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Caprara ALF, Tharwat Ali H, Elrefaey A, Elejla SA, Rissardo JP. Somatosensory Auras in Epilepsy: A Narrative Review of the Literature. MEDICINES (BASEL, SWITZERLAND) 2023; 10:49. [PMID: 37623813 PMCID: PMC10456342 DOI: 10.3390/medicines10080049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 07/06/2023] [Accepted: 08/18/2023] [Indexed: 08/26/2023]
Abstract
An aura is a subjective experience felt in the initial phase of a seizure. Studying auras is relevant as they can be warning signs for people with epilepsy. The incidence of aura tends to be underestimated due to misdiagnosis or underrecognition by patients unless it progresses to motor features. Also, auras are associated with seizure remission after epilepsy surgery and are an important prognostic factor, guiding the resection site and improving surgical outcomes. Somatosensory auras (SSAs) are characterized by abnormal sensations on one or more body parts that may spread to other parts following a somatotopic pattern. The occurrence of SSAs among individuals with epilepsy can range from 1.42% to 80%. The upper extremities are more commonly affected in SSAs, followed by the lower extremities and the face. The most common type of somatosensory aura is paresthetic, followed by painful and thermal auras. In the primary somatosensory auras, sensations occur more commonly contralaterally, while the secondary somatosensory auras can be ipsilateral or bilateral. Despite the high localizing features of somatosensory areas, cortical stimulation studies have shown overlapping sensations originating in the insula and the supplementary sensorimotor area.
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Affiliation(s)
| | | | - Ahmed Elrefaey
- Faculty of Medicine, Ain Shams University, Cairo 11835, Egypt;
| | - Sewar A. Elejla
- Medicine Department, Alquds University, Jerusalem P850, Palestine;
| | - Jamir Pitton Rissardo
- Medicine Department, Federal University of Santa Maria, Santa Maria 97105-900, Brazil;
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Xia X, Wang Y, Huang Y, Zhang H, Lu H, Zheng JC. Exosomal miRNAs in central nervous system diseases: biomarkers, pathological mediators, protective factors and therapeutic agents. Prog Neurobiol 2019; 183:101694. [PMID: 31542363 PMCID: PMC7323939 DOI: 10.1016/j.pneurobio.2019.101694] [Citation(s) in RCA: 120] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 06/14/2019] [Accepted: 09/09/2019] [Indexed: 12/12/2022]
Abstract
Exosomes are small bilipid layer-enclosed extracellular vesicles that can be found in tissues and biological fluids. As a key cell-to-cell and distant communication mediator, exosomes are involved in various central nervous system (CNS) diseases, potentially through transferring their contents such as proteins, lipids and nucleic acids to the target cells. Exosomal miRNAs, which are small non-coding RNAs in the exosomes, are known to be more stable than free miRNAs and therefore have lasting effects on disease-related gene expressions. There are distinct profiles of exosomal miRNAs in different types of CNS diseases even before the onset of irreversible neurological damages, indicating that exosomal miRNAs within tissues and biological fluids could serve as promising biomarkers. Emerging evidence has also demonstrated the pathological effects of several exosomal miRNAs in CNS diseases via specific modulation of disease-related factors. Moreover, exosomes carry therapeutically beneficial miRNAs across the blood-brain-barrier, which can be exploited as a powerful drug delivery tool to help alleviating multiple CNS diseases. In this review, we summarize the recent progress made in understanding the biological roles of exosomal miRNAs as potential diagnostic biomarkers, pathological regulators, and therapeutic targets/drugs for CNS diseases. A comprehensive discussion of the main concerns and challenges for the applications of exosomal miRNAs in the clinical setting is also provided.
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Affiliation(s)
- Xiaohuan Xia
- Center for Translational Neurodegeneration and Regenerative Therapy, Shanghai Tenth People's Hospital affiliated to Tongji University School of Medicine, Shanghai 200072, China
| | - Yi Wang
- Center for Translational Neurodegeneration and Regenerative Therapy, Shanghai Tenth People's Hospital affiliated to Tongji University School of Medicine, Shanghai 200072, China
| | - Yunlong Huang
- Center for Translational Neurodegeneration and Regenerative Therapy, Shanghai Tenth People's Hospital affiliated to Tongji University School of Medicine, Shanghai 200072, China; Departments of Pharmacology and Experimental Neuroscience, University of Nebraska Medical Center, Omaha, NE, 68198-5930, USA
| | - Han Zhang
- Second Military Medical University, Shanghai 200433, China
| | - Hongfang Lu
- Center for Translational Neurodegeneration and Regenerative Therapy, Shanghai Tenth People's Hospital affiliated to Tongji University School of Medicine, Shanghai 200072, China
| | - Jialin C Zheng
- Center for Translational Neurodegeneration and Regenerative Therapy, Shanghai Tenth People's Hospital affiliated to Tongji University School of Medicine, Shanghai 200072, China; Collaborative Innovation Center for Brain Science, Tongji University, Shanghai 200092, China; Departments of Pharmacology and Experimental Neuroscience, University of Nebraska Medical Center, Omaha, NE, 68198-5930, USA.
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Catala A, Grandgeorge M, Schaff JL, Cousillas H, Hausberger M, Cattet J. Dogs demonstrate the existence of an epileptic seizure odour in humans. Sci Rep 2019; 9:4103. [PMID: 30923326 PMCID: PMC6438971 DOI: 10.1038/s41598-019-40721-4] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Accepted: 02/19/2019] [Indexed: 11/09/2022] Open
Abstract
Although different studies have shown that diseases such as breast or lung cancer are associated with specific bodily odours, no study has yet tested the possibility that epileptic seizures may be reflected in an olfactory profile, probably because there is a large variety of seizure types. The question is whether a “seizure-odour”, that would be transversal to individuals and types of seizures, exists. This would be a pre requisite for potential anticipation, either by electronic systems (e.g., e-noses) or trained dogs. The aim of the present study therefore was to test whether trained dogs, as demonstrated for cancer or diabetes, may discriminate a general epileptic seizure odor (different from body odours of the same person in other contexts and common to different persons). The results were very clear: all dogs discriminated the seizure odour. The sensitivity and specificity obtained were amongst the highest shown up to now for discrimination of diseases. This constitutes a first proof that, despite the variety of seizures and individual odours, seizures are associated with olfactory characteristics. These results open a large field of research on the odour signature of seizures. Further studies will aim to look at potential applications in terms of anticipation of seizures.
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Affiliation(s)
- Amélie Catala
- Univ Rennes, Normandie Univ, CNRS, EthoS (Éthologie animale et humaine) - UMR 6552, F-35380 Paimpont, France. .,Association Handi'Chiens, 13 Rue de l'Abbé Groult, Paris, France.
| | - Marine Grandgeorge
- Univ Rennes, Normandie Univ, CNRS, EthoS (Éthologie animale et humaine) - UMR 6552, F-35380 Paimpont, France
| | - Jean-Luc Schaff
- Association Handi'Chiens, 13 Rue de l'Abbé Groult, Paris, France.,Centre d'Observation et de Cure pour Enfants Epileptiques, Ets OHS de Lorraine, 46 rue du doyen J. Parisot, Flavigny-sur-Moselle, France.,Service de Neurologie du CHRU de Nancy, 29, avenue du Maréchal de Lattre de Tassigny, Nancy, France
| | - Hugo Cousillas
- Univ Rennes, Normandie Univ, CNRS, EthoS (Éthologie animale et humaine) - UMR 6552, F-35000 Rennes, France
| | - Martine Hausberger
- CNRS, Univ Rennes, Normandie Univ, EthoS (Éthologie animale et humaine) - UMR 6552, F-35380 Paimpont, France
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Leukocyte expression profiles reveal gene sets with prognostic value for seizure-free outcome following stereotactic laser amygdalohippocampotomy. Sci Rep 2019; 9:1086. [PMID: 30705324 PMCID: PMC6355811 DOI: 10.1038/s41598-018-37763-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Accepted: 12/13/2018] [Indexed: 02/08/2023] Open
Abstract
Among patients with intractable epilepsy, the most commonly performed surgical procedure is craniotomy for amygdalohippocampectomy (AH). Stereotactic laser amygdalohippocampotomy (SLAH) has also been recently employed as a minimally invasive treatment for intractable temporal lobe epilepsy (TLE). Among patients treated with AH and SLAH approximately 65% and 54% of patients become seizure-free, respectively. Therefore, selection criteria for surgical candidates with improved prognostic value for post-operative seizure-free outcome are greatly needed. In this study, we perform RNA sequencing (RNA-Seq) on whole blood leukocyte samples taken from 16 patients with intractable TLE prior to SLAH to test the hypothesis that pre-operative leukocyte RNA expression profiles are prognostic for post-operative seizure outcome. Multidimensional scaling analysis of the RNA expression data indicated separate clustering of patients with seizure free (SF) and non-seizure-free (NSF) outcomes. Differential expression (DE) analysis performed on SF versus NSF groups revealed 24 significantly differentially expressed genes (≥2.0-fold change, p-value < 0.05, FDR <0.05). Network and pathway analyses identified differential activation of pathways involved in lipid metabolism, morphology of oligodendrocytes, inflammatory response, and development of astrocytes. These results suggest that pre-operative leukocyte expression profiles have prognostic value for seizure outcome following SLAH.
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Catala A, Cousillas H, Hausberger M, Grandgeorge M. Dog alerting and/or responding to epileptic seizures: A scoping review. PLoS One 2018; 13:e0208280. [PMID: 30513112 PMCID: PMC6279040 DOI: 10.1371/journal.pone.0208280] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Accepted: 11/14/2018] [Indexed: 11/20/2022] Open
Abstract
Recently, there has been a rising interest in service dogs for people with epilepsy. Dogs have been reported as being sensitive to epileptic episodes in their owners, alerting before and/or responding during or after a seizure, with or without specific training. The purpose of this review is to present a comprehensive overview of the scientific research on seizure-alert/response dogs for people with epilepsy. We aimed to identify the existing scientific literature on the topic, describe the characteristics of seizure-alert/response dogs, and evaluate the state of the evidence base and outcomes. Out of 28 studies published in peer-reviewed journals dealing with this topic, only 5 (one prospective study and four self-reported questionnaires) qualified for inclusion according to PRISMA guidelines. Reported times of alert before seizure varied widely among dogs (with a range from 10 seconds to 5 hours) but seemed to be reliable (accuracy from ≥70% to 85% according to owner reports). Alerting behaviors were generally described as attention-getting. The alert applied to many seizure types. Dogs mentioned as being seizure-alert dogs varied in size and breed. Training methods differed between service animal programs, partially relying on hypothesized cues used by dogs (e.g., variations in behavior, scent, heart rate). Most studies indicated an increase in quality of life and a reduction in the seizure frequency when living with a dog demonstrating seizure-related behavior. However, the level of methodological rigor was generally poor. In conclusion, scientific data are still too scarce and preliminary to reach any definitive conclusion regarding the success of dogs in alerting for an impending seizure, the cues on which this ability may be based, the best type of dog, and associated training. While these preliminary data suggest that this is a promising topic, further research is needed.
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Affiliation(s)
- Amélie Catala
- Université de Rennes, Normandie Univ, CNRS, EthoS (Éthologie animale et humaine)—UMR 6552, Paimpont, France
- Association Handi’Chiens, Paris, France
| | - Hugo Cousillas
- Université de Rennes, Normandie Univ, CNRS, EthoS (Éthologie animale et humaine)—UMR 6552, Rennes, France
| | - Martine Hausberger
- CNRS, Université de Rennes, Normandie Univ, EthoS (Éthologie animale et humaine)—UMR 6552, Paimpont, France
| | - Marine Grandgeorge
- Université de Rennes, Normandie Univ, CNRS, EthoS (Éthologie animale et humaine)—UMR 6552, Paimpont, France
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Tian N, Boring M, Kobau R, Zack MM, Croft JB. Active Epilepsy and Seizure Control in Adults - United States, 2013 and 2015. MMWR-MORBIDITY AND MORTALITY WEEKLY REPORT 2018; 67:437-442. [PMID: 29672474 PMCID: PMC6191103 DOI: 10.15585/mmwr.mm6715a1] [Citation(s) in RCA: 91] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Approximately 3 million American adults reported active epilepsy* in 2015 (1). Active epilepsy, especially when seizures are uncontrolled, poses substantial burdens because of somatic, neurologic, and mental health comorbidity; cognitive and physical dysfunction; side effects of antiseizure medications; higher injury and mortality rates; poorer quality of life; and increased financial cost (2). Thus, prompt diagnosis and seizure control (i.e., seizure-free in the 12 months preceding the survey) confers numerous clinical and social advantages to persons with active epilepsy. To obtain recent and reliable estimates of active epilepsy and seizure control status in the U.S. population, CDC analyzed aggregated data from the 2013 and the 2015 National Health Interview Surveys (NHISs). Overall, an annual estimated 2.6 million (1.1%) U.S. adults self-reported having active epilepsy, 67% of whom had seen a neurologist or an epilepsy specialist in the past year, and 90% of whom reported taking epilepsy medication. Among those taking epilepsy medication, only 44% reported having their seizures controlled. A higher prevalence of active epilepsy and poorer seizure control were associated with low family income, unemployment, and being divorced, separated, or widowed. Use of epilepsy medication was higher among adults who saw an epilepsy specialist in the past year than among those who did not. Health care and public health should ensure that adults with uncontrolled seizures have appropriate care and self-management support in order to promote seizure control, improve health and social outcomes, and reduce health care costs.
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Hernández L, Marín K. Interacciones medicamentosas de los anticonvulsivantes de primera línea con antipsicóticos y/o antidepresivos. REPERTORIO DE MEDICINA Y CIRUGÍA 2017. [DOI: 10.1016/j.reper.2017.05.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Ghasemi M, Hadipour-Niktarash A. Pathologic role of neuronal nicotinic acetylcholine receptors in epileptic disorders: implication for pharmacological interventions. Rev Neurosci 2016; 26:199-223. [PMID: 25565544 DOI: 10.1515/revneuro-2014-0044] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2014] [Accepted: 10/16/2014] [Indexed: 12/30/2022]
Abstract
Accumulating evidence suggests that neuronal nicotinic acetylcholine receptors (nAChRs) may play a key role in the pathophysiology of some neurological diseases such as epilepsy. Based on genetic studies in patients with epileptic disorders worldwide and animal models of seizure, it has been demonstrated that nAChR activity is altered in some specific types of epilepsy, including autosomal dominant nocturnal frontal lobe epilepsy (ADNFLE) and juvenile myoclonic epilepsy (JME). Neuronal nAChR antagonists also have antiepileptic effects in pre-clinical studies. There is some evidence that conventional antiepileptic drugs may affect neuronal nAChR function. In this review, we re-examine the evidence for the involvement of nAChRs in the pathophysiology of some epileptic disorders, especially ADNFLE and JME, and provide an overview of nAChR antagonists that have been evaluated in animal models of seizure.
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Gallek MJ, Skoch J, Ansay T, Behbahani M, Mount D, Manziello A, Witte M, Bernas M, Labiner DM, Weinand ME. Cortical gene expression: prognostic value for seizure outcome following temporal lobectomy and amygdalohippocampectomy. Neurogenetics 2016; 17:211-218. [PMID: 27251580 DOI: 10.1007/s10048-016-0484-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Accepted: 04/27/2016] [Indexed: 11/27/2022]
Abstract
Whole genome analyses were performed to test the hypothesis that temporal cortical gene expression differs between epilepsy patients rendered seizure-free versus non-seizure-free following anterior temporal lobectomy with amygdalohippocampectomy (ATL/AH). Twenty four patients underwent ATL/AH to treat medically intractable seizures of temporal lobe origin (mean age 35.5 years, mean follow-up 42.2 months); they were then dichotomized into seizure-free and non-seizure-free groups. Tissue RNA was isolated from the lateral temporal cortex and gene expression analysis was performed. Whole genome data were analyzed for prognostic value for seizure-free outcome following ATL/AH by logistic regression. Genes that could distinguish seizure outcome groups were identified based on providing an accuracy of >0.90 judging by area under the receiver operating characteristic curve, AUC, with a P value of the slope coefficient of <0.05. Four genes and seven RNA probes were with prognostic value for post-operative seizure-free outcome. Gene expression associated with seizure-free outcome included relative down-regulation of zinc finger protein 852 (ZNF852), CUB domain-containing protein 2 (CDCP2), proline-rich transmembrane protein 1 (PRRT1), hypothetical LOC440200 (FLJ41170), RNA probe 8047763, RNA probe 8126238, RNA probe 8113489, RNA probe 8092883, RNA probe 7935228, RNA probe 806293, and RNA probe 8104131. This study describes the predictive value of temporal cortical gene expression for seizure-free outcome after ATL/AH. Four genes and seven RNA probes were found to predict post-operative seizure-free outcome. Future prospective investigation of these genes and probes in human brain tissue and blood could establish new biomarkers predictive of seizure outcome following ATL/AH.
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Affiliation(s)
- Matthew J Gallek
- College of Nursing, University of Arizona, 1305 N Martin Ave, PO Box 210203, Tucson, AZ, 85721, USA.
| | - Jesse Skoch
- College of Medicine, Department of Surgery, Division of Neurosurgery, University of Arizona, Tucson, AZ, USA
| | - Tracy Ansay
- Department of Neurosurgery, Brigham and Women's Hospital, Boston, MA, USA
| | - Mandana Behbahani
- College of Medicine, Department of Neurosurgery, University of Illinois at Chicago, Chicago, IL, USA
| | - David Mount
- Informatics/Bioinformatics Shared Services, Arizona Cancer Center, University of Arizona, Tucson, AZ, USA
| | - Ann Manziello
- Informatics/Bioinformatics Shared Services, Arizona Cancer Center, University of Arizona, Tucson, AZ, USA
| | - Marlys Witte
- College of Medicine, Department of Surgery, University of Arizona, Tucson, AZ, USA
| | - Michael Bernas
- College of Medicine, Department of Surgery, University of Arizona, Tucson, AZ, USA
| | - David M Labiner
- Department of Neurology, College of Medicine, University of Arizona, Tucson, AZ, USA
| | - Martin E Weinand
- College of Medicine, Department of Surgery, Division of Neurosurgery, University of Arizona, Tucson, AZ, USA
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Cortical gene expression correlates of temporal lobe epileptogenicity. ACTA ACUST UNITED AC 2016; 23:181-90. [PMID: 27354343 DOI: 10.1016/j.pathophys.2016.05.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Revised: 05/19/2016] [Accepted: 05/27/2016] [Indexed: 01/23/2023]
Abstract
INTRODUCTION Despite being one of the most common neurological diseases, it is unknown whether there may be a genetic basis to temporal lobe epilepsy (TLE). Whole genome analyses were performed to test the hypothesis that temporal cortical gene expression differs between TLE patients with high vs. low baseline seizure frequency. METHODS Baseline seizure frequency was used as a clinical measure of epileptogenicity. Twenty-four patients in high or low seizure frequency groups (median seizures/month) underwent anterior temporal lobectomy with amygdalohippocampectomy for intractable TLE. RNA was isolated from the lateral temporal cortex and submitted for expression analysis. Genes significantly associated with baseline seizure frequency on likelihood ratio test were identified based on >0.90 area under the ROC curve, P value of <0.05. RESULTS Expression levels of forty genes were significantly associated with baseline seizure frequency. Of the seven most significant, four have been linked to other neurologic diseases. Expression levels associated with high seizure frequency included low expression of Homeobox A10, Forkhead box A2, Lymphoblastic leukemia derived sequence 1, HGF activator, Kelch repeat and BTB (POZ) domain containing 11, Thanatos-associated protein domain containing 8 and Heparin sulfate (glucosamine) 3-O-sulfotransferase 3A1. CONCLUSIONS This study describes novel associations between forty known genes and a clinical marker of epileptogenicity, baseline seizure frequency. Four of the seven discussed have been previously related to other neurologic diseases. Future investigation of these genes could establish new biomarkers for predicting epileptogenicity, and could have significant implications for diagnosis and management of temporal lobe epilepsy, as well as epilepsy pathogenesis.
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Taras HL, Kalichman MW, Schulteis G, Dumbauld J, Bell Y, Seligman FF, West KD. Soliciting views of various communities on health research: a prelude to engagement in specific research projects. Health Expect 2015; 18:2753-63. [PMID: 25103450 PMCID: PMC4320671 DOI: 10.1111/hex.12249] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/16/2014] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Members of the public are increasingly engaged in health-service and biomedical research and provide input into the content of research, design and data sharing. As there is variation among different communities on how research is perceived, to engage all sectors of the general public research institutions need to customize their approach. OBJECTIVE This paper explores how research institutions and community leaders can partner to determine the best ways to engage different sectors of the public in research. DESIGN Following a literature review, a research institution engaged with four different sectors of the public through their respective representative community-based organizations (CBOs) by interviews with leaders, community member focus groups and a joint project. SETTING San Diego and Imperial Counties, California, United States of America (USA). CONCLUSION Before embarking on more specific research projects, investigators can gain valuable insights about different communities' attitudes to, and understanding of, health services and biomedical research by interacting directly with members of the community, collaborating with community leaders, and jointly identifying steps of engagement tailored to the community.
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Affiliation(s)
- Howard L. Taras
- Clinical & Translational Research InstituteUniversity of California‐San DiegoLa JollaCAUSA
| | | | - Gery Schulteis
- Research & DevelopmentVA San Diego Healthcare SystemDepartment of AnesthesiologyUniversity of California‐San DiegoLa JollaCAUSA
| | - Jill Dumbauld
- Clinical & Translational Research InstituteUniversity of California‐San DiegoLa JollaCAUSA
| | - Yvonne Bell
- Clinicas de Salud del Pueblo, Inc.BrawleyCAUSA
| | | | - Kathy D. West
- Epilepsy Foundation of San Diego CountySan DiegoCAUSA
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Challal S, Buenafe OEM, Queiroz EF, Maljevic S, Marcourt L, Bock M, Kloeti W, Dayrit FM, Harvey AL, Lerche H, Esguerra CV, de Witte PAM, Wolfender JL, Crawford AD. Zebrafish bioassay-guided microfractionation identifies anticonvulsant steroid glycosides from the Philippine medicinal plant Solanum torvum. ACS Chem Neurosci 2014; 5:993-1004. [PMID: 25127088 DOI: 10.1021/cn5001342] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Medicinal plants used for the treatment of epilepsy are potentially a valuable source of novel antiepileptic small molecules. To identify anticonvulsant secondary metabolites, we performed an in vivo, zebrafish-based screen of medicinal plants used in Southeast Asia for the treatment of seizures. Solanum torvum Sw. (Solanaceae) was identified as having significant anticonvulsant activity in zebrafish larvae with seizures induced by the GABAA antagonist pentylenetetrazol (PTZ). This finding correlates well with the ethnomedical use of this plant in the Philippines, where a water decoction of S. torvum leaves is used to treat epileptic seizures. HPLC microfractionation of the bioactive crude extract, in combination with the in vivo zebrafish seizure assay, enabled the rapid localization of several bioactive compounds that were partially identified online by UHPLC-TOF-MS as steroid glycosides. Targeted isolation of the active constituents from the methanolic extract enabled the complete de novo structure identification of the six main bioactive compounds that were also present in the traditional preparation. To partially mimic the in vivo metabolism of these triterpene glycosides, their common aglycone was generated by acid hydrolysis. The isolated molecules exhibited significant anticonvulsant activity in zebrafish seizure assays. These results underscore the potential of zebrafish bioassay-guided microfractionation to rapidly identify novel bioactive small molecules of natural origin.
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Affiliation(s)
- Soura Challal
- School
of Pharmaceutical Sciences, University of Geneva, University of Lausanne, 30, quai Ernest-Ansermet, CH-1211 Geneva 4, Switzerland
| | - Olivia E. M. Buenafe
- Laboratory
for Molecular Biodiscovery, Department of Pharmaceutical and Pharmacological
Sciences, KU Leuven - University of Leuven, Herestraat 49, 3000 Leuven, Belgium
| | - Emerson F. Queiroz
- School
of Pharmaceutical Sciences, University of Geneva, University of Lausanne, 30, quai Ernest-Ansermet, CH-1211 Geneva 4, Switzerland
| | - Snezana Maljevic
- Department
of Neurology and Epileptology, Hertie Institute for Clinical Brain
Research, University of Tübingen, Hoppe-Seyler-Strasse 3, 72076 Tübingen, Germany
| | - Laurence Marcourt
- School
of Pharmaceutical Sciences, University of Geneva, University of Lausanne, 30, quai Ernest-Ansermet, CH-1211 Geneva 4, Switzerland
| | - Merle Bock
- Department
of Neurology and Epileptology, Hertie Institute for Clinical Brain
Research, University of Tübingen, Hoppe-Seyler-Strasse 3, 72076 Tübingen, Germany
| | - Werner Kloeti
- School
of Pharmaceutical Sciences, University of Geneva, University of Lausanne, 30, quai Ernest-Ansermet, CH-1211 Geneva 4, Switzerland
| | - Fabian M. Dayrit
- Department
of Chemistry, Ateneo de Manila University, Loyola Heights, 1108 Quezon City, Philippines
| | - Alan L. Harvey
- Strathclyde
Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, 161 Cathedral Street, Glasgow G4 0RE, Scotland, United Kingdom
| | - Holger Lerche
- Department
of Neurology and Epileptology, Hertie Institute for Clinical Brain
Research, University of Tübingen, Hoppe-Seyler-Strasse 3, 72076 Tübingen, Germany
| | - Camila V. Esguerra
- Laboratory
for Molecular Biodiscovery, Department of Pharmaceutical and Pharmacological
Sciences, KU Leuven - University of Leuven, Herestraat 49, 3000 Leuven, Belgium
| | - Peter A. M. de Witte
- Laboratory
for Molecular Biodiscovery, Department of Pharmaceutical and Pharmacological
Sciences, KU Leuven - University of Leuven, Herestraat 49, 3000 Leuven, Belgium
| | - Jean-Luc Wolfender
- School
of Pharmaceutical Sciences, University of Geneva, University of Lausanne, 30, quai Ernest-Ansermet, CH-1211 Geneva 4, Switzerland
| | - Alexander D. Crawford
- Laboratory
for Molecular Biodiscovery, Department of Pharmaceutical and Pharmacological
Sciences, KU Leuven - University of Leuven, Herestraat 49, 3000 Leuven, Belgium
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Dugan P, Carlson C, Bluvstein J, Chong DJ, Friedman D, Kirsch HE. Auras in generalized epilepsy. Neurology 2014; 83:1444-9. [PMID: 25230998 DOI: 10.1212/wnl.0000000000000877] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE We studied the frequency of auras in generalized epilepsy (GE) using a detailed semistructured diagnostic interview. METHODS In this cross-sectional study, participants with GE were drawn from the Epilepsy Phenome/Genome Project (EPGP). Responses to the standardized diagnostic interview regarding tonic-clonic (grand mal) seizures were then examined. This questionnaire initially required participants to provide their own description of any subjective phenomena before their "grand mal seizures." Participants who provided answers to these questions were considered to have an aura. All participants were then systematically queried regarding a list of specific symptoms occurring before grand mal seizures, using structured (closed-ended) questions. RESULTS Seven hundred ninety-eight participants with GE were identified, of whom 530 reported grand mal seizures. Of these, 112 (21.3%) reported auras in response to the open-ended question. Analysis of responses to the closed-ended questions suggested that 341 participants (64.3%) experienced at least one form of aura. CONCLUSIONS Auras typically associated with focal epilepsy were reported by a substantial proportion of EPGP subjects with GE. This finding may support existing theories of cortical and subcortical generators of GE with variable spread patterns. Differences between responses to the open-ended question and closed-ended questions may also reflect clinically relevant variation in patient responses to history-taking and surveys. Open-ended questions may underestimate the prevalence of specific types of auras and may be in part responsible for the underrecognition of auras in GE. In addition, structured questions may influence participants, possibly leading to a greater representation of symptoms.
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Affiliation(s)
- Patricia Dugan
- From the Department of Neurology (P.D., J.B., D.J.C., D.F.), New York University Langone Medical Center, New York; Department of Neurology (C.C.), Medical College of Wisconsin, Milwaukee; and Department of Neurology (H.E.K.), University of California, San Francisco.
| | - Chad Carlson
- From the Department of Neurology (P.D., J.B., D.J.C., D.F.), New York University Langone Medical Center, New York; Department of Neurology (C.C.), Medical College of Wisconsin, Milwaukee; and Department of Neurology (H.E.K.), University of California, San Francisco
| | - Judith Bluvstein
- From the Department of Neurology (P.D., J.B., D.J.C., D.F.), New York University Langone Medical Center, New York; Department of Neurology (C.C.), Medical College of Wisconsin, Milwaukee; and Department of Neurology (H.E.K.), University of California, San Francisco
| | - Derek J Chong
- From the Department of Neurology (P.D., J.B., D.J.C., D.F.), New York University Langone Medical Center, New York; Department of Neurology (C.C.), Medical College of Wisconsin, Milwaukee; and Department of Neurology (H.E.K.), University of California, San Francisco
| | - Daniel Friedman
- From the Department of Neurology (P.D., J.B., D.J.C., D.F.), New York University Langone Medical Center, New York; Department of Neurology (C.C.), Medical College of Wisconsin, Milwaukee; and Department of Neurology (H.E.K.), University of California, San Francisco
| | - Heidi E Kirsch
- From the Department of Neurology (P.D., J.B., D.J.C., D.F.), New York University Langone Medical Center, New York; Department of Neurology (C.C.), Medical College of Wisconsin, Milwaukee; and Department of Neurology (H.E.K.), University of California, San Francisco
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Antinuclear antibodies and glutamic acid decarboxylase antibodies in children with refractory epilepsy. EGYPTIAN PEDIATRIC ASSOCIATION GAZETTE 2013. [DOI: 10.1016/j.epag.2013.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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15
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Gulati V, Wallace R. Rafts, Nanoparticles and Neural Disease. NANOMATERIALS (BASEL, SWITZERLAND) 2012; 2:217-250. [PMID: 28348305 PMCID: PMC5304588 DOI: 10.3390/nano2030217] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/12/2012] [Revised: 07/19/2012] [Accepted: 07/20/2012] [Indexed: 11/17/2022]
Abstract
This review examines the role of membrane rafts in neural disease as a rationale for drug targeting utilizing lipid-based nanoparticles. The article begins with an overview of methodological issues involving the existence, sizes, and lifetimes of rafts, and then examines raft function in the etiologies of three major neural diseases-epilepsy, Parkinson's disease, and Alzheimer's disease-selected as promising candidates for raft-based therapeutics. Raft-targeting drug delivery systems involving liposomes and solid lipid nanoparticles are then examined in detail.
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Affiliation(s)
- Vishal Gulati
- Ross University School of Medicine, Miami Beach Community Health Center, 11645 Biscayne Boulevard, North Miami, FL 33181, USA.
| | - Ron Wallace
- Department of Anthropology, University of Central Florida, Orlando, FL 32816, USA.
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16
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Ghasemi M, Schachter SC. The NMDA receptor complex as a therapeutic target in epilepsy: a review. Epilepsy Behav 2011; 22:617-40. [PMID: 22056342 DOI: 10.1016/j.yebeh.2011.07.024] [Citation(s) in RCA: 141] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2011] [Revised: 07/01/2011] [Accepted: 07/18/2011] [Indexed: 01/02/2023]
Abstract
A substantial amount of research has shown that N-methyl-D-aspartate receptors (NMDARs) may play a key role in the pathophysiology of several neurological diseases, including epilepsy. Animal models of epilepsy and clinical studies demonstrate that NMDAR activity and expression can be altered in association with epilepsy and particularly in some specific seizure types. NMDAR antagonists have been shown to have antiepileptic effects in both clinical and preclinical studies. There is some evidence that conventional antiepileptic drugs may also affect NMDAR function. In this review, we describe the evidence for the involvement of NMDARs in the pathophysiology of epilepsy and provide an overview of NMDAR antagonists that have been investigated in clinical trials and animal models of epilepsy.
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Affiliation(s)
- Mehdi Ghasemi
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA.
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17
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Schachter SC. What needs to change: Goals for clinical and social management and research in the next 60 years. Seizure 2010; 19:686-9. [DOI: 10.1016/j.seizure.2010.10.024] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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18
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Sharkey RJ, Kosior RK, Federico P, Frayne R. Age effects on voxel-based relaxometry used for epileptic patients. Epilepsy Res 2010; 92:41-7. [PMID: 20850271 DOI: 10.1016/j.eplepsyres.2010.08.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2010] [Revised: 07/10/2010] [Accepted: 08/15/2010] [Indexed: 11/26/2022]
Abstract
PURPOSE T2 voxel-based relaxometry (VBR) is a technique that allows for a quantitative, unbiased analysis of T2 relaxation time across the whole brain. Previous studies have shown that this technique is effective for clinical analysis of single patients; however, the effects of age normal age-related changes on these data were unknown. Our study was therefore designed to assess the effect of normal aging on VBR data. METHODS A linear regression with age as a predictor of T2 was run in both a (1) whole-brain voxel-based manner to determine regions which showed significant age-related change and subsequently (2) on a selection of regions-of-interest to allow for a more detailed analysis of the trends. RESULTS T2 estimates showed a significant increase with age in the frontal lobe white matter and a significant decrease with age in the putamen with region-of-interest and voxel-based regressions (p<0.05). There was also a general trend for T2 to decrease in inferior temporal lobe grey matter in the voxel-based regression. CONCLUSIONS Age causes changes in T2 relaxation time in healthy control subjects, with increases being observed in frontal lobe white matter and decreases in the putamen. These changes should be accounted for when interpreting single subject VBR data.
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Affiliation(s)
- Rachel J Sharkey
- Department of Radiology, University of Calgary, Calgary, Alberta, Canada; Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada
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Regular Primary Care Decreases the Likelihood of Mortality in Older People With Epilepsy. Med Care 2010; 48:472-6. [DOI: 10.1097/mlr.0b013e3181d68994] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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