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Kim JE, Park H, Kang TC. Peroxiredoxin 6 Regulates Glutathione Peroxidase 1-Medited Glutamine Synthase Preservation in the Hippocampus of Chronic Epilepsy Rats. Antioxidants (Basel) 2023; 12:antiox12010156. [PMID: 36671018 PMCID: PMC9855017 DOI: 10.3390/antiox12010156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 01/03/2023] [Accepted: 01/05/2023] [Indexed: 01/11/2023] Open
Abstract
Clasmatodendrosis (an autophagic astroglial degeneration) plays an important role in the regulation of spontaneous seizure duration but not seizure frequency or behavioral seizure severity in chronic epilepsy rats. Recently, it has been reported that N-acetylcysteine (NAC), a precursor to glutathione (GSH), attenuates clasmatodendritic degeneration and shortens spontaneous seizure duration in chronic epilepsy rats, although the underlying mechanisms of its anti-convulsive effects are not fully understood. To elucidate this, the present study was designed to investigate whether NAC affects astroglial glutamine synthase (GS) expression mediated by GSH peroxidase 1 (GPx1) and/or peroxiredoxin 6 (Prdx6) in the epileptic hippocampus. As compared to control animals, GS and GPx1 expressions were upregulated in reactive CA1 astrocytes of chronic epilepsy rats, while their expressions were significantly decreased in clasmatodendritic CA1 astrocytes and reactive astrocytes within the molecular layer of the dentate gyrus. Prdx6 expression was increased in reactive CA1 astrocytes as well as clasmatodendritic CA1 astrocytes. In the molecular layer of the dentate gyrus, Prdx6 expression levels were similar to those in control animals. NAC ameliorated clasmatodendrosis through the increment of GS and GPx1 expressions, while it abolished Prdx6 upregulation. 1-hexadecyl-3-(trifluoroethgl)-sn-glycerol-2 phosphomethanol (MJ33, a selective inhibitor of aiPLA2 activity of Prdx6) alleviated clasmatodendrosis by enhancing GPx1 and GS expressions in clasmatodendritic CA1 astrocytes without changing the Prdx6 level. NAC or MJ33 did not affect GS, GPx1 and Prdx6 expression in astrocytes within the molecular layer of the dentate gyrus. These findings indicate that upregulated aiPLA2 activity of Prdx6 may abolish GPx1-mediated GS preservation and lead to clasmatodendrosis in CA1 astrocytes, which would extend spontaneous seizure duration due to impaired glutamate-glutamine conversion regulated by GS. Therefore, the present data suggest that aiPLA2 activity of Prdx6 in astrocytes may be one of the upstream effectors of seizure duration in the epileptic hippocampus.
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Affiliation(s)
- Ji-Eun Kim
- Department of Anatomy and Neurobiolog, College of Medicine, Hallym University, Chuncheon 24252, Republic of Korea
- Institute of Epilepsy Research, Hallym University, Chuncheon 24252, Republic of Korea
| | - Hana Park
- Department of Anatomy and Neurobiolog, College of Medicine, Hallym University, Chuncheon 24252, Republic of Korea
- Institute of Epilepsy Research, Hallym University, Chuncheon 24252, Republic of Korea
| | - Tae-Cheon Kang
- Department of Anatomy and Neurobiolog, College of Medicine, Hallym University, Chuncheon 24252, Republic of Korea
- Institute of Epilepsy Research, Hallym University, Chuncheon 24252, Republic of Korea
- Correspondence: ; Tel.: +82-33-248-2524; Fax: +82-33-248-2525
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Dhaher R, Bronen RA, Spencer L, Colic L, Brown F, Mian A, Sandhu M, Pittman B, Spencer D, Blumberg HP, Altalib H. The Dorsal Bed Nucleus of the Stria Terminalis in Depressed and Non-Depressed Temporal Lobe Epilepsy Patients. Epilepsia 2022; 63:2561-2570. [PMID: 35883245 DOI: 10.1111/epi.17377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 07/25/2022] [Accepted: 07/25/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Temporal lobe epilepsy (TLE) and depression are common comorbid disorders whose underlying shared neural network has yet to be determined. While animal studies demonstrate a role for the dorsal bed nucleus of the stria terminalis (dBNST) in both seizures and depression, and humans clinical studies demonstrate a therapeutic effect of stimulating this region on treatment-resistant depression, the role for the dBNST in depressed and non-depressed TLE patients is still unclear. Here, we tested the hypothesis that this structure is morphologically abnormal in these epilepsy patients, with an increased abnormality in TLE patients with comorbid depression. METHODS In this case-controlled study, three Tesla structural magnetic resonance imaging scans were obtained from TLE patients with no depression (TLEonly), with depression (TLEdep) and healthy comparison subjects (HC). TLE subjects were recruited from the Yale University Comprehensive Epilepsy Center, diagnosed with the International League Against Epilepsy 2014 Diagnostic Guidelines, and confirmed by video electroencephalography. Diagnosis of major depressive disorder was confirmed by a trained neuropsychologist through a Mini International Neuropsychiatric Interview based on the DSM-IV. The dBNST was delineated manually by reliable raters using Bioimage Suite software. RESULTS The number of patients and subjects included 35 TLEonly patients, 20 TLEdep patients, and 102 HC subjects. Both TLEonly and TLEdep patients had higher dBNST volumes compared to HC subjects, unilaterally in the left hemisphere in the TLEonly patients (p=0.003), and bilaterally in the TLEdep patients (p<0·0001). Furthermore, the TLEdep patients had a higher dBNST volume than the TLEonly patients in the right hemisphere (p=0.02). SIGNIFICANCE Here we demonstrate an abnormality of the dBNST in TLE patients, both without depression (left enlargement) and with depression (bilateral enlargement). Our results demonstrate this region to underlie both temporal lobe epilepsy with and without depression, implicating it as a target to treat the comorbidity between these two disorders.
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Affiliation(s)
- Roni Dhaher
- Department of Neurosurgery, Yale School of Medicine, New Haven, CT, USA
| | - Richard A Bronen
- Department of Neurosurgery, Yale School of Medicine, New Haven, CT, USA.,Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT, USA
| | - Linda Spencer
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Lejla Colic
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA.,Department of Psychiatry and Psychotherapy, University Hospital Jena, Jena, Germany.,Center for Intervention and Research on adaptive and maladaptive brain Circuits underlying mental health, Jena, Germany
| | - Franklin Brown
- Department of Neurology, Yale School of Medicine, New Haven, CT, USA
| | - Ali Mian
- Department of Radiology, Washington University School of Medicine, St Louis, MI, USA
| | - Mani Sandhu
- Department of Laboratory Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Brian Pittman
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Dennis Spencer
- Department of Neurosurgery, Yale School of Medicine, New Haven, CT, USA
| | - Hilary P Blumberg
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA.,Child Study Center, Yale School of Medicine, New Haven, CT, USA.,Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT, USA
| | - Hamada Altalib
- Department of Neurology, Yale School of Medicine, New Haven, CT, USA
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Dhaher R, Chen EC, Perez E, Rapuano A, Sandhu MRS, Gruenbaum SE, Deshpande K, Dai F, Zaveri HP, Eid T. Oral glutamine supplementation increases seizure severity in a rodent model of mesial temporal lobe epilepsy. Nutr Neurosci 2022; 25:64-69. [PMID: 31900092 PMCID: PMC8970572 DOI: 10.1080/1028415x.2019.1708568] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Background: Glutamine synthetase (GS) is the only enzyme known to synthesize significant amounts of glutamine in mammals, and loss of GS in the hippocampus has been implicated in the pathophysiology of medication refractory mesial temporal lobe epilepsy (MTLE). Moreover, loss-of-function mutations of the GS gene causes severe epileptic encephalopathy, and supplementation with glutamine has been shown to normalize EEG and possibly improve the outcome in these patients. Here we examined whether oral glutamine supplementation is an effective treatment for MTLE by assessing the frequency and severity of seizures after supplementation in a translationally relevant model of the disease.Methods: Male Sprague Dawley rats (380-400 g) were allowed to drink unlimited amounts of glutamine in water (3.6% w/v; n = 8) or pure water (n = 8) for several weeks. Ten days after the start of glutamine supplementation, GS was chronically inhibited in the hippocampus to induce MTLE. Continuous video-intracranial EEG was collected for 21 days to determine the frequency and severity of seizures.Results: While there was no change in seizure frequency between the groups, the proportion of convulsive seizures was significantly higher in glutamine treated animals during the first three days of GS inhibition.Conclusion: The results suggest that oral glutamine supplementation transiently increases seizure severity in the initial stages of an epilepsy model, indicating a potential role of the amino acid in seizure propagation and epileptogenesis.
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Affiliation(s)
- Roni Dhaher
- Department of Neurosurgery, Yale School of Medicine, New Haven, CT 06520, USA,Correspondence Roni Dhaher, PhD, Associate Research Scientist in Neurosurgery, Yale School of Medicine, 330 Cedar St., P.O. Box 208035, New Haven, CT 06520-8035, USA, Fax: +1-203-688-8597,
| | - Eric C. Chen
- Department of Laboratory Medicine, Yale School of Medicine, New Haven, CT 06520, USA
| | - Edgar Perez
- Department of Laboratory Medicine, Yale School of Medicine, New Haven, CT 06520, USA
| | - Amedeo Rapuano
- Department of Neurosurgery, Yale School of Medicine, New Haven, CT 06520, USA
| | | | - Shaun E. Gruenbaum
- Department of Anesthesiology, Yale School of Medicine, New Haven, CT 06520, USA
| | - Ketaki Deshpande
- Department of Laboratory Medicine, Yale School of Medicine, New Haven, CT 06520, USA
| | - Feng Dai
- Department of Biostatistics, Yale School of Medicine, New Haven, CT 06520, USA
| | - Hitten P. Zaveri
- Department of Neurology, Yale School of Medicine, New Haven, CT 06520, USA
| | - Tore Eid
- Department of Laboratory Medicine, Yale School of Medicine, New Haven, CT 06520, USA
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Inhibition of Glutamate Release, but Not of Glutamine Recycling to Glutamate, Is Involved in Delaying the Onset of Initial Lithium-Pilocarpine-Induced Seizures in Young Rats by a Non-Convulsive MSO Dose. Int J Mol Sci 2021; 22:ijms222011127. [PMID: 34681786 PMCID: PMC8536987 DOI: 10.3390/ijms222011127] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 10/08/2021] [Accepted: 10/12/2021] [Indexed: 12/12/2022] Open
Abstract
Initial seizures observed in young rats during the 60 min after administration of pilocarpine (Pilo) were delayed and attenuated by pretreatment with a non-convulsive dose of methionine sulfoximine (MSO). We hypothesized that the effect of MSO results from a) glutamine synthetase block-mediated inhibition of conversion of Glu/Gln precursors to neurotransmitter Glu, and/or from b) altered synaptic Glu release. Pilo was administered 60 min prior to sacrifice, MSO at 75 mg/kg, i.p., 2.5 h earlier. [1,2-13C]acetate and [U-13C]glucose were i.p.-injected either together with Pilo (short period) or 15 min before sacrifice (long period). Their conversion to Glu and Gln in the hippocampus and entorhinal cortex was followed using [13C] gas chromatography-mass spectrometry. Release of in vitro loaded Glu surrogate, [3H]d-Asp from ex vivo brain slices was monitored in continuously collected superfusates. [3H]d-Asp uptake was tested in freshly isolated brain slices. At no time point nor brain region did MSO modify incorporation of [13C] to Glu or Gln in Pilo-treated rats. MSO pretreatment decreased by ~37% high potassium-induced [3H]d-Asp release, but did not affect [3H]d-Asp uptake. The results indicate that MSO at a non-convulsive dose delays the initial Pilo-induced seizures by interfering with synaptic Glu-release but not with neurotransmitter Glu recycling.
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Sandhu MRS, Gruenbaum BF, Gruenbaum SE, Dhaher R, Deshpande K, Funaro MC, Lee TSW, Zaveri HP, Eid T. Astroglial Glutamine Synthetase and the Pathogenesis of Mesial Temporal Lobe Epilepsy. Front Neurol 2021; 12:665334. [PMID: 33927688 PMCID: PMC8078591 DOI: 10.3389/fneur.2021.665334] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Accepted: 03/19/2021] [Indexed: 12/21/2022] Open
Abstract
The enzyme glutamine synthetase (GS), also referred to as glutamate ammonia ligase, is abundant in astrocytes and catalyzes the conversion of ammonia and glutamate to glutamine. Deficiency or dysfunction of astrocytic GS in discrete brain regions have been associated with several types of epilepsy, including medically-intractable mesial temporal lobe epilepsy (MTLE), neocortical epilepsies, and glioblastoma-associated epilepsy. Moreover, experimental inhibition or deletion of GS in the entorhinal-hippocampal territory of laboratory animals causes an MTLE-like syndrome characterized by spontaneous, recurrent hippocampal-onset seizures, loss of hippocampal neurons, and in some cases comorbid depressive-like features. The goal of this review is to summarize and discuss the possible roles of astroglial GS in the pathogenesis of epilepsy.
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Affiliation(s)
| | - Benjamin F Gruenbaum
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Jacksonville, FL, United States
| | - Shaun E Gruenbaum
- Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Jacksonville, FL, United States
| | - Roni Dhaher
- Department of Neurosurgery, New Haven, CT, United States
| | | | - Melissa C Funaro
- Harvey Cushing/John Hay Whitney Medical Library, Yale University, New Haven, CT, United States
| | | | - Hitten P Zaveri
- Department of Neurology, Yale School of Medicine, New Haven, CT, United States
| | - Tore Eid
- Department of Laboratory Medicine, New Haven, CT, United States
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6
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Dhaher R, Gruenbaum SE, Sandhu MRS, Ottestad-Hansen S, Tu N, Wang Y, Lee TSW, Deshpande K, Spencer DD, Danbolt NC, Zaveri HP, Eid T. Network-Related Changes in Neurotransmitters and Seizure Propagation During Rodent Epileptogenesis. Neurology 2021; 96:e2261-e2271. [PMID: 33722994 PMCID: PMC8166437 DOI: 10.1212/wnl.0000000000011846] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 01/29/2021] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE To test the hypothesis that glutamate and GABA are linked to the formation of epilepsy networks and the triggering of spontaneous seizures, we examined seizure initiation/propagation characteristics and neurotransmitter levels during epileptogenesis in a translationally relevant rodent model of mesial temporal lobe epilepsy. METHODS The glutamine synthetase (GS) inhibitor methionine sulfoximine was infused into one of the hippocampi in laboratory rats to create a seizure focus. Long-term video-intracranial EEG recordings and brain microdialysis combined with mass spectrometry were used to examine seizure initiation, seizure propagation, and extracellular brain levels of glutamate and GABA. RESULTS All seizures (n = 78 seizures, n = 3 rats) appeared first in the GS-inhibited hippocampus of all animals, followed by propagation to the contralateral hippocampus. Propagation time decreased significantly from 11.65 seconds early in epileptogenesis (weeks 1-2) to 6.82 seconds late in epileptogenesis (weeks 3-4, paired t test, p = 0.025). Baseline extracellular glutamate levels were 11.6-fold higher in the hippocampus of seizure propagation (7.3 µM) vs the hippocampus of seizure onset (0.63 µM, analysis of variance/Fisher least significant difference, p = 0.01), even though the concentrations of the major glutamate transporter proteins excitatory amino acid transporter subtypes 1 and 2 and xCT were unchanged between the brain regions. Finally, extracellular GABA in the seizure focus decreased significantly from baseline several hours before a spontaneous seizure (paired t test/false discovery rate). CONCLUSION The changes in glutamate and GABA suggest novel and potentially important roles of the amino acids in epilepsy network formation and in the initiation and propagation of spontaneous seizures.
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Affiliation(s)
- Roni Dhaher
- From the Departments of Laboratory Medicine (R.D., M.R.S.S., N.T., Y.W., K.D., T.E.), Anesthesiology (S.E.G.), Neurosurgery (D.D.S.), Psychiatry (T.-S.W.L.), and Neurology (H.P.Z.), Yale School of Medicine, New Haven, CT; and Department of Molecular Medicine (S.O.-H., N.C.D.), Division of Anatomy, Institute for Basic Medical Sciences, University of Oslo, Norway
| | - Shaun E Gruenbaum
- From the Departments of Laboratory Medicine (R.D., M.R.S.S., N.T., Y.W., K.D., T.E.), Anesthesiology (S.E.G.), Neurosurgery (D.D.S.), Psychiatry (T.-S.W.L.), and Neurology (H.P.Z.), Yale School of Medicine, New Haven, CT; and Department of Molecular Medicine (S.O.-H., N.C.D.), Division of Anatomy, Institute for Basic Medical Sciences, University of Oslo, Norway
| | - Mani Ratnesh S Sandhu
- From the Departments of Laboratory Medicine (R.D., M.R.S.S., N.T., Y.W., K.D., T.E.), Anesthesiology (S.E.G.), Neurosurgery (D.D.S.), Psychiatry (T.-S.W.L.), and Neurology (H.P.Z.), Yale School of Medicine, New Haven, CT; and Department of Molecular Medicine (S.O.-H., N.C.D.), Division of Anatomy, Institute for Basic Medical Sciences, University of Oslo, Norway
| | - Sigrid Ottestad-Hansen
- From the Departments of Laboratory Medicine (R.D., M.R.S.S., N.T., Y.W., K.D., T.E.), Anesthesiology (S.E.G.), Neurosurgery (D.D.S.), Psychiatry (T.-S.W.L.), and Neurology (H.P.Z.), Yale School of Medicine, New Haven, CT; and Department of Molecular Medicine (S.O.-H., N.C.D.), Division of Anatomy, Institute for Basic Medical Sciences, University of Oslo, Norway
| | - Nathan Tu
- From the Departments of Laboratory Medicine (R.D., M.R.S.S., N.T., Y.W., K.D., T.E.), Anesthesiology (S.E.G.), Neurosurgery (D.D.S.), Psychiatry (T.-S.W.L.), and Neurology (H.P.Z.), Yale School of Medicine, New Haven, CT; and Department of Molecular Medicine (S.O.-H., N.C.D.), Division of Anatomy, Institute for Basic Medical Sciences, University of Oslo, Norway
| | - Yue Wang
- From the Departments of Laboratory Medicine (R.D., M.R.S.S., N.T., Y.W., K.D., T.E.), Anesthesiology (S.E.G.), Neurosurgery (D.D.S.), Psychiatry (T.-S.W.L.), and Neurology (H.P.Z.), Yale School of Medicine, New Haven, CT; and Department of Molecular Medicine (S.O.-H., N.C.D.), Division of Anatomy, Institute for Basic Medical Sciences, University of Oslo, Norway
| | - Tih-Shih W Lee
- From the Departments of Laboratory Medicine (R.D., M.R.S.S., N.T., Y.W., K.D., T.E.), Anesthesiology (S.E.G.), Neurosurgery (D.D.S.), Psychiatry (T.-S.W.L.), and Neurology (H.P.Z.), Yale School of Medicine, New Haven, CT; and Department of Molecular Medicine (S.O.-H., N.C.D.), Division of Anatomy, Institute for Basic Medical Sciences, University of Oslo, Norway
| | - Ketaki Deshpande
- From the Departments of Laboratory Medicine (R.D., M.R.S.S., N.T., Y.W., K.D., T.E.), Anesthesiology (S.E.G.), Neurosurgery (D.D.S.), Psychiatry (T.-S.W.L.), and Neurology (H.P.Z.), Yale School of Medicine, New Haven, CT; and Department of Molecular Medicine (S.O.-H., N.C.D.), Division of Anatomy, Institute for Basic Medical Sciences, University of Oslo, Norway
| | - Dennis D Spencer
- From the Departments of Laboratory Medicine (R.D., M.R.S.S., N.T., Y.W., K.D., T.E.), Anesthesiology (S.E.G.), Neurosurgery (D.D.S.), Psychiatry (T.-S.W.L.), and Neurology (H.P.Z.), Yale School of Medicine, New Haven, CT; and Department of Molecular Medicine (S.O.-H., N.C.D.), Division of Anatomy, Institute for Basic Medical Sciences, University of Oslo, Norway
| | - Niels Christian Danbolt
- From the Departments of Laboratory Medicine (R.D., M.R.S.S., N.T., Y.W., K.D., T.E.), Anesthesiology (S.E.G.), Neurosurgery (D.D.S.), Psychiatry (T.-S.W.L.), and Neurology (H.P.Z.), Yale School of Medicine, New Haven, CT; and Department of Molecular Medicine (S.O.-H., N.C.D.), Division of Anatomy, Institute for Basic Medical Sciences, University of Oslo, Norway
| | - Hitten P Zaveri
- From the Departments of Laboratory Medicine (R.D., M.R.S.S., N.T., Y.W., K.D., T.E.), Anesthesiology (S.E.G.), Neurosurgery (D.D.S.), Psychiatry (T.-S.W.L.), and Neurology (H.P.Z.), Yale School of Medicine, New Haven, CT; and Department of Molecular Medicine (S.O.-H., N.C.D.), Division of Anatomy, Institute for Basic Medical Sciences, University of Oslo, Norway
| | - Tore Eid
- From the Departments of Laboratory Medicine (R.D., M.R.S.S., N.T., Y.W., K.D., T.E.), Anesthesiology (S.E.G.), Neurosurgery (D.D.S.), Psychiatry (T.-S.W.L.), and Neurology (H.P.Z.), Yale School of Medicine, New Haven, CT; and Department of Molecular Medicine (S.O.-H., N.C.D.), Division of Anatomy, Institute for Basic Medical Sciences, University of Oslo, Norway.
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Binder DK, Steinhäuser C. Astrocytes and Epilepsy. Neurochem Res 2021; 46:2687-2695. [PMID: 33661442 DOI: 10.1007/s11064-021-03236-x] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 01/04/2021] [Accepted: 01/06/2021] [Indexed: 12/12/2022]
Abstract
Changes in astrocyte channels, transporters, and metabolism play a critical role in seizure generation and epilepsy. In particular, alterations in astrocyte potassium, glutamate, water and adenosine homeostasis and gap junctional coupling have all been associated with hyperexcitability and epileptogenesis (largely in temporal lobe epilepsy). Distinct astrocytic changes have also been identified in other types of epilepsy, such as tuberous sclerosis, tumor-associated epilepsy and post-traumatic epilepsy. Together, the emerging literature on astrocytes and epilepsy provides powerful rationale for distinct new therapeutic targets that are astrocyte-specific.
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Affiliation(s)
- Devin K Binder
- Center for Glial-Neuronal Interactions, Division of Biomedical Sciences, School of Medicine, University of California, Riverside, CA, USA.
| | - Christian Steinhäuser
- Institute of Cellular Neurosciences, Medical Faculty, University of Bonn, Bonn, Germany
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8
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Zaveri HP, Schelter B, Schevon CA, Jiruska P, Jefferys JGR, Worrell G, Schulze-Bonhage A, Joshi RB, Jirsa V, Goodfellow M, Meisel C, Lehnertz K. Controversies on the network theory of epilepsy: Debates held during the ICTALS 2019 conference. Seizure 2020; 78:78-85. [PMID: 32272333 DOI: 10.1016/j.seizure.2020.03.010] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 03/13/2020] [Accepted: 03/15/2020] [Indexed: 12/21/2022] Open
Abstract
Debates on six controversial topics on the network theory of epilepsy were held during two debate sessions, as part of the International Conference for Technology and Analysis of Seizures, 2019 (ICTALS 2019) convened at the University of Exeter, UK, September 2-5 2019. The debate topics were (1) From pathologic to physiologic: is the epileptic network part of an existing large-scale brain network? (2) Are micro scale recordings pertinent for defining the epileptic network? (3) From seconds to years: do we need all temporal scales to define an epileptic network? (4) Is it necessary to fully define the epileptic network to control it? (5) Is controlling seizures sufficient to control the epileptic network? (6) Does the epileptic network want to be controlled? This article, written by the organizing committee for the debate sessions and the debaters, summarizes the arguments presented during the debates on these six topics.
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Affiliation(s)
- Hitten P Zaveri
- Department of Neurology, Yale University, New Haven, CT 06520, USA
| | - Björn Schelter
- Institute for Complex Systems and Mathematical Biology, University of Aberdeen, Aberdeen AB24 3UE, UK
| | | | - Premysl Jiruska
- Department of Physiology, Second Faculty of Medicine, Charles University, Prague, Czech Republic
| | - John G R Jefferys
- Department of Physiology, Second Faculty of Medicine, Charles University, Prague, Czech Republic; Department of Pharmacology, University of Oxford, Oxford OX1 3QT, UK
| | - Gregory Worrell
- Mayo Systems Electrophysiology Laboratory, Departments of Neurology and Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN 55905, USA
| | | | - Rasesh B Joshi
- Department of Neurobiology and Anatomy, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Viktor Jirsa
- Institut de Neurosciences des Systèmes, Aix Marseille University, Marseille, France
| | - Marc Goodfellow
- Living Systems Institute, University of Exeter, Exeter, UK; Wellcome Trust Centre for Biomedical Modelling and Analysis, University of Exeter, Exeter, UK; EPSRC Centre for Predictive Modelling in Healthcare, University of Exeter, Exeter, UK
| | - Christian Meisel
- Department of Neurology, Boston Children's Hospital, 300 Longwood Ave, Boston, MA 02115, USA; Department of Neurology, University Clinic Carl Gustav Carus, Fetscherstrasse 74, 01307 Dresden, Germany
| | - Klaus Lehnertz
- Department of Epileptology, University of Bonn, Venusberg Campus 1, 53127 Bonn, Germany; Interdisciplinary Center for Complex Systems, University of Bonn, Brühler Str. 7, 53175 Bonn, Germany.
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9
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Eid T, Lee TSW, Patrylo P, Zaveri HP. Astrocytes and Glutamine Synthetase in Epileptogenesis. J Neurosci Res 2019; 97:1345-1362. [PMID: 30022509 PMCID: PMC6338538 DOI: 10.1002/jnr.24267] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Revised: 05/15/2018] [Accepted: 05/22/2018] [Indexed: 12/31/2022]
Abstract
The cellular, molecular, and metabolic mechanisms that underlie the development of mesial temporal lobe epilepsy are incompletely understood. Here we review the role of astrocytes in epilepsy development (a.k.a. epileptogenesis), particularly astrocyte pathologies related to: aquaporin 4, the inwardly rectifying potassium channel Kir4.1, monocarboxylate transporters MCT1 and MCT2, excitatory amino acid transporters EAAT1 and EAAT2, and glutamine synthetase. We propose that inhibition, dysfunction or loss of astrocytic glutamine synthetase is an important causative factor for some epilepsies, particularly mesial temporal lobe epilepsy and glioblastoma-associated epilepsy. We postulate that the regulatory mechanisms of glutamine synthetase as well as the downstream effects of glutamine synthetase dysfunction, represent attractive, new targets for antiepileptogenic interventions. Currently, no antiepileptogenic therapies are available for human use. The discovery of such interventions is important as it will fundamentally change the way we approach epilepsy by preventing the disease from ever becoming manifest after an epileptogenic insult to the brain.
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Affiliation(s)
- Tore Eid
- Department of Laboratory Medicine, Yale School of Medicine
- Department of Molecular Medicine, University of Oslo
| | | | - Peter Patrylo
- Department of Physiology, Southern Illinois University School of Medicine
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10
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Janz P, Hauser P, Heining K, Nestel S, Kirsch M, Egert U, Haas CA. Position- and Time-Dependent Arc Expression Links Neuronal Activity to Synaptic Plasticity During Epileptogenesis. Front Cell Neurosci 2018; 12:244. [PMID: 30154698 PMCID: PMC6102356 DOI: 10.3389/fncel.2018.00244] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Accepted: 07/18/2018] [Indexed: 12/14/2022] Open
Abstract
In mesial temporal lobe epilepsy (mTLE) an initial precipitating injury can trigger aberrant wiring of neuronal circuits causing seizure activity. While circuit reorganization is known to be largely activity-dependent, the interactions between neuronal activity and synaptic plasticity during the development of mTLE remain poorly understood. Therefore, the present study aimed at delineating the spatiotemporal relationship between epileptic activity, activity-dependent gene expression and synaptic plasticity during kainic acid-induced epileptogenesis in mice. We show that during epileptogenesis the sclerotic hippocampus differed from non-sclerotic regions by displaying a consistently lower power of paroxysmal discharges. However, the power of these discharges steadily increased during epileptogenesis. This increase was paralleled by the upregulation of the activity-related cytoskeleton protein (Arc) gene expression in dentate granule cells (DGCs) of the sclerotic hippocampus. Importantly, we found that Arc mRNA-upregulating DGCs exhibited increased spine densities and spine sizes, but at the same time decreased AMPA-type glutamate receptor (AMPAR) densities. Finally, we show that in vivo optogenetic stimulation of DGC synapses evoked robust seizure activity in epileptic mice, but failed to induce dendritic translocation of Arc mRNA as under healthy conditions, supporting the theory of a breakdown of the dentate gate in mTLE. We conclude that during epileptogenesis epileptic activity emerges early and persists in the whole hippocampus, however, only the sclerotic part shows modulation of discharge amplitudes accompanied by plasticity of DGCs. In this context, we identified Arc as a putative mediator between seizure activity and synaptic plasticity.
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Affiliation(s)
- Philipp Janz
- Experimental Epilepsy Research, Department of Neurosurgery, University Medical Center, University of Freiburg, Freiburg, Germany.,Faculty of Biology, University of Freiburg, Freiburg, Germany
| | - Pascal Hauser
- Experimental Epilepsy Research, Department of Neurosurgery, University Medical Center, University of Freiburg, Freiburg, Germany.,Faculty of Biology, University of Freiburg, Freiburg, Germany
| | - Katharina Heining
- Faculty of Biology, University of Freiburg, Freiburg, Germany.,Laboratory for Biomicrotechnology, Department of Microsystems Engineering, University of Freiburg, Freiburg, Germany.,Bernstein Center Freiburg, University of Freiburg, Freiburg, Germany
| | - Sigrun Nestel
- Institute for Anatomy and Cell Biology, Department of Neuroanatomy, University of Freiburg, Freiburg, Germany.,Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Matthias Kirsch
- Institute for Anatomy and Cell Biology, Department of Neuroanatomy, University of Freiburg, Freiburg, Germany.,Faculty of Medicine, University of Freiburg, Freiburg, Germany.,BrainLinks-BrainTools Cluster of Excellence, University of Freiburg, Freiburg, Germany
| | - Ulrich Egert
- Laboratory for Biomicrotechnology, Department of Microsystems Engineering, University of Freiburg, Freiburg, Germany.,Bernstein Center Freiburg, University of Freiburg, Freiburg, Germany.,BrainLinks-BrainTools Cluster of Excellence, University of Freiburg, Freiburg, Germany
| | - Carola A Haas
- Experimental Epilepsy Research, Department of Neurosurgery, University Medical Center, University of Freiburg, Freiburg, Germany.,Bernstein Center Freiburg, University of Freiburg, Freiburg, Germany.,Faculty of Medicine, University of Freiburg, Freiburg, Germany.,BrainLinks-BrainTools Cluster of Excellence, University of Freiburg, Freiburg, Germany
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11
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Gummadavelli A, Zaveri HP, Spencer DD, Gerrard JL. Expanding Brain-Computer Interfaces for Controlling Epilepsy Networks: Novel Thalamic Responsive Neurostimulation in Refractory Epilepsy. Front Neurosci 2018; 12:474. [PMID: 30108472 PMCID: PMC6079216 DOI: 10.3389/fnins.2018.00474] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Accepted: 06/22/2018] [Indexed: 01/01/2023] Open
Abstract
Seizures have traditionally been considered hypersynchronous excitatory events and epilepsy has been separated into focal and generalized epilepsy based largely on the spatial distribution of brain regions involved at seizure onset. Epilepsy, however, is increasingly recognized as a complex network disorder that may be distributed and dynamic. Responsive neurostimulation (RNS) is a recent technology that utilizes intracranial electroencephalography (EEG) to detect seizures and delivers stimulation to cortical and subcortical brain structures for seizure control. RNS has particular significance in the clinical treatment of medically refractory epilepsy and brain–computer interfaces in epilepsy. Closed loop RNS represents an important step forward to understand and target nodes in the seizure network. The thalamus is a central network node within several functional networks and regulates input to the cortex; clinically, several thalamic nuclei are safe and feasible targets. We highlight the network theory of epilepsy, potential targets for neuromodulation in epilepsy and the first reported use of RNS as a first generation brain–computer interface to detect and stimulate the centromedian intralaminar thalamic nucleus in a patient with bilateral cortical onset of seizures. We propose that advances in network analysis and neuromodulatory techniques using brain–computer interfaces will significantly improve outcomes in patients with epilepsy. There are numerous avenues of future direction in brain–computer interface devices including multi-modal sensors, flexible electrode arrays, multi-site targeting, and wireless communication.
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Affiliation(s)
- Abhijeet Gummadavelli
- Department of Neurosurgery, Yale University School of Medicine, Yale University, New Haven, CT, United States
| | - Hitten P Zaveri
- Department of Neurology, Yale University School of Medicine, Yale University, New Haven, CT, United States
| | - Dennis D Spencer
- Department of Neurosurgery, Yale University School of Medicine, Yale University, New Haven, CT, United States
| | - Jason L Gerrard
- Department of Neurosurgery, Yale University School of Medicine, Yale University, New Haven, CT, United States.,Department of Neuroscience, Yale University School of Medicine, Yale University, New Haven, CT, United States
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12
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Abstract
Epilepsy is a common and devastating neurological disorder characterized by recurrent and unprovoked spontaneous seizures. One leading hypothesis for the development and progression of epilepsy is that large-scale changes in gene transcription and protein expression contribute to aberrant network restructuring and hyperexcitability, resulting in the genesis of repeated seizures. Current research shows that epigenetic mechanisms, including posttranslational alterations to the proteins around which DNA is coiled, chemical modifications to DNA, and the activity of various noncoding RNA molecules exert important influences on these gene networks in experimental epilepsy. Key findings from animal models have been replicated in humans using brain tissue obtained from living patients at the time of neurosurgical resection for pharmacoresistant epilepsy. These findings have spurred efforts to target epigenetic processes to disrupt or modify epilepsy in experimental models with varying degrees of success. In this review, we will (1) summarize the epigenetic mechanisms implicated in epileptogenesis and epilepsy, (2) explore the influence of metabolic factors on epigenetic mechanisms, and (3) assess the potential of using epigenetic markers to support diagnosis and prognosis. Translation of these findings may guide the development of molecular biomarkers and novel therapeutics for prevention or modification of epileptic disorders.
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Affiliation(s)
- Rebecca M. Hauser
- Evelyn F. McKnight Brain Institute, Department of Neurobiology, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - David C. Henshall
- Department of Physiology and Medical Physics, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Farah D. Lubin
- Evelyn F. McKnight Brain Institute, Department of Neurobiology, The University of Alabama at Birmingham, Birmingham, AL, USA
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13
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Turning down the volume: Astrocyte volume change in the generation and termination of epileptic seizures. Neurobiol Dis 2017; 104:24-32. [PMID: 28438505 DOI: 10.1016/j.nbd.2017.04.016] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Revised: 04/18/2017] [Accepted: 04/20/2017] [Indexed: 12/20/2022] Open
Abstract
Approximately 1% of the global population suffers from epilepsy, a class of disorders characterized by recurrent and unpredictable seizures. Of these cases roughly one-third are refractory to current antiepileptic drugs, which typically target neuronal excitability directly. The events leading to seizure generation and epileptogenesis remain largely unknown, hindering development of new treatments. Some recent experimental models of epilepsy have provided compelling evidence that glial cells, especially astrocytes, could be central to seizure development. One of the proposed mechanisms for astrocyte involvement in seizures is astrocyte swelling, which may promote pathological neuronal firing and synchrony through reduction of the extracellular space and elevated glutamate concentrations. In this review, we discuss the common conditions under which astrocytes swell, the resultant effects on neural excitability, and how seizure development may ultimately be influenced by these effects.
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