1
|
Xing B, Barbour AJ, Vithayathil J, Li X, Dutko S, Fawcett-Patel J, Lancaster E, Talos DM, Jensen FE. Reversible synaptic adaptations in a subpopulation of murine hippocampal neurons following early-life seizures. J Clin Invest 2024; 134:e175167. [PMID: 38227384 PMCID: PMC10904056 DOI: 10.1172/jci175167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 01/11/2024] [Indexed: 01/17/2024] Open
Abstract
Early-life seizures (ELSs) can cause permanent cognitive deficits and network hyperexcitability, but it is unclear whether ELSs induce persistent changes in specific neuronal populations and whether these changes can be targeted to mitigate network dysfunction. We used the targeted recombination of activated populations (TRAP) approach to genetically label neurons activated by kainate-induced ELSs in immature mice. The ELS-TRAPed neurons were mainly found in hippocampal CA1, remained uniquely susceptible to reactivation by later-life seizures, and displayed sustained enhancement in α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) receptor-mediated (AMPAR-mediated) excitatory synaptic transmission and inward rectification. ELS-TRAPed neurons, but not non-TRAPed surrounding neurons, exhibited enduring decreases in Gria2 mRNA, responsible for encoding the GluA2 subunit of the AMPARs. This was paralleled by decreased synaptic GluA2 protein expression and heightened phosphorylated GluA2 at Ser880 in dendrites, indicative of GluA2 internalization. Consistent with increased GluA2-lacking AMPARs, ELS-TRAPed neurons showed premature silent synapse depletion, impaired long-term potentiation, and impaired long-term depression. In vivo postseizure treatment with IEM-1460, an inhibitor of GluA2-lacking AMPARs, markedly mitigated ELS-induced changes in TRAPed neurons. These findings show that enduring modifications of AMPARs occur in a subpopulation of ELS-activated neurons, contributing to synaptic dysplasticity and network hyperexcitability, but are reversible with early IEM-1460 intervention.
Collapse
|
2
|
Primiani CT, Lee JK, O’Brien CE, Chen MW, Perin J, Kulikowicz E, Santos P, Adams S, Lester B, Rivera-Diaz N, Olberding V, Niedzwiecki MV, Ritzl EK, Habela CW, Liu X, Yang ZJ, Koehler RC, Martin LJ. Hypothermic Protection in Neocortex Is Topographic and Laminar, Seizure Unmitigating, and Partially Rescues Neurons Depleted of RNA Splicing Protein Rbfox3/NeuN in Neonatal Hypoxic-Ischemic Male Piglets. Cells 2023; 12:2454. [PMID: 37887298 PMCID: PMC10605428 DOI: 10.3390/cells12202454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 10/10/2023] [Accepted: 10/13/2023] [Indexed: 10/28/2023] Open
Abstract
The effects of hypothermia on neonatal encephalopathy may vary topographically and cytopathologically in the neocortex with manifestations potentially influenced by seizures that alter the severity, distribution, and type of neuropathology. We developed a neonatal piglet survival model of hypoxic-ischemic (HI) encephalopathy and hypothermia (HT) with continuous electroencephalography (cEEG) for seizures. Neonatal male piglets received HI-normothermia (NT), HI-HT, sham-NT, or sham-HT treatments. Randomized unmedicated sham and HI piglets underwent cEEG during recovery. Survival was 2-7 days. Normal and pathological neurons were counted in different neocortical areas, identified by cytoarchitecture and connectomics, using hematoxylin and eosin staining and immunohistochemistry for RNA-binding FOX-1 homolog 3 (Rbfox3/NeuN). Seizure burden was determined. HI-NT piglets had a reduced normal/total neuron ratio and increased ischemic-necrotic/total neuron ratio relative to sham-NT and sham-HT piglets with differing severities in the anterior and posterior motor, somatosensory, and frontal cortices. Neocortical neuropathology was attenuated by HT. HT protection was prominent in layer III of the inferior parietal cortex. Rbfox3 immunoreactivity distinguished cortical neurons as: Rbfox3-positive/normal, Rbfox3-positive/ischemic-necrotic, and Rbfox3-depleted. HI piglets had an increased Rbfox3-depleted/total neuron ratio in layers II and III compared to sham-NT piglets. Neuronal Rbfox3 depletion was partly rescued by HT. Seizure burdens in HI-NT and HI-HT piglets were similar. We conclude that the neonatal HI piglet neocortex has: (1) suprasylvian vulnerability to HI and seizures; (2) a limited neuronal cytopathological repertoire in functionally different regions that engages protective mechanisms with HT; (3) higher seizure burden, insensitive to HT, that is correlated with more panlaminar ischemic-necrotic neurons in the somatosensory cortex; and (4) pathological RNA splicing protein nuclear depletion that is sensitive to HT. This work demonstrates that HT protection of the neocortex in neonatal HI is topographic and laminar, seizure unmitigating, and restores neuronal depletion of RNA splicing factor.
Collapse
Affiliation(s)
- Christopher T. Primiani
- Department of Neurology, Johns Hopkins University School of Medicine, 558 Ross Building, 720 Rutland Avenue, Baltimore, MD 21205-2196, USA
| | - Jennifer K. Lee
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, 558 Ross Building, 720 Rutland Avenue, Baltimore, MD 21205-2196, USA; (J.K.L.); (E.K.); (V.O.); (M.V.N.)
| | - Caitlin E. O’Brien
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, 558 Ross Building, 720 Rutland Avenue, Baltimore, MD 21205-2196, USA; (J.K.L.); (E.K.); (V.O.); (M.V.N.)
| | - May W. Chen
- Department Pediatrics, Johns Hopkins University School of Medicine, 558 Ross Building, 720 Rutland Avenue, Baltimore, MD 21205-2196, USA
| | - Jamie Perin
- Department of Biostatistics and Epidemiology, Johns Hopkins University School of Medicine, 558 Ross Building, 720 Rutland Avenue, Baltimore, MD 21205-2196, USA
| | - Ewa Kulikowicz
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, 558 Ross Building, 720 Rutland Avenue, Baltimore, MD 21205-2196, USA; (J.K.L.); (E.K.); (V.O.); (M.V.N.)
| | - Polan Santos
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, 558 Ross Building, 720 Rutland Avenue, Baltimore, MD 21205-2196, USA; (J.K.L.); (E.K.); (V.O.); (M.V.N.)
| | - Shawn Adams
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, 558 Ross Building, 720 Rutland Avenue, Baltimore, MD 21205-2196, USA; (J.K.L.); (E.K.); (V.O.); (M.V.N.)
| | - Bailey Lester
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, 558 Ross Building, 720 Rutland Avenue, Baltimore, MD 21205-2196, USA; (J.K.L.); (E.K.); (V.O.); (M.V.N.)
| | - Natalia Rivera-Diaz
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, 558 Ross Building, 720 Rutland Avenue, Baltimore, MD 21205-2196, USA; (J.K.L.); (E.K.); (V.O.); (M.V.N.)
| | - Valerie Olberding
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, 558 Ross Building, 720 Rutland Avenue, Baltimore, MD 21205-2196, USA; (J.K.L.); (E.K.); (V.O.); (M.V.N.)
| | - Mark V. Niedzwiecki
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, 558 Ross Building, 720 Rutland Avenue, Baltimore, MD 21205-2196, USA; (J.K.L.); (E.K.); (V.O.); (M.V.N.)
| | - Eva K. Ritzl
- Department of Neurology, Johns Hopkins University School of Medicine, 558 Ross Building, 720 Rutland Avenue, Baltimore, MD 21205-2196, USA
| | - Christa W. Habela
- Department of Neurology, Johns Hopkins University School of Medicine, 558 Ross Building, 720 Rutland Avenue, Baltimore, MD 21205-2196, USA
| | - Xiuyun Liu
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, 558 Ross Building, 720 Rutland Avenue, Baltimore, MD 21205-2196, USA; (J.K.L.); (E.K.); (V.O.); (M.V.N.)
| | - Zeng-Jin Yang
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, 558 Ross Building, 720 Rutland Avenue, Baltimore, MD 21205-2196, USA; (J.K.L.); (E.K.); (V.O.); (M.V.N.)
| | - Raymond C. Koehler
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, 558 Ross Building, 720 Rutland Avenue, Baltimore, MD 21205-2196, USA; (J.K.L.); (E.K.); (V.O.); (M.V.N.)
| | - Lee J. Martin
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, 558 Ross Building, 720 Rutland Avenue, Baltimore, MD 21205-2196, USA; (J.K.L.); (E.K.); (V.O.); (M.V.N.)
- Department of Pathology, Johns Hopkins University School of Medicine, 558 Ross Building, 720 Rutland Avenue, Baltimore, MD 21205-2196, USA
- Department of Neuroscience, Johns Hopkins University School of Medicine, 558 Ross Building, 720 Rutland Avenue, Baltimore, MD 21205-2196, USA
- The Pathobiology Graduate Training Program, Johns Hopkins University School of Medicine, 558 Ross Building, 720 Rutland Avenue, Baltimore, MD 21205-2196, USA
| |
Collapse
|
3
|
Saleem A, Santos AC, Aquilino MS, Sivitilli AA, Attisano L, Carlen PL. Modelling hyperexcitability in human cerebral cortical organoids: Oxygen/glucose deprivation most effective stimulant. Heliyon 2023; 9:e14999. [PMID: 37089352 PMCID: PMC10113787 DOI: 10.1016/j.heliyon.2023.e14999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 03/13/2023] [Accepted: 03/23/2023] [Indexed: 03/31/2023] Open
Abstract
Epilepsy is a common neurological disorder that affects 1% of the global population. The neonatal period constitutes the highest incidence of seizures. Despite the continual developments in seizure modelling and anti-epileptic drug development, the mechanisms involved in neonatal seizures remain poorly understood. This leaves infants with neonatal seizures at a high risk of death, poor prognosis of recovery and risk of developing neurological disorders later in life. Current in vitro platforms for modelling adult and neonatal epilepsies - namely acute cerebral brain slices or cell-derived cultures, both derived from animals-either lack a complex cytoarchitecture, high-throughput capabilities or physiological similarities to the neonatal human brain. Cerebral organoids, derived from human embryonic stem cells (hESCs), are an emerging technology that could better model neurodevelopmental disorders in the developing human brain. Herein, we study induced hyperexcitability in human cerebral cortical organoids - setting the groundwork for neonatal seizure modelling - using electrophysiological techniques and pharmacological manipulations. In neonatal seizures, energy failure - specifically due to deprivation of oxygen and glucose - is a consistent and reliable seizure induction method that has been used to study the underlying cellular and molecular mechanisms. Here, we applied oxygen-glucose deprivation (OGD) as well as common chemoconvulsants in 3-7-month-old cerebral organoids. Remarkably, OGD resulted in hyperexcitability, with increased power and spontaneous events compared to other common convulsants tested at the population level. These findings characterize OGD as the stimulus most capable of inducing hyperexcitable changes in cerebral organoid tissue, which could be extended to future modelling of neonatal epilepsies in cerebral organoids.
Collapse
|
4
|
Acute and Repeated Administration of NLX-101, a Selective Serotonin-1A Receptor Biased Agonist, Reduces Audiogenic Seizures in Developing Fmr1 Knockout Mice. Neuroscience 2023; 509:113-124. [PMID: 36410632 DOI: 10.1016/j.neuroscience.2022.11.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 11/03/2022] [Accepted: 11/13/2022] [Indexed: 11/22/2022]
Abstract
Fragile XSyndrome (FXS) is a leading known genetic cause of Autism Spectrum Disorders (ASD) and intellectual disability. A consistent and debilitating phenotype of FXS is sensory hypersensitivity that manifests strongly in the auditory domain and may lead to delayed language and high anxiety. The mouse model of FXS, the Fmr1 KO mouse, also shows auditory hypersensitivity, an extreme form of which is seen as audiogenic seizures (AGS). The midbrain inferior colliculus (IC) is critically involved in generating audiogenic seizures and IC neurons are hyper-responsive to sounds in developing Fmr1 KO mice. Serotonin-1A receptor (5-HT1A) activation reduces IC activity. Therefore, we tested whether 5-HT1A activation is sufficient to reduce audiogenic seizures in Fmr1 KO mice. A selective and post-synaptic 5-HT1A receptor biased agonist, 3-Chloro-4-fluorophenyl-[4-fluoro-4-[[(5-methylpyrimidin-2-ylmethyl)amino]methyl]piperidin-1-yl] methanone (NLX-101, 0.6, 1.2, 1.8 or 2.4 mg/kg, i.p.) was administered to Fmr1 KO mice 15 min before seizure induction. Whereas the 0.6 mg/kg dose was ineffective in reducing seizures, the 1.2, 1.8 and 2.4 mg/kg doses of NLX-101 dramatically reduced seizures and increased mouse survival. Treatment with a combination of NLX-101 and 5-HT1A receptor antagonists prevented the protective effects of NLX-101, indicating that NLX-101 acts selectively through 5-HT1A receptors to reduce audiogenic seizures. NLX-101 (1.8 mg/kg) was still strongly effective in reducing seizures even after repeated administration over 5 days, suggesting an absence of tachyphylaxis to the effects of the compound. Together, these studies point to a promising treatment option targeting post-synaptic 5-HT1A receptors to reduce auditory hypersensitivity in FXS, and potentially across autism spectrum disorders.
Collapse
|
5
|
Bigelow LJ, Fiset C, Jarvis JHM, Macleod S, Wöhr M, Benke TA, Bernard PB. Early-life seizures modify behavioral response to ultrasonic vocalization playback in adult rats. Epilepsy Behav 2022; 127:108494. [PMID: 34954511 DOI: 10.1016/j.yebeh.2021.108494] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 12/02/2021] [Accepted: 12/02/2021] [Indexed: 12/12/2022]
Abstract
Early-life seizures (ELS) are associated with autism spectrum disorder (ASD); however, due to a lack of effective treatments for ELS, it is not clear whether ELS plays a causal role, potentiates the ASD phenotype, or is the result of a common pathophysiology. Deficits in communications are a core feature of ASD. To isolate the impact of ELS on communication, we probed the behavioral consequences of a single episode of kainic acid-induced early-life seizures (KA-ELS) in male and female Sprague-Dawley (CD) rats. Deficits in auditory communication were observed in adult male rats as assessed by behavioral response to ultrasonic vocalization (USV) playback. Ultrasonic vocalizations are classified into two major categories - 50-kHz (positive) calls and 22-kHz (aversive) calls. Behavioral response was assessed via rat preference for different USV playback in a radial arm maze. Response to 22-kHz calls was not impacted by ELS while response to 50-kHz calls was impacted. All rats demonstrated positional preference for the arms adjacent to where 50-kHz calls were playing compared to background noise; however, male ELS rats demonstrated a greater positional preference for the arms adjacent to where 50-kHz calls were playing compared to male control rats. These studies demonstrate that responses to socially relevant auditory cues are chronically altered in adult male rats following a single episode of ELS. We speculate that these changes contribute to previously reported social deficits associated with ELS.
Collapse
Affiliation(s)
- Logan J Bigelow
- University of Prince Edward Island, Biomedical Sciences, Charlottetown, PE, Canada
| | - Catherine Fiset
- University of Prince Edward Island, Biomedical Sciences, Charlottetown, PE, Canada
| | - Jack H M Jarvis
- University of Prince Edward Island, Biomedical Sciences, Charlottetown, PE, Canada
| | - Sarah Macleod
- University of Prince Edward Island, Biomedical Sciences, Charlottetown, PE, Canada
| | - Markus Wöhr
- KU Leuven, Faculty of Psychology and Educational Sciences, Research Unit Brain and Cognition, Laboratory of Biological Psychology, Social and Affective Neuroscience Research Group, B-3000 Leuven, Belgium; KU Leuven, Leuven Brain Institute, B-3000 Leuven, Belgium; Behavioral Neuroscience, Experimental and Biological Psychology, Faculty of Psychology, Philipps University of Marburg, Gutenbergstr. 18, D-35032 Marburg, Germany; Center for Mind, Brain and Behavior, Philipps-University of Marburg, Hans-Meerwein-Str. 6, D-35032 Marburg, Germany
| | - Tim A Benke
- University of Colorado School of Medicine, Department of Pediatrics, Aurora, CO, United States
| | - Paul B Bernard
- University of Prince Edward Island, Biomedical Sciences, Charlottetown, PE, Canada.
| |
Collapse
|
6
|
Singh H, Ramon A, Finore D, Burnham K, McRobert S, Lippman-Bell J. Learning Deficits and Attenuated Adaptive Stress Response After Early-Life Seizures in Zebrafish. Front Neurosci 2022; 16:869671. [PMID: 35527822 PMCID: PMC9073075 DOI: 10.3389/fnins.2022.869671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 03/29/2022] [Indexed: 11/13/2022] Open
Abstract
Early-life seizures (ELS) are often associated with the development of cognitive deficits. However, methods to predict and prevent these deficits are lacking. To increase the range of research models available to study cognitive consequences of ELS, we investigated whether seizures in larval zebrafish (Danio rerio) lead to behavioral deficits later in life. We thus modified the existing pentylenetetrazole (PTZ)-induced seizure model in larval zebrafish, exposing zebrafish to PTZ daily from 5 to 7 days post-fertilization (dpf). We then compared later-life learning, social behavior (shoaling), and behavioral and chemical measures of anxiety in the PTZ-exposed zebrafish (PTZ group) to that of naïve clutchmates (untouched controls, UC) and to a second control group (handling control, HC) that experienced the same handling as the PTZ group, but without PTZ exposure. We observed that only the PTZ group displayed a significant deficit in a y-maze learning task, while only the HC group displayed a social deficit of decreased shoaling. HC fish also showed an increased frequency of behavioral freezing and elevated cortisol responses to netting, heightened stress responses not seen in the PTZ fish. Since mild stressors, such as the handling the HC fish experienced, can lead to learned, advantageous responses to stress later in life, we tested escape response in the HC fish using an acoustic startle stimulus. The HC group showed an enhanced startle response, swimming significantly farther than either the PTZ or UC group immediately after being startled. Taken together, these results indicate that seizures in larval zebrafish impair learning and the development of an adaptive, heightened stress response after early-life stress. These findings expand the behavioral characterization of the larval zebrafish seizure model, strengthening the power of this model for ELS research.
Collapse
Affiliation(s)
- Harsimran Singh
- Department of Bio-Medical Sciences, Philadelphia College of Osteopathic Medicine, Philadelphia, PA, United States
| | - Alfonsina Ramon
- Department of Bio-Medical Sciences, Philadelphia College of Osteopathic Medicine, Philadelphia, PA, United States
| | - Dana Finore
- Department of Biology, Saint Joseph's University, Philadelphia, PA, United States
| | - Kaleigh Burnham
- Department of Bio-Medical Sciences, Philadelphia College of Osteopathic Medicine, Philadelphia, PA, United States
| | - Scott McRobert
- Department of Biology, Saint Joseph's University, Philadelphia, PA, United States
| | - Jocelyn Lippman-Bell
- Department of Bio-Medical Sciences, Philadelphia College of Osteopathic Medicine, Philadelphia, PA, United States
| |
Collapse
|
7
|
Lippman-Bell JJ, Handy M, Nieder CG, Getzfread M, Jensen FE. Altered hippocampal dendritic spine maturation after hypoxia-induced seizures in neonatal rats. Mol Cell Neurosci 2021; 113:103629. [PMID: 34015497 DOI: 10.1016/j.mcn.2021.103629] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 05/10/2021] [Accepted: 05/12/2021] [Indexed: 12/01/2022] Open
Abstract
Cognitive comorbidities often follow early-life seizures (ELS), especially in the setting of autism and other neurodevelopmental syndromes. However, there is an incomplete understanding of whether neuronal and synaptic development are concomitantly dysregulated. We have previously shown that hypoxia-induced seizures (HS) in postnatal day (P)10 rats increase acute and later-life hippocampal glutamatergic neurotransmission and spontaneous recurrent seizures, and impair cognition and behavior. As dendritic spines critically regulate synaptic function, we hypothesized that ELS can induce developmentally specific changes in dendritic spine maturation. At intervals during one month following HS in P10 rats, we assessed dendritic spine development on pyramidal neurons in the stratum radiatum of hippocampal area CA1. Compared to control rats in which spine density significantly decreased from P10 to early adulthood (P38), post-seizure rats failed to show a developmental decrease in spine density, and spines from P38 post-seizure rats appeared more immature-shaped (long, thin). In addition, compared to P38 control rats, post-seizure P38 rats expressed significantly more synaptic PSD-95, a marker of mature synapses. These changes were preceded by a transient increase in hippocampal expression of cofilin phosphorylated at Ser3, representing a decrease in cofilin activity. These results suggest that early-life seizures may impair normal dendritic spine maturation and pruning in CA1 during development, resulting in an excess of less efficient synapses, via activity-dependent modification of actin-regulating proteins such as cofilin. Given that multiple neurodevelopmental disorders show similar failures in developmental spine pruning, the current findings may represent a deficit in structural plasticity that could be a component of a mechanism leading to later-life cognitive consequences associated with early-life seizures.
Collapse
Affiliation(s)
- Jocelyn J Lippman-Bell
- Department of Biomedical Sciences, Philadelphia College of Osteopathic Medicine, Philadelphia, PA, United States of America; Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States of America.
| | - Marcus Handy
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States of America
| | - Cassidy G Nieder
- Department of Biomedical Sciences, Philadelphia College of Osteopathic Medicine, Philadelphia, PA, United States of America
| | - Mollie Getzfread
- Department of Biomedical Sciences, Philadelphia College of Osteopathic Medicine, Philadelphia, PA, United States of America
| | - Frances E Jensen
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States of America.
| |
Collapse
|
8
|
Hodges SL, Womble PD, Kwok EM, Darner AM, Senger SS, Binder MS, Faust AM, Condon SM, Nolan SO, Quintero SI, Lugo JN. Rapamycin, but not minocycline, significantly alters ultrasonic vocalization behavior in C57BL/6J pups in a flurothyl seizure model. Behav Brain Res 2021; 410:113317. [PMID: 33910029 DOI: 10.1016/j.bbr.2021.113317] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Revised: 02/24/2021] [Accepted: 04/21/2021] [Indexed: 12/11/2022]
Abstract
Epilepsy is one of the most common neurological disorders, with individuals having an increased susceptibility of seizures in the first few years of life, making children at risk of developing a multitude of cognitive and behavioral comorbidities throughout development. The present study examined the role of PI3K/Akt/mTOR pathway activity and neuroinflammatory signaling in the development of autistic-like behavior following seizures in the neonatal period. Male and female C57BL/6J mice were administered 3 flurothyl seizures on postnatal (PD) 10, followed by administration of minocycline, the mTOR inhibitor rapamycin, or a combined treatment of both therapeutics. On PD12, isolation-induced ultrasonic vocalizations (USVs) of mice were examined to determine the impact of seizures and treatment on communicative behaviors, a component of the autistic-like phenotype. Seizures on PD10 increased the quantity of USVs in female mice and reduced the amount of complex call types emitted in males compared to controls. Inhibition of mTOR with rapamycin significantly reduced the quantity and duration of USVs in both sexes. Changes in USVs were associated with increases in mTOR and astrocyte levels in male mice, however, three PD10 seizures did not result in enhanced proinflammatory cytokine expression in either sex. Beyond inhibition of mTOR activity by rapamycin, both therapeutics did not demonstrate beneficial effects. These findings emphasize the importance of differences that may exist across preclinical seizure models, as three flurothyl seizures did not induce as drastic of changes in mTOR activity or inflammation as observed in other rodent models.
Collapse
Affiliation(s)
- Samantha L Hodges
- Institute of Biomedical Studies, Baylor University, Waco, TX, 76798, USA.
| | - Paige D Womble
- Department of Psychology and Neuroscience, Baylor University, Waco, TX, 76798, USA
| | - Eliesse M Kwok
- Department of Psychology and Neuroscience, Baylor University, Waco, TX, 76798, USA
| | - Alyssa M Darner
- Department of Psychology and Neuroscience, Baylor University, Waco, TX, 76798, USA
| | - Savannah S Senger
- Department of Psychology and Neuroscience, Baylor University, Waco, TX, 76798, USA
| | - Matthew S Binder
- Department of Psychology and Neuroscience, Baylor University, Waco, TX, 76798, USA
| | - Amanda M Faust
- Department of Psychology and Neuroscience, Baylor University, Waco, TX, 76798, USA
| | - Siena M Condon
- Department of Psychology and Neuroscience, Baylor University, Waco, TX, 76798, USA
| | - Suzanne O Nolan
- Department of Psychology and Neuroscience, Baylor University, Waco, TX, 76798, USA
| | - Saul I Quintero
- Department of Psychology and Neuroscience, Baylor University, Waco, TX, 76798, USA
| | - Joaquin N Lugo
- Institute of Biomedical Studies, Baylor University, Waco, TX, 76798, USA; Department of Psychology and Neuroscience, Baylor University, Waco, TX, 76798, USA; Department of Biology, Baylor University, Waco, TX, 76798, USA
| |
Collapse
|
9
|
Abstract
Epilepsy and autism frequently co-occur. Epilepsy confers an increased risk of autism and autism confers an increased risk of epilepsy. Specific epilepsy syndromes, intellectual disability, and female gender present a particular risk of autism in individuals with epilepsy. Epilepsy and autism are likely to share common etiologies, which predispose individuals to either or both conditions. Genetic factors, metabolic disorders, mitochondrial disorders, and immune dysfunction all can be implicated.
Collapse
Affiliation(s)
- Frank M C Besag
- East London NHS Foundation Trust, 5-7 Rush Court, Bedford MK40 3JT, UK; University College London, London, UK; King's College London, London, UK.
| | - Michael J Vasey
- East London NHS Foundation Trust, 5-7 Rush Court, Bedford MK40 3JT, UK
| |
Collapse
|
10
|
Ribeiro FT, de Serro-Azul MIS, Lorena FB, do Nascimento BPP, Arnold AJT, Barbosa GHL, Ribeiro MO, Cysneiros RM. Increased Endocannabinoid Signaling Reduces Social Motivation in Intact Rats and Does Not Affect Animals Submitted to Early-Life Seizures. Front Behav Neurosci 2020; 14:560423. [PMID: 33362484 PMCID: PMC7756094 DOI: 10.3389/fnbeh.2020.560423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 11/12/2020] [Indexed: 11/24/2022] Open
Abstract
The early life status epilepticus (SE) causes high anxiety and chronic socialization abnormalities, revealed by a low preference for social novelty and deficit in social discrimination. This study investigated the involvement of the endocannabinoid system on the sociability in this model, due to its role in social motivation regulation. Male Wistar rats at postnatal day 9 were subjected to pilocarpine-induced neonatal SE and controls received saline. From P60 the groups received vehicle or JZL195 2 h before each behavioral test to increase endocannabinoids availability. In the sociability test, animals subjected to neonatal SE exhibited impaired sociability, characterized by social discrimination deficit, which was unaffected by the JZL195 treatment. In contrast, JZL195-treated control rats showed low sociability and impaired social discrimination. The negative impact of JZL195 over the sociability in control rats and the lack of effect in animals subjected to neonatal SE was confirmed in the social memory paradigm. In this paradigm, as expected for vehicle-treated control rats, the investigation toward the same social stimulus decreased with the sequential exposition and increased toward a novel stimulus. In animals subjected to neonatal SE, regardless of the treatment, as well as in JZL195-treated control rats, the investigation toward the same social stimulus was significantly reduced with no improvement toward a novel stimulus. Concerning the locomotion, the JZL195 increased it only in control rats. After behavioral tests, brain tissues of untreated animals were used for CB1 receptor quantification by Elisa and for gene expression by RT-PCR: no difference between control and experimental animals was noticed. The results reinforce the evidence that the early SE causes chronic socialization abnormalities, revealed by the low social interest for novelty and impaired social discrimination. The dual FAAH/MAGL inhibitor (JZL195) administration before the social encounter impaired the social interaction in intact rats with no effect in animals subjected to early-life seizures.
Collapse
Affiliation(s)
- Fernanda Teixeira Ribeiro
- Developmental Disabilities Postgraduate Program, Laboratory of Neurobiology and Metabolism, Mackenzie Presbyterian University, São Paulo, Brazil
| | - Marcia Ivany Silva de Serro-Azul
- Developmental Disabilities Postgraduate Program, Laboratory of Neurobiology and Metabolism, Mackenzie Presbyterian University, São Paulo, Brazil
| | - Fernanda Beraldo Lorena
- Postgraduate Program in Translational Medicine, Federal University of São Paulo, São Paulo, Brazil
| | | | - Alexandre José Tavolari Arnold
- Developmental Disabilities Postgraduate Program, Laboratory of Neurobiology and Metabolism, Mackenzie Presbyterian University, São Paulo, Brazil
| | - Geraldo Henrique Lemos Barbosa
- Developmental Disabilities Postgraduate Program, Laboratory of Neurobiology and Metabolism, Mackenzie Presbyterian University, São Paulo, Brazil
| | - Miriam Oliveira Ribeiro
- Developmental Disabilities Postgraduate Program, Laboratory of Neurobiology and Metabolism, Mackenzie Presbyterian University, São Paulo, Brazil
| | - Roberta Monterazzo Cysneiros
- Developmental Disabilities Postgraduate Program, Laboratory of Neurobiology and Metabolism, Mackenzie Presbyterian University, São Paulo, Brazil
| |
Collapse
|
11
|
Moreira JD, Siqueira LV, Müller AP, Porciúncula LO, Vinadé L, Souza DO. Dietary omega-3 fatty acids prevent neonatal seizure-induced early alterations in the hippocampal glutamatergic system and memory deficits in adulthood. Nutr Neurosci 2020; 25:1066-1077. [PMID: 33107813 DOI: 10.1080/1028415x.2020.1837569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE We investigated the influence of dietary omega-3 polyunsaturated fatty acids (n-3 PUFAs) on glutamatergic system modulation after a single episode of neonatal seizures and their possible effects on seizure-induced long-lasting behavioral deficits. METHODS Male Wistar rats receiving an omega-3 diet (n-3) or an n-3 deficient diet (D) from the prenatal period were subjected to a kainate-induced seizure model at P7. Glutamate transporter activity and immunocontents (GLT-1 and GLAST) were assessed in the hippocampus at 12, 24, and 48 h after the seizure episode. Fluorescence intensity for glial cells (GFAP) and neurons (NeuN) was assessed 24 h after seizure in the hippocampus. Behavioral analysis (elevated-plus maze and inhibitory avoidance memory task) was performed at 60 days of age. RESULTS The D group showed a decrease in glutamate uptake 24 h after seizure. In this group only, the GLT1 content increased at 12 h, followed by a decrease at 24 h. GLAST increased up to 24 h after seizure. GFAP fluorescence was higher, and NeuN fluorescence decreased, in the D group independent of seizures. In adulthood, the D group presented memory deficits independent of seizures, but short-term memory (1.5 h after a training session) was abolished in the D group treated with kainate. SIGNIFICANCE N-3 PUFA positively influenced the glutamatergic system during seizure and prevented seizure-related memory deficits in adulthood.
Collapse
Affiliation(s)
- Júlia D Moreira
- Postgraduate Program in Nutrition, Translational Nutrition Neuroscience Working Group, Health Science Centre, Universidade Federal de Santa Catarina, Santa Catarina, Brazil
| | - Letícia Vicari Siqueira
- Postgraduate Program in Biological Science - Biochemistry, Basic Health Science Institute, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Alexandre P Müller
- Postgraduate Program in Pharmacology, Health Science Centre, Universidade Federal de Santa Catarina, Brazil
| | - Lisiane O Porciúncula
- Postgraduate Program in Biological Science - Biochemistry, Basic Health Science Institute, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Lúcia Vinadé
- Master Graduation Program in Biological Sciences (Programa de Pós-Graduação em Ciências Biológicas), Universidade Federal do Pampa - UNIPAMPA, Campus São Gabriel, São Gabriel, Brazil
| | - Diogo O Souza
- Postgraduate Program in Biological Science - Biochemistry, Basic Health Science Institute, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| |
Collapse
|
12
|
Huebschman JL, Hodges SL, Reynolds CD, Nolan SO, Lugo JN. A single episode of early-life status epilepticus impacts neonatal ultrasonic vocalization behavior in the Fmr1 knockout mouse. Epilepsy Behav 2020; 111:107279. [PMID: 32693376 PMCID: PMC7541794 DOI: 10.1016/j.yebeh.2020.107279] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 06/17/2020] [Accepted: 06/19/2020] [Indexed: 10/23/2022]
Abstract
Fragile X syndrome (FXS) is a genetic disorder caused by a trinucleotide (CGG) expansion mutation in the Fmr1 gene located on the X chromosome. It is characterized by hyperactivity, increased anxiety, repetitive-stereotyped behaviors, and impaired language development. Many children diagnosed with FXS also experience seizures during their lifetime. However, the underlying etiology of the relationship between FXS and epilepsy is not fully understood. Ultrasonic vocalizations (UVs) are one tool that may be used to measure early behavioral changes in mouse pups. In the present study, neonatal UVs were analyzed as a measure of communicative behavior in a mouse model of FXS, both with and without early-life seizures (ELSs). On postnatal day (PD) 10, status epilepticus (SE) was induced via intraperitoneal injections of 0.5% kainic acid (2.0 mg/kg) in male Fmr1 knockout (KO) and wild-type (WT) mice. On PD 12, all pups were temporarily isolated from their dam and UVs were recorded. Significant alterations were found in both spectral and temporal measures across genotype and seizure groups. Early-life seizure experience resulted in a significant increase in the quantity of UVs only in WT animals (p < 0.05). We also found that while there was no difference between genotypes in the total number of vocalizations made, calls produced by Fmr1 KO mice were significantly shorter and had a higher peak frequency compared with WT mice. Overall, these findings support the use of vocalization behavior as an early phenotypic marker and highlight the importance of utilizing double-hit models to better understand comorbid disorders.
Collapse
Affiliation(s)
- Jessica L Huebschman
- Institute for Neuroscience, Texas A&M University, College Station, TX 77843, USA
| | - Samantha L Hodges
- Institute of Biomedical Studies, Baylor University, Waco, TX 76798, USA
| | - Conner D Reynolds
- Texas College of Osteopathic Medicine, University of North Texas Health Science Center, Fort Worth, TX 76107, USA
| | - Suzanne O Nolan
- Department of Pharmacology, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Joaquin N Lugo
- Institute of Biomedical Studies, Baylor University, Waco, TX 76798, USA; Department of Psychology and Neuroscience, Baylor University, Waco, TX 76798, USA; Department of Biology, Baylor University, Waco, TX 76798, USA.
| |
Collapse
|
13
|
Abstract
Epilepsy and autism frequently co-occur. Epilepsy confers an increased risk of autism and autism confers an increased risk of epilepsy. Specific epilepsy syndromes, intellectual disability, and female gender present a particular risk of autism in individuals with epilepsy. Epilepsy and autism are likely to share common etiologies, which predispose individuals to either or both conditions. Genetic factors, metabolic disorders, mitochondrial disorders, and immune dysfunction all can be implicated.
Collapse
Affiliation(s)
- Frank M C Besag
- East London NHS Foundation Trust, 5-7 Rush Court, Bedford MK40 3JT, UK; University College London, London, UK; King's College London, London, UK.
| | - Michael J Vasey
- East London NHS Foundation Trust, 5-7 Rush Court, Bedford MK40 3JT, UK
| |
Collapse
|
14
|
Pacífico AM, Batista SP, Ribeiro FT, Santos PBD, Silveira GB, Pedrico do Nascimento BP, Junior ED, Barbosa GHL, Ribeiro MO, da Silva SG, Cysneiros RM. Dataset on sociability, cognitive function, gene and protein expression of molecules involved in social behavior, reward system and synapse function following early-life status epilepticus in Wistar rats. Data Brief 2020; 31:105819. [PMID: 32596424 PMCID: PMC7306614 DOI: 10.1016/j.dib.2020.105819] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 06/01/2020] [Accepted: 06/02/2020] [Indexed: 01/30/2023] Open
Abstract
Early-life status epilepticus produces deficit in social interaction and vocalization, enhances anxiety, no cognitive impairment and alters functional connectivity within the hippocampus (CA3-CA1) and between the hippocampus and prefrontal cortex [1], [2], [3], [4], [5], [6], [7], [8], [9], [10], [11], [12], but the underlying mechanisms remain unknown. This data article contains behavioral and molecular data of the adult male Wistar rats subjected to early life pilocarpine-induced seizures. Animal's behaviors were assessed to social memory and social motivation, working and reference memories and cognitive flexibility. The brain tissues (hypothalamus, hippocampus, amygdala, and striatum) were probed to gene and protein expression of molecules related to social behavior, reward system and synaptic function.
Collapse
Affiliation(s)
- Ana Miriã Pacífico
- Developmental Disabilities Graduate Program. Mackenzie Presbyterian University, São Paulo, Brazil. Rua da Consolação, 930. Prédio 28, CEP 01302-907 São Paulo, SP, Brazil
| | - Samuel P. Batista
- Developmental Disabilities Graduate Program. Mackenzie Presbyterian University, São Paulo, Brazil. Rua da Consolação, 930. Prédio 28, CEP 01302-907 São Paulo, SP, Brazil
| | - Fernanda T. Ribeiro
- Developmental Disabilities Graduate Program. Mackenzie Presbyterian University, São Paulo, Brazil. Rua da Consolação, 930. Prédio 28, CEP 01302-907 São Paulo, SP, Brazil
| | - Pedro B. dos Santos
- Developmental Disabilities Graduate Program. Mackenzie Presbyterian University, São Paulo, Brazil. Rua da Consolação, 930. Prédio 28, CEP 01302-907 São Paulo, SP, Brazil
| | - Gabriel Bruno Silveira
- Developmental Disabilities Graduate Program. Mackenzie Presbyterian University, São Paulo, Brazil. Rua da Consolação, 930. Prédio 28, CEP 01302-907 São Paulo, SP, Brazil
| | - Bruna Pascarelli Pedrico do Nascimento
- Developmental Disabilities Graduate Program. Mackenzie Presbyterian University, São Paulo, Brazil. Rua da Consolação, 930. Prédio 28, CEP 01302-907 São Paulo, SP, Brazil
| | - Eduardo Dias Junior
- Developmental Disabilities Graduate Program. Mackenzie Presbyterian University, São Paulo, Brazil. Rua da Consolação, 930. Prédio 28, CEP 01302-907 São Paulo, SP, Brazil
| | - Geraldo Henrique L. Barbosa
- Developmental Disabilities Graduate Program. Mackenzie Presbyterian University, São Paulo, Brazil. Rua da Consolação, 930. Prédio 28, CEP 01302-907 São Paulo, SP, Brazil
| | - Miriam Oliveira Ribeiro
- Developmental Disabilities Graduate Program. Mackenzie Presbyterian University, São Paulo, Brazil. Rua da Consolação, 930. Prédio 28, CEP 01302-907 São Paulo, SP, Brazil
| | - Sergio Gomes da Silva
- Hospital do Câncer de Muriaé - Fundação Cristiano Varella, Muriaé, Brazil
- Centro Universitário UNIFAMINAS, Muriaé, Brazil
| | - Roberta M. Cysneiros
- Developmental Disabilities Graduate Program. Mackenzie Presbyterian University, São Paulo, Brazil. Rua da Consolação, 930. Prédio 28, CEP 01302-907 São Paulo, SP, Brazil
- Corresponding author.
| |
Collapse
|
15
|
Hodges SL, Lugo JN. Therapeutic role of targeting mTOR signaling and neuroinflammation in epilepsy. Epilepsy Res 2020; 161:106282. [DOI: 10.1016/j.eplepsyres.2020.106282] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 01/03/2020] [Accepted: 01/29/2020] [Indexed: 02/08/2023]
|
16
|
Sun H, Takesian AE, Wang TT, Lippman-Bell JJ, Hensch TK, Jensen FE. Early Seizures Prematurely Unsilence Auditory Synapses to Disrupt Thalamocortical Critical Period Plasticity. Cell Rep 2019; 23:2533-2540. [PMID: 29847785 PMCID: PMC6446922 DOI: 10.1016/j.celrep.2018.04.108] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Revised: 01/02/2018] [Accepted: 04/25/2018] [Indexed: 12/31/2022] Open
Abstract
Heightened neural excitability in infancy and childhood results in increased susceptibility to seizures. Such early-life seizures are associated with language deficits and autism that can result from aberrant development of the auditory cortex. Here, we show that early-life seizures disrupt a critical period (CP) for tonotopic map plasticity in primary auditory cortex (A1). We show that this CP is characterized by a prevalence of “silent,” NMDA-receptor (NMDAR)-only, glutamate receptor synapses in auditory cortex that become “unsilenced” due to activity-dependent AMPA receptor (AMPAR) insertion. Induction of seizures prior to this CP occludes tonotopic map plasticity by prematurely unsilencing NMDAR-only synapses. Further, brief treatment with the AMPAR antagonist NBQX following seizures, prior to the CP, prevents synapse unsilencing and permits subsequent A1 plasticity. These findings reveal that early-life seizures modify CP regulators and suggest that therapeutic targets for early post-seizure treatment can rescue CP plasticity.
Collapse
Affiliation(s)
- Hongyu Sun
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA; Department of Neuroscience, Carleton University, Ottawa, ON K1S 5B6, Canada
| | - Anne E Takesian
- F.M. Kirby Neurobiology Center, Department of Neurology, Boston Children's Hospital, Harvard Medical School, 300 Longwood Ave., Boston, MA 02115, USA
| | - Ting Ting Wang
- Department of Neuroscience, Carleton University, Ottawa, ON K1S 5B6, Canada
| | - Jocelyn J Lippman-Bell
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Takao K Hensch
- F.M. Kirby Neurobiology Center, Department of Neurology, Boston Children's Hospital, Harvard Medical School, 300 Longwood Ave., Boston, MA 02115, USA; Center for Brain Science, Department of Molecular & Cellular Biology, Harvard University, 52 Oxford St., Cambridge, MA 02138, USA.
| | - Frances E Jensen
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.
| |
Collapse
|
17
|
A single early-life seizure results in long-term behavioral changes in the adult Fmr1 knockout mouse. Epilepsy Res 2019; 157:106193. [PMID: 31520894 DOI: 10.1016/j.eplepsyres.2019.106193] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 08/06/2019] [Accepted: 08/28/2019] [Indexed: 12/20/2022]
Abstract
Fragile X syndrome (FXS) is the leading cause of inherited intellectual disability and a significant genetic contributor to Autism spectrum disorder. In addition to autistic-like phenotypes, individuals with FXS are subject to developing numerous comorbidities, one of the most prevalent being seizures. In the present study, we investigated how a single early-life seizure superimposed on a genetic condition impacts the autistic-like behavioral phenotype of the mouse. We induced status epilepticus (SE) on postnatal day (PD) 10 in Fmr1 wild type (WT) and knockout (KO) mice. We then tested the mice in a battery of behavioral tests during adulthood (PD90) to examine the long-term impact of an early-life seizure. Our findings replicated prior work that reported a single instance of SE results in behavioral deficits, including increases in repetitive behavior, enhanced hippocampal-dependent learning, and reduced sociability and prepulse inhibition (p < 0.05). We also observed genotypic differences characteristic of the FXS phenotype in Fmr1 KO mice, such as enhanced prepulse inhibition and repetitive behavior, hyperactivity, and reduced startle responses (p < 0.05). Superimposing a seizure on deletion of Fmr1 significantly impacted repetitive behavior in a nosepoke task. Specifically, a single early-life seizure increased consecutive nose poking behavior in the task in WT mice (p < 0.05), yet seizures did not exacerbate the elevated stereotypy observed in Fmr1 KO mice (p > 0.05). Overall, these findings help to elucidate how seizures in a critical period of development can impact long-term behavioral manifestations caused by underlying gene mutations in Fmr1. Utilizing double-hit models, such as superimposing seizures on the Fmr1 mutation, can help to enhance our understanding of comorbidities in disease models.
Collapse
|
18
|
Comorbidities of early-onset temporal epilepsy: Cognitive, social, emotional, and morphologic dimensions. Exp Neurol 2019; 320:113005. [PMID: 31278943 DOI: 10.1016/j.expneurol.2019.113005] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Revised: 04/16/2019] [Accepted: 07/02/2019] [Indexed: 02/06/2023]
Abstract
Epilepsy, the most common neurologic disorder in childhood, is associated with a subset of psychiatric dysfunctions, including cognitive deficits, and alterations in emotionality (e.g., anxiety and depression) and social functioning. In the present study, we evaluated an integrative set of behavioral responses, including cognitive/socio-cognitive and emotional dimensions, using a number of behavioral paradigms in the LiCl/pilocarpine model of status epilepticus (SE) in rats. The aims of the study were to examine whether SE affects: 1) non-associative learning (habituation of exploratory behavior); 2) investigatory response to an indifferent stimulus object; 3) sociability/social novelty preference; 4) social recognition or discrimination; and 4) short- and long-term memory in the Morris water maze (MWM). Finally, we investigated the morphology of key brain structures involved in the examined behavioral dysfunctions. SE did not affect habituation to an open-field arena in juvenile (P25), adolescent (P32), or adult (P80) rats. SE rats spent less time in the central part of the arena. SE adolescent rats (P32) displayed a higher number of rearings with a shorter duration. SE rats displayed a markedly attenuated investigatory response to an indifferent stimulus object. SE rats in all age groups demonstrated pronounced deficits in sociability and the preference for social novelty. In addition, SE rats spent a reduced amount of time investigating a juvenile rat upon first exposure. After 30 min re-exposure together with an additional, novel juvenile, the SE rats spent equal time investigating both juveniles. In the MWM task, acquisition was unimpaired but there was a deficit in delayed memory retention after 10 days. SE did not affect cognitive flexibility expressed by reversal learning. Together, these findings suggest that early-life SE leads to alterations in emotional/anxiety-related behavior and affects sociability/preference for social novelty and social discrimination. Early-life SE did not alter acquisition of spatial learning, but it impaired delayed retention. Using Fluoro Jade B staining performed 24 h after SE revealed apparent neurodegeneration in the dorsal hippocampus, mediodorsal thalamic nucleus and medial amygdala, brain areas that are critically involved in network underlying emotional behavior and cognitive functions.
Collapse
|
19
|
Medlej Y, Salah H, Wadi L, Saad S, Bashir B, Allam J, Atoui Z, Darwish N, Karnib N, Darwish H, Kobeissy F, Wang KKW, Hamade E, Obeid M. Lestaurtinib (CEP-701) modulates the effects of early life hypoxic seizures on cognitive and emotional behaviors in immature rats. Epilepsy Behav 2019; 92:332-340. [PMID: 30769278 DOI: 10.1016/j.yebeh.2019.01.023] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 01/17/2019] [Accepted: 01/18/2019] [Indexed: 11/30/2022]
Abstract
Hypoxic encephalopathy of the newborn is a major cause of long-term neurological sequelae. We have previously shown that CEP-701 (lestaurtinib), a drug with an established safety profile in children, attenuates short-term hyperexcitability and tropomyosin-related kinase B (TrkB) receptor activation in a well-established rat model of early life hypoxic seizures (HS). Here, we investigated the potential long-term neuroprotective effects of a post-HS transient CEP-701 treatment. Following exposure to global hypoxia, 10 day old male Sprague-Dawley pups received CEP-701 or its vehicle and were sequentially subjected to the light-dark box test (LDT), forced swim test (FST), open field test (OFT), Morris water maze (MWM), and the modified active avoidance (MAAV) test between postnatal days 24 and 44 (P24-44). Spontaneous seizure activity was assessed by epidural cortical electroencephalography (EEG) between P50 and 100. Neuronal density and glial fibrillary acidic protein (GFAP) levels were evaluated on histological sections in the hippocampus, amygdala, and prefrontal cortex at P100. Vehicle-treated hypoxic rats exhibited significantly increased immobility in the FST compared with controls, and post-HS CEP-701 administration reversed this HS-induced depressive-like behavior (p < 0.05). In the MAAV test, CEP-701-treated hypoxic rats were slower at learning both context-cued and tone-signaled shock-avoidance behaviors (p < 0.05). All other behavioral outcomes were comparable, and no recurrent seizures, neuronal loss, or increase in GFAP levels were detected in any of the groups. We showed that early life HS predispose to long-lasting depressive-like behaviors, and that these are prevented by CEP-701, likely via TrkB modulation. Future mechanistically more specific studies will further investigate the potential role of TrkB signaling pathway modulation in achieving neuroprotection against neonatal HS, without causing neurodevelopmental adverse effects.
Collapse
Affiliation(s)
- Yasser Medlej
- Department of Anatomy, Cell biology and Physiological Sciences, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Houssein Salah
- Department of Anatomy, Cell biology and Physiological Sciences, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Lara Wadi
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Sarah Saad
- Faculty of Arts and Sciences, American University of Beirut, Lebanon
| | - Bashir Bashir
- Faculty of Arts and Sciences, American University of Beirut, Lebanon
| | - Jad Allam
- Faculty of Arts and Sciences, American University of Beirut, Lebanon
| | - Zahraa Atoui
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Nora Darwish
- Faculty of Arts and Sciences, American University of Beirut, Lebanon
| | - Nabil Karnib
- Department of Anatomy, Cell biology and Physiological Sciences, Faculty of Medicine, American University of Beirut, Beirut, Lebanon; Department of Natural Sciences, School of Arts and Sciences, Lebanese American University, Lebanon
| | - Hala Darwish
- Department of Anatomy, Cell biology and Physiological Sciences, Faculty of Medicine, American University of Beirut, Beirut, Lebanon; Rafic Hariri School of Nursing, American University of Beirut, Beirut, Lebanon
| | - Firas Kobeissy
- Department of Biochemistry and Molecular Genetics, Faculty of Medicine, American University of Beirut, Beirut, Lebanon; Program for Neurotrauma, Neuroproteomics, Department of Emergency Medicine, Department of Chemistry, Department of Neuroscience, and Department of Psychiatry, McKnight Brain Institute, University of Florida, Gainesville, FL, USA
| | - Kevin K W Wang
- Program for Neurotrauma, Neuroproteomics, Department of Emergency Medicine, Department of Chemistry, Department of Neuroscience, and Department of Psychiatry, McKnight Brain Institute, University of Florida, Gainesville, FL, USA
| | - Eva Hamade
- Department of Biochemistry, Faculty of Science, Lebanese University, Lebanon
| | - Makram Obeid
- Department of Anatomy, Cell biology and Physiological Sciences, Faculty of Medicine, American University of Beirut, Beirut, Lebanon; Division of Child Neurology, Department of Pediatric and Adolescent Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
| |
Collapse
|
20
|
Tran LH, Zupanc ML. Neurocognitive Comorbidities in Pediatric Epilepsy: Lessons in the Laboratory and Clinical Profile. Semin Pediatr Neurol 2017; 24:276-281. [PMID: 29249507 DOI: 10.1016/j.spen.2017.10.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Children with epilepsy are at risk for a variety of neurocognitive comorbidities. Animal models have increased our understanding about the neurobiological mechanisms underlying the association between seizures and these comorbidities. This article starts with an overview of the current data on animal model research, studying the influence of early-life seizures, followed by a summary of potential cellular and molecular mechanisms by which seizures can affect cognitive development. We then describe specific abnormal neuropsychological profiles that accompany specific pediatric epilepsy syndromes. Finally, we offer a potential guideline to the treatment and management of children with epilepsy and its neurocognitive comorbidities.
Collapse
Affiliation(s)
- Lily H Tran
- Department of Pediatrics, Pediatric Comprehensive Epilepsy Program, University of California, Irvine, Children's Hospital of Orange County, Orange, CA.
| | - Mary L Zupanc
- Department of Pediatrics and Neurology, University of California, Irvine, Children's Hospital of Orange County, Orange, CA
| |
Collapse
|
21
|
Mazarati AM, Lewis ML, Pittman QJ. Neurobehavioral comorbidities of epilepsy: Role of inflammation. Epilepsia 2017; 58 Suppl 3:48-56. [DOI: 10.1111/epi.13786] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/20/2017] [Indexed: 12/28/2022]
Affiliation(s)
- Andrey M. Mazarati
- Neurology Division; Department of Pediatrics; David Geffen School of Medicine; University of California Los Angeles; Los Angeles California U.S.A
| | - Megan L. Lewis
- Department of Physiology & Pharmacology; Hotchkiss Brain Institute; University of Calgary; Calgary Alberta Canada
| | - Quentin J. Pittman
- Department of Physiology & Pharmacology; Hotchkiss Brain Institute; University of Calgary; Calgary Alberta Canada
| |
Collapse
|
22
|
Barbosa GHL, Batista SP, Dos Santos PB, Thomaz CRC, Scorza FA, Cysneiros RM. Single neonatal status epilepticus does not impair cognitive function in rats. Epilepsy Behav 2017. [PMID: 28624510 DOI: 10.1016/j.yebeh.2017.04.031] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Geraldo H L Barbosa
- Developmental Disabilities Graduate Program, Laboratory of Neurobiology, Mackenzie Presbyterian University, São Paulo, Brazil
| | - Samuel P Batista
- Developmental Disabilities Graduate Program, Laboratory of Neurobiology, Mackenzie Presbyterian University, São Paulo, Brazil
| | - Pedro B Dos Santos
- Developmental Disabilities Graduate Program, Laboratory of Neurobiology, Mackenzie Presbyterian University, São Paulo, Brazil
| | - Cássia R C Thomaz
- Developmental Disabilities Graduate Program, Laboratory of Neurobiology, Mackenzie Presbyterian University, São Paulo, Brazil
| | - Fulvio A Scorza
- Experimental Neurology, Federal University of São Paulo, Brazil
| | - Roberta M Cysneiros
- Developmental Disabilities Graduate Program, Laboratory of Neurobiology, Mackenzie Presbyterian University, São Paulo, Brazil.
| |
Collapse
|
23
|
Singh R, Turner RC, Nguyen L, Motwani K, Swatek M, Lucke-Wold BP. Pediatric Traumatic Brain Injury and Autism: Elucidating Shared Mechanisms. Behav Neurol 2016; 2016:8781725. [PMID: 28074078 PMCID: PMC5198096 DOI: 10.1155/2016/8781725] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2016] [Accepted: 11/23/2016] [Indexed: 02/08/2023] Open
Abstract
Pediatric traumatic brain injury (TBI) and autism spectrum disorder (ASD) are two serious conditions that affect youth. Recent data, both preclinical and clinical, show that pediatric TBI and ASD share not only similar symptoms but also some of the same biologic mechanisms that cause these symptoms. Prominent symptoms for both disorders include gastrointestinal problems, learning difficulties, seizures, and sensory processing disruption. In this review, we highlight some of these shared mechanisms in order to discuss potential treatment options that might be applied for each condition. We discuss potential therapeutic and pharmacologic options as well as potential novel drug targets. Furthermore, we highlight advances in understanding of brain circuitry that is being propelled by improved imaging modalities. Going forward, advanced imaging will help in diagnosis and treatment planning strategies for pediatric patients. Lessons from each field can be applied to design better and more rigorous trials that can be used to improve guidelines for pediatric patients suffering from TBI or ASD.
Collapse
Affiliation(s)
- Rahul Singh
- Department of Neurosurgery, West Virginia University School of Medicine, Morgantown, WV 26505, USA
| | - Ryan C. Turner
- Department of Neurosurgery, West Virginia University School of Medicine, Morgantown, WV 26505, USA
| | - Linda Nguyen
- Department of Basic Pharmaceutical Sciences, West Virginia University School of Medicine, Morgantown, WV 26505, USA
| | - Kartik Motwani
- Department of Medical Sciences, University of Florida School of Medicine, Gainesville, FL 32611, USA
| | - Michelle Swatek
- Department of Psychology, North Carolina State University, Raleigh, NC 27695, USA
| | - Brandon P. Lucke-Wold
- Department of Neurosurgery, West Virginia University School of Medicine, Morgantown, WV 26505, USA
| |
Collapse
|
24
|
Sun H, Juul HM, Jensen FE. Models of hypoxia and ischemia-induced seizures. J Neurosci Methods 2015; 260:252-60. [PMID: 26434705 DOI: 10.1016/j.jneumeth.2015.09.023] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2015] [Accepted: 09/22/2015] [Indexed: 01/19/2023]
Abstract
Despite greater understanding and improved management, seizures continue to be a major problem in childhood. Neonatal seizures are often refractory to conventional antiepileptic drugs, and can result in later life epilepsy and cognitive deficits, conditions for which there are no specific treatments. Hypoxic and/or ischemic encephalopathy (HIE) is the most common cause for neonatal seizures, and accounts for more than two-thirds of neonatal seizure cases. A better understanding of the cellular and molecular mechanisms is essential for identifying new therapeutic strategies that control the neonatal seizures and its cognitive consequences. This heavily relies on animal models that play a critical role in discovering novel mechanisms underlying both epileptogenesis and associated cognitive impairments. To date, a number of animal models have provided a tremendous amount of information regarding the pathophysiology of HIE-induced neonatal seizures. This review provides an overview on the most important features of the main animal models of HIE-induced seizures. In particular, we focus on the methodology of seizure induction and the characterizations of post-HIE injury consequences. These aspects of HIE-induced seizure models are discussed in the light of the suitability of these models in studying human HIE-induced seizures.
Collapse
Affiliation(s)
- Hongyu Sun
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Halvor M Juul
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Frances E Jensen
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States.
| |
Collapse
|
25
|
Zhou C, Sun H, Klein PM, Jensen FE. Neonatal seizures alter NMDA glutamate receptor GluN2A and 3A subunit expression and function in hippocampal CA1 neurons. Front Cell Neurosci 2015; 9:362. [PMID: 26441533 PMCID: PMC4585040 DOI: 10.3389/fncel.2015.00362] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2015] [Accepted: 08/31/2015] [Indexed: 12/02/2022] Open
Abstract
Neonatal seizures are commonly caused by hypoxic and/or ischemic injury during birth and can lead to long-term epilepsy and cognitive deficits. In a rodent hypoxic seizure (HS) model, we have previously demonstrated a critical role for seizure-induced enhancement of the AMPA subtype of glutamate receptor (GluA) in epileptogenesis and cognitive consequences, in part due to GluA maturational upregulation of expression. Similarly, as the expression and function of the N-Methyl-D-aspartate (NMDA) subtype of glutamate receptor (GluN) is also developmentally controlled, we examined how early life seizures during the critical period of synaptogenesis could modify GluN development and function. In a postnatal day (P)10 rat model of neonatal seizures, we found that seizures could alter GluN2/3 subunit composition of GluNs and physiological function of synaptic GluNs. In hippocampal slices removed from rats within 48–96 h following seizures, the amplitudes of synaptic GluN-mediated evoked excitatory postsynaptic currents (eEPSCs) were elevated in CA1 pyramidal neurons. Moreover, GluN eEPSCs showed a decreased sensitivity to GluN2B selective antagonists and decreased Mg2+ sensitivity at negative holding potentials, indicating a higher proportion of GluN2A and GluN3A subunit function, respectively. These physiological findings were accompanied by a concurrent increase in GluN2A phosphorylation and GluN3A protein. These results suggest that altered GluN function and expression could potentially contribute to future epileptogenesis following neonatal seizures, and may represent potential therapeutic targets for the blockade of future epileptogenesis in the developing brain.
Collapse
Affiliation(s)
- Chengwen Zhou
- Department of Neurology, Division of Neuroscience, Boston Children's Hospital Boston, MA, USA ; Program in Neurobiology, Harvard Medical School Boston, MA, USA
| | - Hongyu Sun
- Department of Neurology, Division of Neuroscience, Boston Children's Hospital Boston, MA, USA ; Program in Neurobiology, Harvard Medical School Boston, MA, USA ; Department of Neurology, Perelman School of Medicine, University of Pennsylvania Philadelphia, PA, USA
| | - Peter M Klein
- Department of Neurology, Division of Neuroscience, Boston Children's Hospital Boston, MA, USA
| | - Frances E Jensen
- Department of Neurology, Division of Neuroscience, Boston Children's Hospital Boston, MA, USA ; Program in Neurobiology, Harvard Medical School Boston, MA, USA ; Department of Neurology, Perelman School of Medicine, University of Pennsylvania Philadelphia, PA, USA
| |
Collapse
|
26
|
Stafstrom CE, Benke TA. Autism and Epilepsy: Exploring the Relationship Using Experimental Models. Epilepsy Curr 2015; 15:206-10. [PMID: 26316869 PMCID: PMC4532234 DOI: 10.5698/1535-7511-15.4.206] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
The common co-occurrence of autism and epilepsy suggests that certain neurobiological mechanisms are shared between these disorders. In particular, the profusion of novel genetic mutations being discovered in autism and epilepsy points to abnormalities in synapse formation and function that alter the balance between neuronal excitation and inhibition. Animal models can be informative in sorting out the medical and behavioral complexities in autism and epilepsy and the relationship between them. As mechanistic information accrues, it is anticipated that mutation- and pathway-specific targeted treatments can be developed.
Collapse
Affiliation(s)
- Carl E. Stafstrom
- Division of Pediatric Neurology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Tim A. Benke
- Division of Pediatric Neurology, University of Colorado, School of Medicine, Children's Hospital Colorado, Aurora, CO
| |
Collapse
|
27
|
Bernard PB, Castano AM, Beitzel CS, Carlson VB, Benke TA. Behavioral changes following a single episode of early-life seizures support the latent development of an autistic phenotype. Epilepsy Behav 2015; 44:78-85. [PMID: 25659043 PMCID: PMC4405461 DOI: 10.1016/j.yebeh.2015.01.006] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2014] [Revised: 01/06/2015] [Accepted: 01/07/2015] [Indexed: 01/23/2023]
Abstract
We probed the developmental and behavioral consequences of a single episode of kainic acid-induced early-life seizures (KA-ELS) in the rat on postnatal day 7. Correlates of developmental trajectory were not altered, demonstrating that long-term consequences following KA-ELS are not initiated by secondary causes, such as malnourishment or alterations in maternal care. We report reduced marble burying in adult rats, suggestive of restricted interests, a trait common to experimental and clinical autism. We did not detect increased repetitive grooming during habituated cage behavior. However, we did detect reduced grooming in adult KA-ELS rats in the presence of an unfamiliar rat, supporting altered social anxiety following KA-ELS. Reanalysis of a social approach task further indicated abnormal social interactions. Taken together with previous physiological and behavioral data, these data support the hypothesis that KA-ELS lead to a latent autistic phenotype in adult rats not attributable to other early alterations in development.
Collapse
Affiliation(s)
- Paul B Bernard
- Department of Pediatrics, University of Colorado, School of Medicine, USA
| | - Anna M Castano
- Department of Pediatrics, University of Colorado, School of Medicine, USA
| | - Christy S Beitzel
- Department of Neuroscience Graduate Program, University of Colorado, School of Medicine, USA
| | - Vivian B Carlson
- Department of Pediatrics, University of Colorado, School of Medicine, USA
| | - Tim A Benke
- Department of Pediatrics, University of Colorado, School of Medicine, USA; Department of Neuroscience Graduate Program, University of Colorado, School of Medicine, USA; Department of Neurology, University of Colorado, School of Medicine, USA; Department of Pharmacology, University of Colorado, School of Medicine, USA; Department of Otolaryngology, University of Colorado, School of Medicine, USA.
| |
Collapse
|
28
|
Kang SK, Kadam SD. Neonatal Seizures: Impact on Neurodevelopmental Outcomes. Front Pediatr 2015; 3:101. [PMID: 26636052 PMCID: PMC4655485 DOI: 10.3389/fped.2015.00101] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Accepted: 11/05/2015] [Indexed: 11/24/2022] Open
Abstract
Neonatal period is the most vulnerable time for the occurrence of seizures, and neonatal seizures often pose a clinical challenge both for their acute management and frequency of associated long-term co-morbidities. Etiologies of neonatal seizures are known to play a primary role in the anti-epileptic drug responsiveness and the long-term sequelae. Recent studies have suggested that burden of acute recurrent seizures in neonates may also impact chronic outcomes independent of the etiology. However, not many studies, either clinical or pre-clinical, have addressed the long-term outcomes of neonatal seizures in an etiology-specific manner. In this review, we briefly review the available clinical and pre-clinical research for long-term outcomes following neonatal seizures. As the most frequent cause of acquired neonatal seizures, we focus on the studies evaluating long-term effects of HIE-seizures with the goal to evaluate (1) what parameters evaluated during acute stages of neonatal seizures can reliably be used to predict long-term outcomes? and (2) what available clinical and pre-clinical data are available help determine importance of etiology vs. seizure burdens in long-term sequelae.
Collapse
Affiliation(s)
- Seok Kyu Kang
- Neuroscience Laboratory, Hugo Moser Research Institute at Kennedy Krieger , Baltimore, MD , USA
| | - Shilpa D Kadam
- Neuroscience Laboratory, Hugo Moser Research Institute at Kennedy Krieger , Baltimore, MD , USA ; Department of Neurology, Johns Hopkins University School of Medicine , Baltimore, MD , USA
| |
Collapse
|