement of behavioral responses during kindling. On the other hand, in the IK group (n = 5), simple IIDs occurred at a higher frequency, and did not parallel the changes in seizure behavior. It is concluded that complex IIDs play an important role in the propagation as well as the evolution of kindling effects.

Bilateral hippocampal interictal spiking and kindling expression in rabbits

The temporal/spatial dissemination of interictal spikes among different brain structures was studied during the course of kindling to determine if the long-term dissemination pattern reflects the rate and expression of kindling. The experiments were conducted on adult rabbits with chronically implanted electrodes (dorsal hippocampus, amygdala, caudate, all bilateral, sensory motor and occipital cortices). Rabbits (n = 13) were subjected to once daily electrical stimulation in the left hippocampus. Kindling resulted in the development of two different epileptic phenomena: 7 animals quickly (in 2-3 weeks) achieved a fully kindled state, characterized by generalized seizures, whereas the remaining 6 rabbits did not reliably progress beyond partial seizures even after more prolonged stimulation. Animals were accordingly divided into two groups referred to as generalized seizure and partial seizure. The temporal/spatial dissemination pattern, particularly in the two hippocampi, was very different between the groups. In both groups interictal spiking originated in one of the hippocampi independent of site stimulated and represented formation of the primary hippocampal epileptic focus. The generalized seizure group demonstrated stability of the primary hippocampal epileptic focus with permanent predominance of spiking in it over the course of kindling, and a high level of bilateral synchronous hippocampal interictal spiking. In the partial seizure group the primary hippocampal epileptic focus was established during the first 2-3 weeks of stimulation. This was later suppressed upon the development of an independent secondary focus in the opposite hippocampus. These animals also displayed very low levels of synchronous bilateral hippocampal interictal spiking. We suggest that an antagonistic relationship can develop between mirror hippocampal epileptic foci. This can be associated with a low level of bilateral hippocampal synchronous spiking, kindling retardation, and manifestation of partial seizures.

Evaluation of the hypothesis that hippocampal interictal spikes are caused by long-term potentiation

Hippocampal spontaneous interictal spikes (SISs) occur in the EEG after repeated afterdischarges (ADs) induced by high-frequency (200 Hz) stimulation trains. Because SISs resemble population excitatory postsynaptic potentials (EPSPs), and SISs persist for several days like some types of hippocampal long-term potentiation (LTP), LTP has been suggested as a mechanism for SISs. We specifically examined the hypothesis that SISs are caused by basal-dendritic LTP in CA1. Rats were chronically implanted with bilateral electrodes in the hippocampal CA1 region. In the first experiment, 10-18 patterned primed burst (PB) stimulations were delivered hourly for 2-3 days to activate the commissural basal-dendritic EPSP in CA1. Robust LTP of the basal-dendritic CA1 synapse was detected, typically saturating at 100% enhancement after five stimulations. However, few SISs were detected if ADs were not elicited. In the second experiment, repeated commissurally evoked ADs induced a high rate of SISs, together with LTP of the basal-dendritic and apical-dendritic EPSP in CA1, but the SIS rate was not necessarily related to the level of LTP. In the third experiment, an intraventricular dose (20 micrograms) of an N-methyl-D-aspartate (NMDA) receptor antagonist 2-amino-5-phosphonovalerate (APV) was used to block the basal-dendritic LTP in CA1. The increase in SISs induced by a single AD was not blocked, however, suggesting that NMDA receptors were not critical in generation of SISs. In the fourth experiment, PBs (that induced LTP but no ADs) were able to increase the rate of SISs marginally when SISs were already present. In all, the experiments suggest that LTP at the basal dendrites of CA1 is not critical in generation of hippocampal SISs, although an increase in LTP may increase the rate of SISs marginally when SISs are already present.

Are differences in dorsal hippocampal kindling related to amygdala-piriform area excitability?

It has been suggested that several structures associated with the amygdala-piriform (A-P) area are important, if not critical, for convulsive generalization of limbic seizures. In experiment 1, when examining the development of convulsive seizures kindled from the dorsal hippocampus (cornus ammonis; DH), a broad range of kindling rates was observed. Independent of electrode location within the hippocampus, kindling rates were correlated positively with both local and, more dramatically, distant excitability (measured by the duration of the primary and secondary hippocampal afterdischarges, respectively) at all stages of epileptogenesis. Because kindling rates were bimodally distributed, we bisected the distribution into 'faster' and 'slower' kindling rats. Here we examined the magnitude of both electrophysiological and behavioral differences between 'faster' and 'slower' rats and their changes over time. The 'faster' rats had longer primary and secondary afterdischarge (AD) durations than 'slower' rats throughout all stages of kindling. With the appearance of generalized convulsions, the 'faster' rats showed longer latencies to clonus onset, with longer clonus and AD durations than 'slower' rats. Also, the generalized convulsions of 'faster' rats appeared during a much enlarged secondary AD period, while 'slower' rats convulsed during primary AD. In both groups, convulsions were invariably associated with increased discharge in A-P associated structures. We interpreted the differences between 'faster' and 'slower' DH rats to reflect genetic differences in excitability in both local and A-P associated structures. If the DH kindling profile of the 'faster' rats differed from 'slower' rats largely because of naturally greater excitability in A-P associated structures, then experimentally increased excitability in those structures (via amygdala kindling) in a random sample of rats should duplicate much of the 'faster' DH kindling profile. In experiment 2, this outcome was observed. In conclusion, we suggest that either natural or induced differences in the excitability of A-P associated structures affect both the genesis and the profile of convulsive generalization of limbic kindled seizures.

Effects of seizures and carbamazepine on interictal spiking in amygdala kindled cats

We examined the influence of seizures and carbamazepine (CBZ) on spiking rates in kindled cats. In the first experiment, spiking rates were measured before and after seizures, with and without CBZ. CBZ was administered immediately after seizures in order not to affect them. Spiking rates were measured over 9 h during the different sleep stages. In a second experiment, CBZ was administered before and after seizures so as to affect seizure strength and thus measure its effect on spiking. Results confirmed earlier findings of a large increase in spiking following a stage 6 seizure in fully kindled animals. We also established that: (1) repeated daily seizures caused a further increase in spiking until a ceiling was reached; (2) increased spiking was not a direct effect of postictal alterations in sleep stages; (3) CBZ, despite its effectiveness as an anticonvulsant, did not reduce spiking but rather increased it; (4) postictal increases in spiking were related to seizure 'strength'. These findings support the hypothesis that spiking rates are primarily influenced by seizure occurrence, as was found in patients with temporal lobe seizures, and that anticonvulsants act differently on seizures and spikes. This emphasizes the possibility of distinct pathophysiological mechanisms for interictal spikes and seizures.

Radial maze performance following hippocampal kindling

The relation between hippocampal epileptiform activity and 8-arm radial maze performance was assessed following repetitive afterdischarges (ADs) evoked by stimulation of the hippocampal CA1 region (kindling). Hippocampal kindling, whether to stage V (generalized) convulsions or to a preconvulsive stage, induced deficits in radial maze performance, evaluated by correct arm entries in 8 choices or total maze run (trial) time. The deficits persisted at least until 21 days after the last AD. Hippocampal interictal spikes (ISs) were induced by kindling, but the rate of ISs declined to near zero in a few days. The rate or presence of ISs was not related to maze performance.

Kindling in the posterior cingulate cortex: electrographic and behavioral characteristics

Ictal, postictal and interictal electrical activities were recorded in the posterior cingulate cortex and hippocampus in the rat following kindling stimulations in the cingulate cortex. The afterdischarges (ADs) consisted of fast spikes and slow spike-and-wave of 2-5 Hz. Initial motor signs typically consisted of extension of the forelimbs and head, followed by clonic fore- and/or hind limb movements; there was no consistent laterality in any of the motor signs. Electrodes at or near the cingulum or corpus callosum ('white matter' group) gave kindling rates faster than other sites in the 'grey matter' of cingulate cortex (area 29); 2 of 7 animals had first-trial generalized motor seizures. The 'white matter' group averaged 4.6 ADs to reach the first 'bilateral forelimb clonus,' as compared to 17.8 ADs for the 'grey matter' group. The frequency and morphology of sharp EEG spikes in the cingulate cortex remained largely unchanged during the course of kindling. Cingulate interictal spikes were infrequent. The intimate connections of the cingulate cortex to motor and limbic structures rather than its intrinsic circuitry may be important for its fast kindling rates.

Spontaneous hippocampal interictal spikes following local kindling: time-course of change and relation to behavioral seizures

Spontaneous interictal spikes (SISs) were recorded in the hippocampus in freely behaving rats following hippocampal stimulations that resulted in afterdischarges (ADs). Hippocampal SISs were detected after an average of 5 (range 2-10) daily ADs. The rate of SISs typically increased minutes after a tetanus, and then decayed with time constants of approximately 70 min and 1.5 days. Seizure onset in the kindling paradigm was not related to a consistent change in SIS rate. Following the interruption of daily kindling, SIS rate invariably decreased to near zero by 4-8 days while seizure susceptibility, as tested by the ability to evoke generalized convulsions, remained unchanged. Despite having a low or zero SIS rate the hippocampus seemed to retain an excitability after kindling interruption, as demonstrated by the observation that an average of 1.7 rekindling stimulations resulted in a high SIS rate. In conclusion, changes in hippocampal SISs were closely time-locked to an AD, and not to evoked behavioral seizures. Hippocampal SISs probably reflect an excitability change that is more local than that necessary for evoking behavioral convulsions. The persistence of SISs in terms of hours and days suggests the involvement of long-term potentiation.