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Li J, Liu Y, Yin C, Zeng Y, Mei Y. Structural and functional remodeling of neural networks in β-amyloid driven hippocampal hyperactivity. Ageing Res Rev 2024; 101:102468. [PMID: 39218080 DOI: 10.1016/j.arr.2024.102468] [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: 06/01/2024] [Revised: 08/19/2024] [Accepted: 08/21/2024] [Indexed: 09/04/2024]
Abstract
Early detection of Alzheimer's disease (AD) is essential for improving the patients outcomes and advancing our understanding of disease, allowing for timely intervention and treatment. However, accurate biomarkers are still lacking. Recent evidence indicates that hippocampal hyperexcitability precedes the diagnosis of AD decades ago, can predict cognitive decline. Thus, could hippocampal hyperactivity be a robust biomarker for early-AD, and what drives hippocampal hyperactivity in early-AD? these critical questions remain to be answered. Increasing clinical and experimental studies suggest that early hippocampal activation is closely associated with longitudinal β-amyloid (Aβ) accumulation, Aβ aggregates, in turn, enhances hippocampal activity. Therefore, in this narrative review, we discuss the role of Aβ-induced altered intrinsic neuronal properties as well as structural and functional remodeling of glutamatergic, GABAergic, cholinergic, noradrenergic, serotonergic circuits in hippocampal hyperactivity. In addition, we analyze the available therapies and trials that can potentially be used clinically to attenuate hippocampal hyperexcitability in AD. Overall, the present review sheds lights on the mechanism behind Aβ-induced hippocampal hyperactivity, and highlights that hippocampal hyperactivity could be a robust biomarker and therapeutic target in prodromal AD.
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Affiliation(s)
- Jinquan Li
- Hubei Clinical Research Center for Alzheimer's Disease, Brain Science and Advanced Technology Institute, School of Medicine, Wuhan University of Science and Technology, Wuhan 430065, China
| | - Yanjun Liu
- Hubei Clinical Research Center for Alzheimer's Disease, Brain Science and Advanced Technology Institute, School of Medicine, Wuhan University of Science and Technology, Wuhan 430065, China
| | - Chuhui Yin
- Hubei Clinical Research Center for Alzheimer's Disease, Brain Science and Advanced Technology Institute, School of Medicine, Wuhan University of Science and Technology, Wuhan 430065, China
| | - Yan Zeng
- Hubei Clinical Research Center for Alzheimer's Disease, Brain Science and Advanced Technology Institute, School of Medicine, Wuhan University of Science and Technology, Wuhan 430065, China.
| | - Yufei Mei
- Hubei Clinical Research Center for Alzheimer's Disease, Brain Science and Advanced Technology Institute, School of Medicine, Wuhan University of Science and Technology, Wuhan 430065, China.
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2
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Dezsi G, Ozturk E, Wong D, Hudson MR, Martello G, Gomes FMM, Salzberg MR, Morris MJ, O'Brien TJ, Jones NC. Fluoxetine accelerates epileptogenesis and magnifies disease severity in a rat model of acquired epilepsy. Epilepsia 2024. [PMID: 39102253 DOI: 10.1111/epi.18080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Revised: 07/17/2024] [Accepted: 07/22/2024] [Indexed: 08/06/2024]
Abstract
OBJECTIVE Many people with epilepsy experience comorbid anxiety and depression, and antidepressants remain a primary treatment for this. Emerging evidence suggests that these agents may modulate epileptogenesis to influence disease severity. Here, we assessed how treatment with the selective serotonin reuptake inhibitor (SSRI) antidepressant fluoxetine impacts epileptogenic, behavioral, and pathological sequelae following status epilepticus. METHODS Male Wistar rats received kainic acid to induce status epilepticus (SE) or vehicle (sham). Animals then received either fluoxetine (10 mg/kg/day) or vehicle for 8 weeks via subcutaneous osmotic pump. Video-electroencephalography was recorded continuously until behavioral testing at day 56, including assessments of anxiety- and depression-like behavior and spatial cognition. Postmortem immunocytochemistry studies examined mossy fiber sprouting. RESULTS Fluoxetine treatment significantly accelerated epileptogenesis following SE, reducing the average period to the first spontaneous seizure (from 32 days [vehicle] to 6 days [fluoxetine], p < .01). Also, fluoxetine exposure magnified the severity of the resultant epilepsy, increasing seizure frequency compared to vehicle (p < .01). Exposure to fluoxetine was associated with improved anxiety- and depression-like behaviors but significantly worsened cognition. Mossy fiber sprouting was more pronounced in fluoxetine-treated rats compared to vehicle (p < .0001). SIGNIFICANCE Our studies demonstrate that, using a model exhibiting spontaneous seizures, epileptogenesis is accelerated and magnified by fluoxetine, an effect that may be related to more severe pathological neuroplasticity. The differential influence of fluoxetine on behavior indicates that different circuitry and mechanisms are responsible for these comorbidities. These findings suggest that caution should be exercised when prescribing SSRI antidepressants to people at risk of developing epilepsy.
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Affiliation(s)
- Gabi Dezsi
- Department of Neuroscience, School of Translational Medicine, Monash University and Department of Neurology, Alfred Hospital, Melbourne, Victoria, Australia
- Department of Medicine (Royal Melbourne Hospital), University of Melbourne, Melbourne Brain Centre, Parkville, Victoria, Australia
| | - Ezgi Ozturk
- Department of Neuroscience, School of Translational Medicine, Monash University and Department of Neurology, Alfred Hospital, Melbourne, Victoria, Australia
- Department of Medicine (Royal Melbourne Hospital), University of Melbourne, Melbourne Brain Centre, Parkville, Victoria, Australia
| | - Davy Wong
- Department of Medicine (Royal Melbourne Hospital), University of Melbourne, Melbourne Brain Centre, Parkville, Victoria, Australia
| | - Matthew R Hudson
- Department of Neuroscience, School of Translational Medicine, Monash University and Department of Neurology, Alfred Hospital, Melbourne, Victoria, Australia
| | - Gabriella Martello
- Department of Neuroscience, School of Translational Medicine, Monash University and Department of Neurology, Alfred Hospital, Melbourne, Victoria, Australia
| | - Flavia M M Gomes
- Department of Neuroscience, School of Translational Medicine, Monash University and Department of Neurology, Alfred Hospital, Melbourne, Victoria, Australia
| | - Michael R Salzberg
- Department of Medicine (Royal Melbourne Hospital), University of Melbourne, Melbourne Brain Centre, Parkville, Victoria, Australia
| | - Margaret J Morris
- Department of Pharmacology, School of Biomedical Sciences, University of New South Wales, Sydney, New South Wales, Australia
| | - Terence J O'Brien
- Department of Neuroscience, School of Translational Medicine, Monash University and Department of Neurology, Alfred Hospital, Melbourne, Victoria, Australia
- Department of Medicine (Royal Melbourne Hospital), University of Melbourne, Melbourne Brain Centre, Parkville, Victoria, Australia
| | - Nigel C Jones
- Department of Neuroscience, School of Translational Medicine, Monash University and Department of Neurology, Alfred Hospital, Melbourne, Victoria, Australia
- Department of Medicine (Royal Melbourne Hospital), University of Melbourne, Melbourne Brain Centre, Parkville, Victoria, Australia
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Sarkisova KY, Gabova AV, Fedosova EA, Shatskova AB, Narkevich VB, Kudrin VS. Antidepressant and Anxiolytic Effects of L-Methionine in the WAG/Rij Rat Model of Depression Comorbid with Absence Epilepsy. Int J Mol Sci 2023; 24:12425. [PMID: 37569798 PMCID: PMC10419169 DOI: 10.3390/ijms241512425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 07/29/2023] [Accepted: 08/01/2023] [Indexed: 08/13/2023] Open
Abstract
Depression is a severe and widespread psychiatric disease that often accompanies epilepsy. Antidepressant treatment of depression comorbid with epilepsy is a major concern due to the risk of seizure aggravation. SAMe, a universal methyl donor for DNA methylation and the synthesis of brain monoamines, is known to have high antidepressant activity. This study aimed to find out whether L-methionine (L-MET), a precursor of SAMe, can have antidepressant and/or anxiolytic effects in the WAG/Rij rat model of depression comorbid with absence epilepsy. The results indicate that L-MET reduces the level of anxiety and depression in WAG/Rij rats and suppresses associated epileptic seizures, in contrast to conventional antidepressant imipramine, which aggravates absence seizures. The antidepressant effect of L-MET was comparable with that of the conventional antidepressants imipramine and fluoxetine. However, the antidepressant profile of L-MET was more similar to imipramine than to fluoxetine. Taken together, our findings suggest that L-MET could serve as a promising new antidepressant drug with anxiolytic properties for the treatment of depression comorbid with absence epilepsy. Increases in the level of monoamines and their metabolites-DA, DOPAC, HVA, NA, and MHPG-in several brain structures, is suggested to be a neurochemical mechanism of the beneficial phenotypic effect of L-MET.
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Affiliation(s)
- Karine Yu. Sarkisova
- Institute of Higher Nervous Activity and Neurophysiology of Russian Academy of Sciences, Butlerova Str. 5A, Moscow 117485, Russia; (A.V.G.); (E.A.F.); (A.B.S.)
| | - Alexandra V. Gabova
- Institute of Higher Nervous Activity and Neurophysiology of Russian Academy of Sciences, Butlerova Str. 5A, Moscow 117485, Russia; (A.V.G.); (E.A.F.); (A.B.S.)
| | - Ekaterina A. Fedosova
- Institute of Higher Nervous Activity and Neurophysiology of Russian Academy of Sciences, Butlerova Str. 5A, Moscow 117485, Russia; (A.V.G.); (E.A.F.); (A.B.S.)
| | - Alla B. Shatskova
- Institute of Higher Nervous Activity and Neurophysiology of Russian Academy of Sciences, Butlerova Str. 5A, Moscow 117485, Russia; (A.V.G.); (E.A.F.); (A.B.S.)
| | - Victor B. Narkevich
- Federal State Budgetary Institution “Scientific Research Institute of Pharmacology named after V.V. Zakusov”, Baltiyskaya Str. 8, Moscow 125315, Russia; (V.B.N.); (V.S.K.)
| | - Vladimir S. Kudrin
- Federal State Budgetary Institution “Scientific Research Institute of Pharmacology named after V.V. Zakusov”, Baltiyskaya Str. 8, Moscow 125315, Russia; (V.B.N.); (V.S.K.)
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Vavers E, Zvejniece L, Dambrova M. Sigma-1 receptor and seizures. Pharmacol Res 2023; 191:106771. [PMID: 37068533 PMCID: PMC10176040 DOI: 10.1016/j.phrs.2023.106771] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 04/03/2023] [Accepted: 04/13/2023] [Indexed: 04/19/2023]
Abstract
Over the last decade, sigma-1 receptor (Sig1R) has been recognized as a valid target for the treatment of seizure disorders and seizure-related comorbidities. Clinical trials with Sig1R ligands are underway testing therapies for the treatment of drug-resistant seizures, developmental and epileptic encephalopathies, and photosensitive epilepsy. However, the direct molecular mechanism by which Sig1R modulates seizures and the balance between excitatory and inhibitory pathways has not been fully elucidated. This review article aims to summarize existing knowledge of Sig1R and its involvement in seizures by focusing on the evidence obtained from Sig1R knockout animals and the anti-seizure effects of Sig1R ligands. In addition, this review article includes a discussion of the advantages and disadvantages of the use of existing compounds and describes the challenges and future perspectives on the use of Sig1R as a target for the treatment of seizure disorders.
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Affiliation(s)
- Edijs Vavers
- Latvian Institute of Organic Synthesis, Laboratory of Pharmaceutical Pharmacology, Aizkraukles 21, LV-1006, Riga, Latvia; University of Tartu, Faculty of Science and Technology, Institute of Chemistry, Ravila 14a, 50411, Tartu, Estonia.
| | - Liga Zvejniece
- Latvian Institute of Organic Synthesis, Laboratory of Pharmaceutical Pharmacology, Aizkraukles 21, LV-1006, Riga, Latvia
| | - Maija Dambrova
- Latvian Institute of Organic Synthesis, Laboratory of Pharmaceutical Pharmacology, Aizkraukles 21, LV-1006, Riga, Latvia; Riga Stradiņš University, Faculty of Pharmacy, Konsula 21, LV-1007, Riga, Latvia
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5
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Tallarico M, Pisano M, Leo A, Russo E, Citraro R, De Sarro G. Antidepressant Drugs for Seizures and Epilepsy: Where do we Stand? Curr Neuropharmacol 2023; 21:1691-1713. [PMID: 35761500 PMCID: PMC10514547 DOI: 10.2174/1570159x20666220627160048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Revised: 06/13/2022] [Accepted: 06/18/2022] [Indexed: 11/22/2022] Open
Abstract
People with epilepsy (PWE) are more likely to develop depression and both these complex chronic diseases greatly affect health-related quality of life (QOL). This comorbidity contributes to the deterioration of the QOL further than increasing the severity of epilepsy worsening prognosis. Strong scientific evidence suggests the presence of shared pathogenic mechanisms. The correct identification and management of these factors are crucial in order to improve patients' QOL. This review article discusses recent original research on the most common pathogenic mechanisms of depression in PWE and highlights the effects of antidepressant drugs (ADs) against seizures in PWE and animal models of seizures and epilepsy. Newer ADs, such as selective serotonin reuptake inhibitors (SRRI) or serotonin-noradrenaline reuptake inhibitors (SNRI), particularly sertraline, citalopram, mirtazapine, reboxetine, paroxetine, fluoxetine, escitalopram, fluvoxamine, venlafaxine, duloxetine may lead to improvements in epilepsy severity whereas the use of older tricyclic antidepressant (TCAs) can increase the occurrence of seizures. Most of the data demonstrate the acute effects of ADs in animal models of epilepsy while there is a limited number of studies about the chronic antidepressant effects in epilepsy and epileptogenesis or on clinical efficacy. Much longer treatments are needed in order to validate the effectiveness of these new alternatives in the treatment and the development of epilepsy, while further clinical studies with appropriate protocols are warranted in order to understand the real potential contribution of these drugs in the management of PWE (besides their effects on mood).
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Affiliation(s)
- Martina Tallarico
- System and Applied Pharmacology, Science of Health Department, School of Medicine, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Maria Pisano
- System and Applied Pharmacology, Science of Health Department, School of Medicine, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Antonio Leo
- System and Applied Pharmacology, Science of Health Department, School of Medicine, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Emilio Russo
- System and Applied Pharmacology, Science of Health Department, School of Medicine, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Rita Citraro
- System and Applied Pharmacology, Science of Health Department, School of Medicine, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Giovambattista De Sarro
- System and Applied Pharmacology, Science of Health Department, School of Medicine, Magna Graecia University of Catanzaro, Catanzaro, Italy
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Peng Y, Chiu ATG, Li VWY, Zhang X, Yeung WL, Chan SHS, Tun HM. The role of the gut-microbiome-brain axis in metabolic remodeling amongst children with cerebral palsy and epilepsy. Front Neurol 2023; 14:1109469. [PMID: 36923492 PMCID: PMC10009533 DOI: 10.3389/fneur.2023.1109469] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 02/08/2023] [Indexed: 03/02/2023] Open
Abstract
Background Epilepsy-associated dysbiosis in gut microbiota has been previously described, but the mechanistic roles of the gut microbiome in epileptogenesis among children with cerebral palsy (CP) have yet to be illustrated. Methods Using shotgun metagenomic sequencing coupled with untargeted metabolomics analysis, this observational study compared the gut microbiome and metabolome of eight children with non-epileptic cerebral palsy (NECP) to those of 13 children with cerebral palsy with epilepsy (CPE). Among children with CPE, 8 had drug-sensitive epilepsy (DSE) and five had drug-resistant epilepsy (DRE). Characteristics at enrollment, medication history, and 7-day dietary intake were compared between groups. Results At the species level, CPE subjects had significantly lower abundances of Bacteroides fragilis and Dialister invisus but higher abundances of Phascolarctobacterium faecium and Eubacterium limosum. By contrast, DRE subjects had a significantly higher colonization of Veillonella parvula. Regarding microbial functional pathways, CPE subjects had decreased abundances of pathways for serine degradation, quinolinic acid degradation, glutamate degradation I, glycerol degradation, sulfate reduction, and nitrate reduction but increased abundances of pathways related to ethanol production. As for metabolites, CPE subjects had higher concentrations of kynurenic acid, 2-oxindole, dopamine, 2-hydroxyphenyalanine, 3,4-dihydroxyphenylglycol, L-tartaric acid, and D-saccharic acid; DRE subjects had increased concentrations of indole and homovanilic acid. Conclusions In this study, we found evidence of gut dysbiosis amongst children with cerebral palsy and epilepsy in terms of gut microbiota species, functional pathways, and metabolites. The combined metagenomic and metabolomic analyses have shed insights on the potential roles of B. fragilis and D. invisus in neuroprotection. The combined analyses have also provided evidence for the involvement of GMBA in the epilepsy-related dysbiosis of kynurenine, serotonin, and dopamine pathways and their complex interplay with neuroimmune and neuroendocrinological pathways.
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Affiliation(s)
- Ye Peng
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China.,Microbiota I-Center (MagIC), The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China.,Li Ka Shing Institute of Health Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Annie T G Chiu
- Department of Paediatrics and Adolescent Medicine, Hong Kong Children's Hospital, Kowloon City, Hong Kong SAR, China
| | - Vivien W Y Li
- Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital and Duchess of Kent Children's Hospital, Pokfulam, Hong Kong SAR, China
| | - Xi Zhang
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China.,Li Ka Shing Institute of Health Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Wai L Yeung
- Department of Paediatrics and Adolescent Medicine, Hong Kong Children's Hospital, Kowloon City, Hong Kong SAR, China
| | - Sophelia H S Chan
- Department of Paediatrics and Adolescent Medicine, Hong Kong Children's Hospital, Kowloon City, Hong Kong SAR, China.,Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital and Duchess of Kent Children's Hospital, Pokfulam, Hong Kong SAR, China.,Department of Paediatrics and Adolescent Medicine, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Hein M Tun
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China.,Microbiota I-Center (MagIC), The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China.,Li Ka Shing Institute of Health Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
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7
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Hussain M, Rashid H, Katyal J. Response to sertraline and antiepileptic drugs in pentylenetetrazole kindling in rats. Brain Res 2021; 1771:147645. [PMID: 34480951 DOI: 10.1016/j.brainres.2021.147645] [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: 03/24/2021] [Revised: 08/27/2021] [Accepted: 08/29/2021] [Indexed: 10/20/2022]
Abstract
Anti-epileptic drugs (AEDs) are the mainstay of epilepsy treatment but these may be a potential risk factor for behavioral disturbances particularly depression which requires treatment. In this study, the effect of antidepressant sertraline (SRT) in combination with AEDs sodium valproate (SV) and levetiracetam (LEV) on seizures, cognitive impairment and oxidative stress in rats was evaluated. After administration of 24th injection of pentylenetetrazole (PTZ), 77.8% rats were kindled. Administration of SRT showed no protective effect on kindling development while SV was 100% protective. With LEV 42.9% were kindled. On combining SRT with SV or LEV 25% and 20% rats were kindled. A significant increase in latency to reach platform zone in Morris water maze(MWM), and increased transfer latencies in Elevated plus maze(EPM) was observed in PTZ kindled rats as compared to normal control on day 49 and when LEV was combined with SRT. In EPM test, however none of the drug treatments had any effect on transfer latencies except LEV pretreated kindled group. In Passive avoidance (PA) test, kindling was associated with a significant decrease in retention time(p = 0.018) while LEV and SV had no effect. The PTZ kindled rats showed significantly higher malondialdehyde(MDA) levels in brain hippocampus(p = 0.0286) while both SRT and SV were associated with significantly lower MDA levels as compared to kindled control group. In case of glutathione (GSH), kindling had no significant effect. The use of sertraline for depression in persons with epilepsy on AEDs needs to be carefully evaluated and monitored due to likelihood of individual variation.
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Affiliation(s)
- Md Hussain
- Neuropharmacology Laboratory, Department of Pharmacology, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Haroon Rashid
- Neuropharmacology Laboratory, Department of Pharmacology, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Jatinder Katyal
- Neuropharmacology Laboratory, Department of Pharmacology, All India Institute of Medical Sciences, New Delhi 110029, India.
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Singh T, Goel RK. Epilepsy Associated Depression: An Update on Current Scenario, Suggested Mechanisms, and Opportunities. Neurochem Res 2021; 46:1305-1321. [PMID: 33665775 DOI: 10.1007/s11064-021-03274-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 02/07/2021] [Accepted: 02/10/2021] [Indexed: 12/21/2022]
Abstract
Depression is one of the most frequent psychiatric comorbidities associated with epilepsy having a major impact on the patient's quality of life. Several screening tools are available to identify and follow up psychiatric disorders in epilepsy. Out of various psychiatric disorders, people with epilepsy (PWE) are at greater risk of developing depression. This bidirectional relationship further hinders pharmacotherapy of comorbid depression in PWE as some antiepileptic drugs (AEDs) worsen associated depression and coadministration of existing antidepressants (ADs) to alleviate comorbid depression has been reported to worsen seizures. Selective serotonin reuptake inhibitors (SSRIs) and selective serotonin and norepinephrine reuptake inhibitors (SNRIs) are first choice of ADs and are considered safe in PWE, but there are no high-quality evidences. Similar to observations in people with depression, PWE also showed pharmacoresistant to available SSRI/SNRIs, which further complicates the disease prognosis. Randomized double-blind placebo-controlled clinical trials are necessary to report efficacy and safety of available ADs in PWE. We should also move beyond ADs, and therefore, we reviewed common pathological mechanisms such as neuroinflammation, dysregulated hypothalamus pituitary adrenal (HPA) axis, altered neurogenesis, and altered tryptophan metabolism responsible for coexistent relationship of epilepsy and depression. Based on these common pertinent pathways involved in the genesis of epilepsy and depression, we suggested novel targets and therapeutic approaches for safe management of comorbid depression in epilepsy.
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Affiliation(s)
- Tanveer Singh
- Department of Pharmaceutical Sciences and Drug Research, Punjabi University, Patiala, Punjab, 147002, India
| | - Rajesh Kumar Goel
- Department of Pharmaceutical Sciences and Drug Research, Punjabi University, Patiala, Punjab, 147002, India.
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Vortioxetine increases absence-like seizures in WAG/Rij rats but decreases penicillin- and pentylenetetrazole-induced seizures in Wistar rats. Epilepsy Behav 2021; 116:107797. [PMID: 33561766 DOI: 10.1016/j.yebeh.2021.107797] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 01/08/2021] [Accepted: 01/09/2021] [Indexed: 11/20/2022]
Abstract
AIM Depression is the major psychiatric disorder in patients with epilepsy. Vortioxetine is a novel antidepressant drug for the treatment of major depressive disorders. In the present study, effects of vortioxetine were evaluated in different experimental epilepsy models of rats. MATERIALS AND METHODS Fifty-six adult male Wistar rats and 28 WAG/Rij rats were divided into 12 groups of 7 rats each. Experiments were conducted with penicillin (500 IU, i.c.) and pentylenetetrazole models (50 mg/kg, intraperitoneally (i.p.)) in Wistar rats and genetic absence epileptic WAG/Rij rats. The vortioxetine (1, 5, or 10 mg/kg, i.p.) was evaluated in these three models. All groups were compared with their control groups. RESULTS In the penicillin-induced seizure model, 1, 5, or 10 mg/kg vortioxetine administration significantly decreased mean spike frequency. In the pentylenetetrazole-induced seizure model, 1, 5, or 10 mg/kg vortioxetine demonstrated a significant dose-dependent decrease in mean spike frequency, an increase in the latency to minor and major seizures, and a decrease in total duration of major seizure and convulsion stage. In genetic absence epileptic WAG/Rij rats, 1 mg/kg vortioxetine caused no significant alteration in the number and duration of SWDs compared to the controls, while 5 and 10 mg/kg doses of vortioxetine increased the number and duration of SWDs. Amplitude of the epileptiform activity did not change in any of the experimental epilepsy models. CONCLUSION The results of this study suggested that vortioxetine has anticonvulsant activity in penicillin- and pentylenetetrazole-induced seizure models. However, it exhibited proconvulsant activity in the absence epileptic WAG/Rij rats.
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10
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Borowicz-Reutt KK, Czuczwar SJ, Rusek M. Interactions of antiepileptic drugs with drugs approved for the treatment of indications other than epilepsy. Expert Rev Clin Pharmacol 2020; 13:1329-1345. [PMID: 33305639 DOI: 10.1080/17512433.2020.1850258] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Introduction: Comorbidities of epilepsy may significantly interfere with its treatment as diseases in the general population are also encountered in epilepsy patients and some of them even more frequently (for instance, depression, anxiety, or heart disease). Obviously, some drugs approved for other than epilepsy indications can modify the anticonvulsant activity of antiepileptics. Areas covered: This review highlights the drug-drug interactions between antiepileptics and aminophylline, some antidepressant, antiarrhythmic (class I-IV), selected antihypertensive drugs and non-barbiturate injectable anesthetics (ketamine, propofol, etomidate, and alphaxalone). The data were reviewed mainly from experimental models of seizures. Whenever possible, clinical data were provided. PUBMED data base was the main search source.Expert opinion: Aminophylline generally reduced the protective activity of antiepileptics, which, to a certain degree, was consistent with scarce clinical data on methylxanthine derivatives and worse seizure control. The only antiarrhythmic with this profile of action was mexiletine when co-administered with VPA. Among antidepressants and non-barbiturate injectable anesthetics, trazodone, mianserin and etomidate or alphaxalone, respectively, negatively affected the anticonvulsant action of some antiepileptic drugs. Clinical data indicate that only amoxapine, bupropion, clomipramine and maprotiline should be used with caution. Possibly, drugs reducing the anticonvulsant potential of antiepileptics should be avoided in epilepsy patients.
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Affiliation(s)
- Kinga K Borowicz-Reutt
- Independent Unit of Experimental Neuropathophysiology, Department of Pathophysiology, Medical University of Lublin , Lublin, Poland
| | | | - Marta Rusek
- Department of Pathophysiology, Medical University of Lublin , Lublin, Poland.,Department of Dermatology, Venereology and Pediatric Dermatology, Laboratory for Immunology of Skin Diseases, Medical University of Lublin , Lublin, Poland
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Jazayeri D, Braine E, McDonald S, Dworkin S, Powell KL, Griggs K, Vajda FJE, O'Brien TJ, Jones NC. A rat model of valproate teratogenicity from chronic oral treatment during pregnancy. Epilepsia 2020; 61:1291-1300. [PMID: 32415786 DOI: 10.1111/epi.16536] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 04/23/2020] [Accepted: 04/23/2020] [Indexed: 01/26/2023]
Abstract
OBJECTIVE Sodium valproate (VPA), the most effective antiepileptic drug for patients with genetic generalized epilepsy (GGE), is a potent human teratogen that increases the risk of a range of congenital malformations, including spina bifida. The mechanisms underlying this teratogenicity are not known, but may involve genetic risk factors. This study aimed to develop an animal model of VPA-induced birth defects. METHODS We used three different rat strains: inbred Genetic Absence Epilepsy Rats From Strasbourg (GAERS), a model of GGE with absence seizures; inbred Non-Epileptic Controls (NEC); and outbred nonepileptic Wistars. Female rats were fed standard chow or VPA (20 g/kg food) mixed in standard chow for 2 weeks prior to conception, and then mated with same-strain males. Treatment continued throughout pregnancy. Fetuses were extracted via C-section on gestational day 21 and examined for birth defects, including external assessment and spinal measurements. RESULTS VPA-exposed pups showed significant reductions in weight, length, and whole-body development compared with controls of all three strains (P < .0001). Gestational VPA treatment altered intravertebral distances, and resulted in underdeveloped vertebral arches between thoracic region T11 and caudal region C2 in most pups (GAERS, 100%; NEC, 95%; Wistar, 80%), more frequently than in controls (9%, 13%, 19%). SIGNIFICANCE Gestational VPA treatment results in similar developmental and morphological abnormalities in three rat strains, including one with GGE, indicating that the genetic underpinnings of epilepsy do not contribute markedly to VPA-induced birth defects. This model may be used in future studies to investigate mechanisms involved in the pathogenesis of antiepileptic drug-induced birth defects.
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Affiliation(s)
- Dana Jazayeri
- Department of Medicine (Royal Melbourne Hospital), Melbourne Brain Centre, University of Melbourne, Parkville, Victoria, Australia.,La Trobe Centre for Sport and Exercise Medicine Research, School of Allied Health, Human Services, and Sport, La Trobe University, Bundoora, Victoria, Australia
| | - Emma Braine
- Department of Medicine (Royal Melbourne Hospital), Melbourne Brain Centre, University of Melbourne, Parkville, Victoria, Australia.,Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Victoria, Australia.,Department of Neurology, Alfred Hospital, Melbourne, Victoria, Australia
| | - Stuart McDonald
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Victoria, Australia.,Department of Neurology, Alfred Hospital, Melbourne, Victoria, Australia.,Department of Physiology, Anatomy, and Microbiology, School of Life Sciences, La Trobe University, Melbourne, Victoria, Australia
| | - Sebastian Dworkin
- Department of Physiology, Anatomy, and Microbiology, School of Life Sciences, La Trobe University, Melbourne, Victoria, Australia
| | - Kim L Powell
- Department of Medicine (Royal Melbourne Hospital), Melbourne Brain Centre, University of Melbourne, Parkville, Victoria, Australia.,Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Victoria, Australia.,Department of Neurology, Alfred Hospital, Melbourne, Victoria, Australia
| | - Karen Griggs
- Department of Physiology, Anatomy, and Microbiology, School of Life Sciences, La Trobe University, Melbourne, Victoria, Australia
| | - Frank J E Vajda
- Department of Medicine (Royal Melbourne Hospital), Melbourne Brain Centre, University of Melbourne, Parkville, Victoria, Australia.,Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Victoria, Australia.,Department of Neurology, Alfred Hospital, Melbourne, Victoria, Australia
| | - Terence J O'Brien
- Department of Medicine (Royal Melbourne Hospital), Melbourne Brain Centre, University of Melbourne, Parkville, Victoria, Australia.,Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Victoria, Australia.,Department of Neurology, Alfred Hospital, Melbourne, Victoria, Australia
| | - Nigel C Jones
- Department of Medicine (Royal Melbourne Hospital), Melbourne Brain Centre, University of Melbourne, Parkville, Victoria, Australia.,Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Victoria, Australia.,Department of Neurology, Alfred Hospital, Melbourne, Victoria, Australia
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12
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Christensen J, Pedersen HS, Fenger-Grøn M, Fann JR, Jones NC, Vestergaard M. Selective serotonin reuptake inhibitors and risk of epilepsy after traumatic brain injury - A population based cohort study. PLoS One 2019; 14:e0219137. [PMID: 31323024 PMCID: PMC6641473 DOI: 10.1371/journal.pone.0219137] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Accepted: 06/17/2019] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Traumatic brain injury (TBI) is common and associated with a marked increased risk of developing epilepsy. Animal studies indicate that treatment with selective serotonin reuptake inhibitors (SSRIs) may increase the risk of epilepsy after TBI. The aim of this study was to investigate whether use of SSRIs modifies the risk of epilepsy after TBI. METHODS This was a cohort study of 205,715 persons, who suffered a TBI in Denmark from 1996 to 2013. For each person with TBI, we matched 10 reference persons (N = 2,057,150) who were alive on the day of TBI and who had the same age and gender but had no history of TBI. We used a stratified Cox regression to calculate the relative risk of epilepsy after TBI for persons exposed to TBI, SSRI or both after adjustment for income, civil status, medical and neurological comorbidities, severe mental disease, and substance abuse. RESULTS The risk of epilepsy was 5.61 times higher for persons who used SSRI at time of TBI (adjusted Hazard Ratio (aHR): 5.61 (95% CI: 4.88; 6.45)), 3.23 times higher for persons who had a TBI but did not use SSRI at time of TBI (aHR: 3.23 (95% CI: 3.12;3.35)), and 1.31 times higher for persons who used SSRI but had no TBI (aHR: 1.31 (95% CI: 1.18; 1.45)) compared to persons unexposed to both TBI and SSRI. CONCLUSIONS This large population based cohort study showed that people using SSRI at the time of a TBI had higher risk of developing epilepsy compared to people not using SSRI at the time of TBI. The results are in line with those of animal studies and calls for further studies to evaluate whether the association is due to SSRIs or to the underlying disease (e.g. depression or anxiety).
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Affiliation(s)
- Jakob Christensen
- Department of Neurology, Aarhus University Hospital, Aarhus, Denmark
| | - Henrik Schou Pedersen
- Research Unit for General Practice and Section for General Medical Practice, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Morten Fenger-Grøn
- Research Unit for General Practice and Section for General Medical Practice, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Jesse R. Fann
- Department of Psychiatry, University of Washington, Seattle, Washington, United States of America
| | - Nigel C. Jones
- Department of Medicine (RMH), University of Melbourne, Melbourne Brain Centre, Parkville, Victoria, Australia
- Department of Neuroscience, Central Clinical School, Monash University and Department of Neurology, The Alfred Hospital, Melbourne, Victoria, Australia
| | - Mogens Vestergaard
- Research Unit for General Practice and Section for General Medical Practice, Department of Public Health, Aarhus University, Aarhus, Denmark
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13
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Di Maio R, Colangeli R, Di Giovanni G. WIN 55,212-2 Reverted Pilocarpine-Induced Status Epilepticus Early Changes of the Interaction among 5-HT 2C/NMDA/CB 1 Receptors in the Rat Hippocampus. ACS Chem Neurosci 2019; 10:3296-3306. [PMID: 30912644 DOI: 10.1021/acschemneuro.9b00080] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
The molecular basis for temporal lobe epileptogenesis remains poorly defined. Recent evidence shows that serotonin 2C receptors (5-HT2CRs), NR2A and NR2B subunit-containing N-methyl-d-aspartate receptors (NMDARs) and cannabinoid 1 receptors (CB1Rs) may be involved in the progression of the epileptic disorders. Moreover, CB1R activation has been reported to modulate the activity of 5-HT2C and NMDA receptors. Here, we treated Sprague-Dawley rats with the pro-convulsant agent pilocarpine (PILO) to induce status epilepticus (SE) in order to study the effect, with regards to receptor signaling and their interactions, of the preactivation of the CB1Rs on early changes that occur 24 h from the initial insult in the hippocampus. Pretreatment with the synthetic CB1/2R agonist WIN 55,212-2 (2 mg/kg, ip) counteracted PILO-induced 5-HT2CR downregulation. Moreover, WIN 55,212-2 uncoupled PILO-induced 5-HT2CR/NR2A and prevented NR2ATyr1325 phosphorylation indirectly since no 5-HT2CR/CB1R interactions were observed. WIN 55,212-2 treatment also prevented PILO-mediated impairment of CB1R/NR2B interactions and NR2B subunit internalization, suggesting a possible role of CB1R in NR2B-containing NMDAR turn over. All the effects observed in animals treated with WIN 55,212-2 were blocked by pretreatment with the selective CB1R antagonist AM251 (1 mg/kg, ip) given 45 min before PILO injection. These results, obtained in vivo in post-PILO-induced SE, provide new insights on the early cellular responses during epileptogenesis and identify new CB1R-mediated mechanisms by which cannabinoids may prevent the development of chronic epilepsy.
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Affiliation(s)
- Roberto Di Maio
- Pittsburgh Institute for Neurodegenerative Diseases and Department of Neurology, University of Pittsburgh, Pittsburgh, Pennsylvania 15260, United States
| | - Roberto Colangeli
- Laboratory of Neurophysiology, Department of Physiology and Biochemistry, Faculty of Medicine and Surgery, University of Malta, Msida MSD 2080, Malta
| | - Giuseppe Di Giovanni
- Laboratory of Neurophysiology, Department of Physiology and Biochemistry, Faculty of Medicine and Surgery, University of Malta, Msida MSD 2080, Malta
- School of Biosciences, Cardiff University, Cardiff CF10 3AT, U.K
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14
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Ögün MN, Çetinkaya A, Beyazçiçek E. The effect of vortioxetine on penicillin-induced epileptiform activity in rats. ARQUIVOS DE NEURO-PSIQUIATRIA 2019; 77:412-417. [PMID: 31314843 DOI: 10.1590/0004-282x20190064] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Accepted: 02/18/2019] [Indexed: 11/21/2022]
Abstract
Vortioxetine is a multimodal antidepressant agent that modulates 5-HT receptors and inhibits the serotonin transporter. It is indicated especially in cases of major depressive disorder related to cognitive dysfunction. There are many studies investigating the effects of antidepressants on the seizure threshold and short-term epileptic activity. However, the effect of vortioxetine on epileptic seizures is not exactly known. Our aim was to investigate the effects of vortioxetine on penicillin-induced epileptiform activity. Twenty-seven Wistar rats were divided into three groups: sham-control group, positive control group (diazepam), and vortioxetine group. After a penicillin-induced epilepsy model was formed in each of the three groups of animals, 0.1 ml of saline was administered to the control group, 0.1 ml (10 mg/kg) vortioxetine was administered in the vortioxetine group, and 0.1 mL (5 mg/kg) of diazepam was administered in the positive control group, intraperitoneally. The epileptic activity records were obtained for 120 minutes after the onset of seizure. There was no significant difference in spike wave activity between the vortioxetine and diazepam groups, whereas this was significantly reduced in the vortioxetine group compared with the controls. The administration of vortioxetine at a dose of 10 mg/kg immediately after the seizure induction significantly decreased the spike frequencies of epileptiform activity compared with the control group. No significant difference was found between the vortioxetine and positive controls. This study showed that vortioxetine reduces the number of acutely-induced epileptic discharges. Vortioxetine may be an important alternative for epileptic patients with major depressive disorder-related cognitive dysfunction.
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Affiliation(s)
- Muhammed Nur Ögün
- Bolu Abant Izzet Baysal Universitesi; Nöroloji Anabilim Dalı, Bolu, Türkiye
| | - Ayhan Çetinkaya
- Bolu Abant Izzet Baysal Universitesi; Fizyoloji Anabilim Dalı, Bolu, Türkiye
| | - Ersin Beyazçiçek
- Duzce Universitesi, Duzce Tıp Fakültesi, Fizyoloji Anabilim Dalı, Düzce, Türkiye
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15
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Aygun H. The effect of fluoxetine on penicillin-induced epileptiform activity. Epilepsy Behav 2019; 95:79-86. [PMID: 31026788 DOI: 10.1016/j.yebeh.2019.03.050] [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: 01/31/2019] [Revised: 03/22/2019] [Accepted: 03/28/2019] [Indexed: 01/01/2023]
Abstract
AIM Depression is the most frequent psychiatric comorbidity in patients with epilepsy. Fluoxetine is the most widely used selective serotonin reuptake inhibitor (SSRI) in depression. The aim of the present study was to evaluate the dose-dependent effect of fluoxetine on penicillin-induced seizure by electrocorticogram (ECoG), a model for simple partial epilepsy. METHOD The epileptiform activity was induced by intracortical (i.c.) microinjection of penicillin into the left sensorimotor cortex. Thirty minutes after penicillin injection, 5, 10, or 20 mg/kg doses of fluoxetine were administered intraperitoneally (i.p.). An ECoG recording was performed for 180 min using the data acquisition system. The frequency and the amplitude of the epileptiform activity were analyzed. RESULTS Penicillin induced bilateral spikes and spike-wave complexes within 2-5 min. The 5 and 10 mg/kg doses of fluoxetine significantly reduced the frequency (58%, p < 0.05 and 69%, p < 0.01, 40 and 50 min after fluoxetine injection, respectively) and amplitude (60%, p < 0.01 and 73%, p < 0.05, 40 and 120 min after fluoxetine injection, respectively) of epileptiform activity compared with penicillin-induced seizure group (control). Five-milligram fluoxetine (i.p.) was the most effective dose to decrease frequency and amplitude on penicillin-induced epileptiform activity. However, a higher fluoxetine dose (20 mg/kg) significantly increased frequency (147%, p < 0.01) and amplitude (123%, p < 0.05) of epileptiform activity 40 and 120 min after fluoxetine administration compared with control group. Also, bursts of population spikes were seen in 20 mg/kg fluoxetine doses. CONCLUSION Results of the present study indicate that low and moderate fluoxetine doses have an anticonvulsant effect while high doses have proconvulsant effect on penicillin-induced epileptic activity.
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Affiliation(s)
- Hatice Aygun
- Department of Physiology, Faculty of Medicine, Tokat Gaziosmanpasa University, Tokat, Turkey.
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16
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Luwor R, Morokoff AP, Amiridis S, D'Abaco G, Paradiso L, Stylli SS, Nguyen HPT, Tarleton M, Young KA, O'Brien TJ, Robinson PJ, Chircop M, McCluskey A, Jones NC. Targeting Glioma Stem Cells by Functional Inhibition of Dynamin 2: A Novel Treatment Strategy for Glioblastoma. Cancer Invest 2019; 37:144-155. [PMID: 30907150 DOI: 10.1080/07357907.2019.1582060] [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] [Indexed: 01/04/2023]
Abstract
Glioma stem cells (GSCs) play major roles in drug resistance, tumour maintenance and recurrence of glioblastoma. We investigated inhibition of the GTPase dynamin 2 as a therapy for glioblastoma. Glioma cell lines and patient-derived GSCs were treated with dynamin inhibitors, Dynole 34-2 and CyDyn 4-36. We studied about cell viability, and GSC neurosphere formation in vitro and orthotopic tumour growth in vivo. Dynamin inhibition reduced glioblastoma cell line viability and suppressed neurosphere formation and migration of GSCs. Tumour growth was reduced by CyDyn 4-36 treatment. Dynamin 2 inhibition therefore represents a novel approach for stem cell-directed Glioblastoma therapy.
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Affiliation(s)
- Rodney Luwor
- a Department of Surgery , The University of Melbourne, The Royal Melbourne Hospital , Parkville , Australia
| | - Andrew P Morokoff
- a Department of Surgery , The University of Melbourne, The Royal Melbourne Hospital , Parkville , Australia.,b Department of Neurosurgery , The Royal Melbourne Hospital , Parkville , Australia
| | - Stephanie Amiridis
- a Department of Surgery , The University of Melbourne, The Royal Melbourne Hospital , Parkville , Australia.,c Department of Medicine , The University of Melbourne, The Royal Melbourne Hospital , Parkville , Australia
| | - Giovanna D'Abaco
- d Melbourne School of Engineering, School of Chemical and Biomedical Engineering , The University of Melbourne , Parkville , Australia
| | - Lucia Paradiso
- a Department of Surgery , The University of Melbourne, The Royal Melbourne Hospital , Parkville , Australia
| | - Stanley S Stylli
- a Department of Surgery , The University of Melbourne, The Royal Melbourne Hospital , Parkville , Australia.,b Department of Neurosurgery , The Royal Melbourne Hospital , Parkville , Australia
| | - Hong P T Nguyen
- a Department of Surgery , The University of Melbourne, The Royal Melbourne Hospital , Parkville , Australia
| | - Mark Tarleton
- e Department of Chemistry, School of Environmental and Life Sciences , The University of Newcastle , Callaghan , Australia
| | - Kelly A Young
- e Department of Chemistry, School of Environmental and Life Sciences , The University of Newcastle , Callaghan , Australia
| | - Terence J O'Brien
- c Department of Medicine , The University of Melbourne, The Royal Melbourne Hospital , Parkville , Australia.,f Department of Neuroscience , Central Clinical School, Monash University , Melbourne , Australia.,g Department of Neurology , The Alfred Hospital , Melbourne , Australia
| | - Phillip J Robinson
- e Department of Chemistry, School of Environmental and Life Sciences , The University of Newcastle , Callaghan , Australia.,h Children's Medical Research Institute, The University of Sydney , Westmead , Australia
| | - Megan Chircop
- e Department of Chemistry, School of Environmental and Life Sciences , The University of Newcastle , Callaghan , Australia.,h Children's Medical Research Institute, The University of Sydney , Westmead , Australia
| | - Adam McCluskey
- e Department of Chemistry, School of Environmental and Life Sciences , The University of Newcastle , Callaghan , Australia
| | - Nigel C Jones
- c Department of Medicine , The University of Melbourne, The Royal Melbourne Hospital , Parkville , Australia.,f Department of Neuroscience , Central Clinical School, Monash University , Melbourne , Australia.,g Department of Neurology , The Alfred Hospital , Melbourne , Australia
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17
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Esen M, Aygun H. The effect of duloxetine on penicillin-induced epileptiform activity in rats. Neurol Res 2018; 41:298-305. [DOI: 10.1080/01616412.2018.1560642] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- Mehmet Esen
- Department of Emergency Medicine, Faculty of Medicine, Tokat Gaziosmanpasa University, Tokat, Turkey
| | - Hatice Aygun
- Department of Physiology, Faculty of Medicine, Tokat Gaziosmanpasa University, Tokat, Turkey
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18
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Li C, Silva J, Ozturk E, Dezsi G, O'Brien TJ, Renoir T, Jones NC. Chronic fluoxetine treatment accelerates kindling epileptogenesis in mice independently of 5-HT 2A receptors. Epilepsia 2018; 59:e114-e119. [PMID: 29858497 DOI: 10.1111/epi.14435] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/07/2018] [Indexed: 12/19/2022]
Abstract
Patients with epilepsy often have mood disorders, and these are commonly treated with antidepressant drugs. Although these drugs are often successful in mitigating depressive symptoms, how they affect the epileptogenic processes has been little studied. Recent evidence has demonstrated that treatment with selective serotonin reuptake inhibitor (SSRI) antidepressant drugs adversely promotes epileptogenesis, which may be of great concern considering the number of patients exposed to these drugs. This study investigated 5-HT2A receptor signaling as a potential mechanism driving the pro-epileptogenic effects of the prototypical SSRI fluoxetine. Male homozygous 5-HT2A receptor knockout mice or wild-type littermates (n = 9-14/group) were treated with continuous fluoxetine (10 mg kg-1 d-1 , sc) or vehicle and subjected to electrical kindling of the amygdala. Compared to vehicle, fluoxetine treatment accelerated kindling epileptogenesis (P < .001), but there was no effect of genotype (P = .75), or any treatment x genotype interaction observed (P = .90). Of interest, fluoxetine treatment increased afterdischarge thresholds in both genotypes (P = .007). We conclude that treatment with fluoxetine promotes epileptogenesis in mice, but this effect is not mediated by 5-HT2A receptors. This suggests that antidepressants may accelerate the onset of acquired epilepsy in patients who have experienced epileptogenic cerebral insults.
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Affiliation(s)
- Crystal Li
- Department of Medicine, Royal Melbourne Hospital, The University of Melbourne, Melbourne, VIC, Australia
| | - Juliana Silva
- Department of Medicine, Royal Melbourne Hospital, The University of Melbourne, Melbourne, VIC, Australia
| | - Ezgi Ozturk
- Department of Medicine, Royal Melbourne Hospital, The University of Melbourne, Melbourne, VIC, Australia.,Department of Neuroscience, Central Clinical School, Monash University, Prahran, VIC, Australia.,Department of Neurology, The Alfred Hospital, Melbourne, VIC, Australia
| | - Gabriella Dezsi
- Department of Medicine, Royal Melbourne Hospital, The University of Melbourne, Melbourne, VIC, Australia.,Department of Neuroscience, Central Clinical School, Monash University, Prahran, VIC, Australia.,Department of Neurology, The Alfred Hospital, Melbourne, VIC, Australia
| | - Terence J O'Brien
- Department of Medicine, Royal Melbourne Hospital, The University of Melbourne, Melbourne, VIC, Australia.,Department of Neuroscience, Central Clinical School, Monash University, Prahran, VIC, Australia.,Department of Neurology, The Alfred Hospital, Melbourne, VIC, Australia
| | - Thibault Renoir
- The Florey Institute of Neuroscience and Mental Health, Melbourne Brain Centre, The University of Melbourne, Melbourne, VIC, Australia
| | - Nigel C Jones
- Department of Medicine, Royal Melbourne Hospital, The University of Melbourne, Melbourne, VIC, Australia.,Department of Neuroscience, Central Clinical School, Monash University, Prahran, VIC, Australia.,Department of Neurology, The Alfred Hospital, Melbourne, VIC, Australia
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19
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Russo E, Citraro R. Pharmacology of epileptogenesis and related comorbidities in the WAG/Rij rat model of genetic absence epilepsy. J Neurosci Methods 2018; 310:54-62. [PMID: 29857008 DOI: 10.1016/j.jneumeth.2018.05.020] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Revised: 05/25/2018] [Accepted: 05/28/2018] [Indexed: 01/23/2023]
Abstract
Animal studies currently represent the best source of information also in the field of epileptogenesis research. Many animal models have been proposed and studied so far both from the pathophysiological and pharmacological point of view. Furthermore, they are widely used for the identification of potentially clinically valuable biomarkers. The WAG/Rij rat model, similarly to other genetic animal strains, represents a suitable animal model of absence epileptogenesis accompanied by depressive-like and cognitive comorbidities. Generally, animal models of epileptogenesis are characterized by an identifiable initial insult (e.g. traumatic brain injury), a latent phase lasting up to the appearance of the first spontaneous seizure and a chronic phase characterized by recurrent spontaneous seizures. In most of genetic models: the initial insult should be defined as the mutation causing epilepsy, which is not clearly defined in the WAG/Rij rat model; the latent phase ends at the appearance of the first spontaneous seizure, which is about 2-3 months of age in WAG/Rij rats and thereafter the chronic phase. WAG/Rij rats also display depressive-like comorbidity around the age of 4 months, which is apparently linked to the development of absence seizures considering both its ontogeny and the fact that drugs affecting absence seizures development also block the development of depressive-like behavior. Finally, WAG/Rij rats also display cognitive impairment in some memory tasks, however, this has not been yet definitively linked to absence seizures development and may represent an epiphenomenon. This review is focused on the effects of pharmacological treatments against epileptogenesis and their effects on comorbidities.
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Affiliation(s)
- Emilio Russo
- Science of Health Department, School of Medicine, University of Catanzaro, Italy.
| | - Rita Citraro
- Science of Health Department, School of Medicine, University of Catanzaro, Italy
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20
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Lin WH, Li XF, Lin MX, Zhou Y, Huang HP. Novel insights into the effect of paroxetine administration in pilocarpine‑induced chronic epileptic rats. Mol Med Rep 2017; 16:8245-8252. [PMID: 28983622 DOI: 10.3892/mmr.2017.7659] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Accepted: 05/09/2017] [Indexed: 11/05/2022] Open
Abstract
The aim of the present study was to investigate the role of paroxetine intervention in epilepsy, and its association with the expression of serotonin transporter (SERT) and hippocampal apoptosis. Thirty adult male Sprague Dawley rats were divided into control vehicle (n=6) and epileptic (n=24) groups. Status epilepticus (SE) was induced via systemic injection of pilocarpine, and seizure activity was monitored via video electroencephalogram. The epileptic group was then randomly divided into two groups; Four weeks following SE induction, paroxetine (5 mg/kg/day; SE + paroxetine group) or normal saline (SE group) was intraperitoneally injected for 4 weeks. Brain tissue was collected to evaluate apoptosis via terminal deoxynucleotidyl transferase dUTP nick‑end labeling. SERT, B‑cell lymphoma‑2 (Bcl‑2) and brain derived neurotropic factor (BDNF) expression levels were evaluated by western blotting, and miR‑16 expression was evaluated by reverse transcription‑quantitative polymerase chain reaction. Paroxetine did not affect the mortality of the pilocarpine‑induced chronic epileptic rats. Spontaneous recurrent seizures (SSRs) were observed 7‑28 days following SE induction. The frequency and stage of the SSRs were reduced by paroxetine administration. Apoptotic cells were observed in the epileptic hippocampus. Following paroxetine intervention, the staining intensity and number of apoptotic cells were significantly decreased. Expression levels of BDNF and Bcl‑2 were lower in the SE group compared with the vehicle group. The former was not altered by paroxetine injection; however, the latter was increased. In the SE group, SERT expression was not altered in the raphe nucleus but was decreased in the hippocampus. Following paroxetine administration, SERT expression was decreased in the raphe nucleus and increased in the hippocampus. In the SE group, miR‑16 expression was decreased in the raphe nucleus and increased in the hippocampus. Following paroxetine administration, miR‑16 expression was not altered in the raphe nucleus but was reduced in the hippocampus. In conclusion, the seizures and hippocampal apoptosis observed in chronic epileptic rats were alleviated by paroxetine treatment. This effect may be associated with the reduced Bcl‑2 and BDNF expression and the modulation of SERT expression. The alterations in miR‑16 expression may provide a potential explanation for the modulation of apoptosis; however, further research is required to determine the complete underlying molecular mechanism.
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Affiliation(s)
- Wan-Hui Lin
- Department of Neurology and Geriatrics, Union Hospital of Fujian Medical University, Fuzhou, Fujian 350001, P.R. China
| | - Xiao-Feng Li
- Department of Neurology, Union Hospital of Fujian Medical University, Fuzhou, Fujian 350001, P.R. China
| | - Ming-Xing Lin
- Department of Pediatrics, Union Hospital of Fujian Medical University, Fuzhou, Fujian 350001, P.R. China
| | - Ying Zhou
- Neuroscience Research Center of Fujian Medical University, Fuzhou, Fujian 350001, P.R. China
| | - Hua-Pin Huang
- Department of Neurology and Geriatrics, Union Hospital of Fujian Medical University, Fuzhou, Fujian 350001, P.R. China
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21
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Kaur N, Singh T, Kumar S, Goel RK. Neurochemical evidence based suggested therapy for safe management of epileptogenesis. Epilepsy Behav 2017; 72:8-16. [PMID: 28570965 DOI: 10.1016/j.yebeh.2017.04.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Revised: 03/18/2017] [Accepted: 04/03/2017] [Indexed: 01/05/2023]
Abstract
Most of the clinically available antiepileptic drugs have only antiseizure effects and are reported unable to prevent epileptogenesis. In the past decade, several drugs underwent clinical trials for management of epileptogenesis, but none of the drugs tested was found effective. One of the major lacunas is availability of appropriate preclinical approaches to delineate mechanisms of epileptogenesis. Thus, the present study attempts to suggest a neurochemistry based approach for safe management of epileptogenesis. The altered neurochemical milieu in amygdala, cortex and hippocampus areas of the mice brain in naïve, kindled and kindling resistant animals has been delineated. The endogenous natural antiepileptogenic neurochemical defense mechanism observed in kindling resistant animals may uncover neurochemical mechanisms of epileptogenesis and in turn suggest us novel interventions for safe management of epileptogenesis. The kindling epileptogenesis was carried out in two month old male Swiss albino mice by administering subconvulsive pentylenetetrazole (35mg/kg; i.p.) at an interval of 48±2h for 42days. 2h after the last pentylenetetrazole injection, the animals were subjected to behavioral evaluations. Four hours after behavioral evaluation, all animals were euthanized and discrete parts of brain (amygdala, cortex and hippocampus) were harvested for neurochemical analysis. Results revealed that 60% of animals responded to kindling as observed with decreased seizure threshold, while the rest were found resistant. The kindled animals were found to be associated with anxiety, depression and cognitive impairment; while in kindling resistant animals no such behavioral deficits were observed. The neurochemical analysis revealed that in kindled animals altered glutamate-GABA neurotransmission, and decreased taurine, glycine, d-serine, monoamine levels with elevated indoleamine 2,3-dioxygenase activity were observed, which may be convicted for progression of kindling epileptogenesis. However, in kindling resistant animals elevated GABA, taurine, tryptophan, serotonin, glycine, and d-serine levels with decreased indoleamine 2,3-dioxygenase activity were observed as natural endogenous antiepileptogenic mechanisms, which may be foreseen as safe pharmacological targets for management of epileptogenesis.
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Affiliation(s)
- Navjot Kaur
- Department of Pharmaceutical Sciences and Drug Research, Punjabi University, Patiala, India
| | - Tanveer Singh
- Department of Pharmaceutical Sciences and Drug Research, Punjabi University, Patiala, India
| | - Sandeep Kumar
- Department of Pharmaceutical Sciences and Drug Research, Punjabi University, Patiala, India
| | - Rajesh Kumar Goel
- Department of Pharmaceutical Sciences and Drug Research, Punjabi University, Patiala, India.
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Sierksma ASR, de Nijs L, Hoogland G, Vanmierlo T, van Leeuwen FW, Rutten BPF, Steinbusch HWM, Prickaerts J, van den Hove DLA. Fluoxetine Treatment Induces Seizure Behavior and Premature Death in APPswe/PS1dE9 Mice. J Alzheimers Dis 2016; 51:677-82. [PMID: 26890781 DOI: 10.3233/jad-151066] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Treatment of Alzheimer's disease (AD) patients with the antidepressant fluoxetine is known to improve memory and cognitive function. However, the mechanisms underlying these effects are largely unknown. To unravel these mechanisms, we aimed to treat APPswe/PS1dE9 mice with fluoxetine. Unexpectedly, with time, an increased number of animals displayed seizure behavior and died. Although spontaneous behavioral seizures have been reported previously in this mouse model, the observation of seizures and death consequential to fluoxetine treatment is new. Our results warrant further research on the underlying mechanisms as this may refine the treatment of AD patients.
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Affiliation(s)
- Annerieke S R Sierksma
- School for Mental Health and Neuroscience (MHeNS), Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Laurence de Nijs
- School for Mental Health and Neuroscience (MHeNS), Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Govert Hoogland
- School for Mental Health and Neuroscience (MHeNS), Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.,Department of Neurosurgery, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Tim Vanmierlo
- School for Mental Health and Neuroscience (MHeNS), Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Fred W van Leeuwen
- School for Mental Health and Neuroscience (MHeNS), Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Bart P F Rutten
- School for Mental Health and Neuroscience (MHeNS), Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Harry W M Steinbusch
- School for Mental Health and Neuroscience (MHeNS), Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Jos Prickaerts
- School for Mental Health and Neuroscience (MHeNS), Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Daniel L A van den Hove
- School for Mental Health and Neuroscience (MHeNS), Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.,Department of Psychiatry, Psychosomatics and Psychotherapy, University of Würzburg, Würzburg, Germany
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Banach M, Popławska M, Błaszczyk B, Borowicz KK, Czuczwar SJ. Pharmacokinetic/pharmacodynamic considerations for epilepsy - depression comorbidities. Expert Opin Drug Metab Toxicol 2016; 12:1067-80. [PMID: 27267259 DOI: 10.1080/17425255.2016.1198319] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
INTRODUCTION Epilepsy may be frequently associated with psychiatric disorders and its co-existence with depression usually results in the reduced quality of life of patients with epilepsy. Also, the efficacy of antiepileptic treatment in depressed patients with epilepsy may be significantly reduced. AREAS COVERED Results of experimental studies indicate that antidepressants co-administered with antiepileptic drugs may either increase their anticonvulsant activity, remain neutral or decrease the protective action of antiepileptic drugs in models of seizures. Apart from purely pharmacodynamic interactions, pharmacokinetic mechanisms have been proven to contribute to the final outcome. We report on clinical data regarding the pharmacokinetic interactions of enzyme-inducing antiepileptic drugs with various antidepressants, whose plasma concentration may be significantly reduced. On the other hand, antidepressants (especially selective serotonin reuptake inhibitors) may influence the metabolism of antiepileptics, in many cases resulting in the elevation of plasma concentration of antiepileptic drugs. EXPERT OPINION The preclinical data may provide valuable clues on how to combine these two groups of drugs - antidepressant drugs neutral or potentiating the anticonvulsant action of antiepileptics are recommended in this regard. Avoidance of antidepressants clearly decreasing the convulsive threshold or decreasing the anticonvulsant efficacy of antiepileptic drugs (f.e. bupropion or mianserin) in patients with epilepsy is recommended.
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Affiliation(s)
- Monika Banach
- a Experimental Neuropathophysiology Unit, Department of Pathophysiology , Medical University , Lublin , Poland
| | - Monika Popławska
- a Experimental Neuropathophysiology Unit, Department of Pathophysiology , Medical University , Lublin , Poland
| | - Barbara Błaszczyk
- b Faculty of Health Sciences , High School of Economics, Law and Medical Sciences , Kielce , Poland
| | - Kinga K Borowicz
- a Experimental Neuropathophysiology Unit, Department of Pathophysiology , Medical University , Lublin , Poland
| | - Stanisław J Czuczwar
- c Department of Pathophysiology , Medical University , Lublin , Poland.,d Department of Physiopathology , Institute of Rural Health , Lublin , Poland
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Citalopram as a good candidate for treatment of depression in patients with epilepsy. Epilepsy Behav 2015; 44:96-7. [PMID: 25659046 DOI: 10.1016/j.yebeh.2015.01.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Accepted: 01/10/2015] [Indexed: 10/24/2022]
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Jason LA, Zinn ML, Zinn MA. Myalgic Encephalomyelitis: Symptoms and Biomarkers. Curr Neuropharmacol 2015; 13:701-34. [PMID: 26411464 PMCID: PMC4761639 DOI: 10.2174/1570159x13666150928105725] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Revised: 04/09/2015] [Accepted: 07/14/2015] [Indexed: 01/01/2023] Open
Abstract
Myalgic Encephalomyelitis (ME) continues to cause significant morbidity worldwide with an estimated one million cases in the United States. Hurdles to establishing consensus to achieve accurate evaluation of patients with ME continue, fueled by poor agreement about case definitions, slow progress in development of standardized diagnostic approaches, and issues surrounding research priorities. Because there are other medical problems, such as early MS and Parkinson's Disease, which have some similar clinical presentations, it is critical to accurately diagnose ME to make a differential diagnosis. In this article, we explore and summarize advances in the physiological and neurological approaches to understanding, diagnosing, and treating ME. We identify key areas and approaches to elucidate the core and secondary symptom clusters in ME so as to provide some practical suggestions in evaluation of ME for clinicians and researchers. This review, therefore, represents a synthesis of key discussions in the literature, and has important implications for a better understanding of ME, its biological markers, and diagnostic criteria. There is a clear need for more longitudinal studies in this area with larger data sets, which correct for multiple testing.
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Affiliation(s)
- Leonard A. Jason
- Department of Psychology, Center for Community Research, DePaul University, Chicago, Illinois, United States
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Sucrose consumption test reveals pharmacoresistant depression-associated behavior in two mouse models of temporal lobe epilepsy. Exp Neurol 2014; 263:263-71. [PMID: 25220610 DOI: 10.1016/j.expneurol.2014.09.004] [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] [Received: 03/28/2014] [Revised: 08/16/2014] [Accepted: 09/04/2014] [Indexed: 01/21/2023]
Abstract
Among the comorbidities observed in epilepsy patients depression is the most frequent one. Likewise, depression by itself is accompanied by an increased risk to develop epilepsy. Both epilepsy and depression are characterized by a high incidence of pharmacoresistance, which might be based on overactivity of multidrug transporters like P-glycoprotein at the blood-brain barrier. Using genetically modified mice in preclinical epilepsy research is pivotal for investigating this bidirectional relationship. In the present study, we used the sucrose consumption test (SCT) in the pilocarpine and the intrahippocampal kainate mouse post-status epilepticus model to reveal anhedonic behavior, i.e. hyposensitivity to pleasure, as a key symptom of depression. Mice were repetitively investigated by SCT during early epilepsy and the chronic phase of the disease, during which response to antidepressant drug treatment was assessed. SCT revealed long-lasting anhedonia in both models. Anhedonia appeared to be pharmacoresistant, as neither chronic treatment with imipramine in the pilocarpine model nor chronic treatment with fluoxetine in the kainate model could annihilate the differences in sucrose consumption between control and epileptic mice. Moreover, knock-out of P-glycoprotein did not improve the treatment effect of fluoxetine. In conclusion, our findings show for the first time that the SCT is suited for detection of depression-like behavior in mouse models of temporal-lobe epilepsy. Both models might serve as tools to further investigate the neurobiology and pharmacology of epilepsy-associated pharmacoresistant depression.
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