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Yang H, Liu W, Gao T, Liu Q, Zhang M, Liu Y, Ma X, Zhang N, Shi K, Duan M, Ma S, Zhang X, Cheng Y, Qu H, Chen M, Zhan S. Causal associations between gut microbiota, circulating inflammatory proteins, and epilepsy: a multivariable Mendelian randomization study. Front Immunol 2024; 15:1438645. [PMID: 39315097 PMCID: PMC11416947 DOI: 10.3389/fimmu.2024.1438645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2024] [Accepted: 08/22/2024] [Indexed: 09/25/2024] Open
Abstract
Background Previous studies have suggested that gut microbiota (GM) may be involved in the pathogenesis of epilepsy through the microbiota-gut-brain axis (MGBA). However, the causal relationship between GM and different epilepsy subtypes and whether circulating inflammatory proteins act as mediators to participate in epileptogenesis through the MGBA remain unclear. Therefore, it is necessary to identify specific GM associated with epilepsy and its subtypes and explore their underlying inflammatory mechanisms for risk prediction, personalized treatment, and prognostic monitoring of epilepsy. Methods We hypothesized the existence of a pathway GM-inflammatory proteins-epilepsy. We found genetic variants strongly associated with GM, circulating inflammatory proteins, epilepsy and its subtypes, including generalized and partial seizures, from large-scale genome-wide association studies (GWAS) summary data and used Multivariate Mendelian Randomization to explore the causal relationship between the three and whether circulating inflammatory proteins play a mediating role in the pathway from GM to epilepsy, with inverse variance weighted (IVW) method as the primary statistical method, supplemented by four methods: MR-Egger, weighted median estimator (WME), Weighted mode and Simple mode. Results 16 positive and three negative causal associations were found between the genetic liability of GM and epilepsy and its subtypes. There were nine positive and nine negative causal associations between inflammatory proteins and epilepsy and its subtypes. Furthermore, we found that C-X-C motif chemokine 11 (CXCL11) levels mediated the causal association between Genus Family XIII AD3011 group and epilepsy. Conclusion Our study highlights the possible causal role of specific GM and specific inflammatory proteins in the development of epilepsy and suggests that circulating inflammatory proteins may mediate epileptogenesis through the MGBA.
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Affiliation(s)
- Han Yang
- Department of Neurology, the Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Wei Liu
- Department of Pediatric Surgery, the Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Tiantian Gao
- Department of Neurology, the Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Qifan Liu
- Department of Transplant Surgery, the Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Mengyuan Zhang
- Department of Neurology, the Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Yixin Liu
- Department of Neurology, the Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Xiaodong Ma
- Department of Neurology, the Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Nan Zhang
- Department of Neurology, the Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Kaili Shi
- Department of Neurology, the Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Minyu Duan
- Department of Neurology, the Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Shuyin Ma
- Department of Neurology, the Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Xiaodong Zhang
- Department of Neurology, the Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Yuxuan Cheng
- Department of Neurology, the Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Huiyang Qu
- Department of Neurology, the Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Mengying Chen
- Department of Neurology, the Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Shuqin Zhan
- Department of Neurology, the Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
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Lieberman S, Rivera DA, Morton R, Hingorani A, Southard TL, Johnson L, Reukauf J, Radwanski RE, Zhao M, Nishimura N, Bracko O, Schwartz TH, Schaffer CB. Circumscribing Laser Cuts Attenuate Seizure Propagation in a Mouse Model of Focal Epilepsy. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2024; 11:e2300747. [PMID: 38810146 PMCID: PMC11304327 DOI: 10.1002/advs.202300747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 02/24/2024] [Indexed: 05/31/2024]
Abstract
In partial onset epilepsy, seizures arise focally in the brain and often propagate. Patients frequently become refractory to medical management, leaving neurosurgery, which can cause neurologic deficits, as a primary treatment. In the cortex, focal seizures spread through horizontal connections in layers II/III, suggesting that severing these connections can block seizures while preserving function. Focal neocortical epilepsy is induced in mice, sub-surface cuts are created surrounding the seizure focus using tightly-focused femtosecond laser pulses, and electrophysiological recordings are acquired at multiple locations for 3-12 months. Cuts reduced seizure frequency in most animals by 87%, and only 5% of remaining seizures propagated to the distant electrodes, compared to 80% in control animals. These cuts produced a modest decrease in cortical blood flow that recovered and left a ≈20-µm wide scar with minimal collateral damage. When placed over the motor cortex, cuts do not cause notable deficits in a skilled reaching task, suggesting they hold promise as a novel neurosurgical approach for intractable focal cortical epilepsy.
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Affiliation(s)
- Seth Lieberman
- Meinig School of Biomedical EngineeringCornell UniversityIthacaNY14853USA
- College of Veterinary MedicineCornell UniversityIthacaNY14853USA
| | - Daniel A. Rivera
- Meinig School of Biomedical EngineeringCornell UniversityIthacaNY14853USA
| | - Ryan Morton
- Meinig School of Biomedical EngineeringCornell UniversityIthacaNY14853USA
| | - Amrit Hingorani
- Meinig School of Biomedical EngineeringCornell UniversityIthacaNY14853USA
| | | | - Lynn Johnson
- Statistical Consulting UnitCornell UniversityIthacaNY14853USA
| | - Jennifer Reukauf
- Meinig School of Biomedical EngineeringCornell UniversityIthacaNY14853USA
- College of Veterinary MedicineCornell UniversityIthacaNY14853USA
| | - Ryan E. Radwanski
- Meinig School of Biomedical EngineeringCornell UniversityIthacaNY14853USA
| | - Mingrui Zhao
- Department of Neurological SurgeryWeill Cornell Medicine of Cornell UniversityNew YorkNY10065USA
- Brain and Mind Research InstituteWeill Cornell Medicine of Cornell UniversityNew YorkNY10021USA
| | - Nozomi Nishimura
- Meinig School of Biomedical EngineeringCornell UniversityIthacaNY14853USA
| | - Oliver Bracko
- Department of BiologyThe University of MiamiCoral GablesFL33134USA
| | - Theodore H. Schwartz
- Department of Neurological SurgeryWeill Cornell Medicine of Cornell UniversityNew YorkNY10065USA
- Brain and Mind Research InstituteWeill Cornell Medicine of Cornell UniversityNew YorkNY10021USA
| | - Chris B. Schaffer
- Meinig School of Biomedical EngineeringCornell UniversityIthacaNY14853USA
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Jiang Z, Fu Y, Shen H. UGT1A4*3 polymorphism influences serum concentration and therapeutic effect of lamotrigine for epilepsy treatment: A meta-analysis. PLoS One 2024; 19:e0307377. [PMID: 39024362 PMCID: PMC11257390 DOI: 10.1371/journal.pone.0307377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Accepted: 07/04/2024] [Indexed: 07/20/2024] Open
Abstract
BACKGROUND Lamotrigine as a broad-spectrum antiepileptic drug, is widely applied and its clinical efficacy is highly recognized. However, significant differences are observed in blood drug concentration of lamotrigine among individuals, which may have an impact on its efficacy. UGT1A4 is the main metabolic enzyme. However, it was inconsistent for the influence of UGT1A4 genetic polymorphism on concentration and efficacy of lamotrigine therapy. This study aimed to evaluate the influences of UGT1A4*3 genetic polymorphisms on lamotrigine concentration and therapeutic effect through meta-analysis. METHODS The literature search was conducted in Medline, Embase, PubMed, Web of Science, Wan Fang Database, China National Knowledge Infrastructure, China Science and Technology Journal Database until January 2024. The primary outcome included the mean serum concentration, concentration-to-dose-ratio by body weight (CDR), or efficacy related to different UGT1A4*3 genotype for lamotrigine therapy. Data were collected to access the Mean Difference or odds ratio with 95% confidence interval. Meta-analysis was performed by RevMan 5.2. RESULTS A total of eleven studies were enrolled. The meta-analysis for mean serum concentration of lamotrigine showed no significant difference between patients carrying TT genotypes and TG and GG genotypes group (MD: 0.12, 95% [-0.35, 0.58], P = 0.62). There was significant difference in CDR (MD: 0.49, 95% [0.03, 0.94], P = 0.04) and therapeutic efficacy (OR: 7.18, 95% [4.01, 12.83], P<0.00001) of lamotrigine, however no significant difference was found in subgroup analysis of CDR of children (MD: 0.03, 95% [-0.35, 0.42], P = 0.87) between patients carrying TT genotypes and TG and GG genotypes group. CONCLUSIONS Polymorphism of UGT1A4*3 influenced the CDR and therapeutic efficacy of lamotrigine for antiepileptic therapy. Genotype analysis provided reference for personalized medication in the future. However, more high-quality evidences are necessary for precise and definitive conclusion.
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Affiliation(s)
- Zhimei Jiang
- Department of Pharmacy, West China Second University Hospital of Sichuan University, Chengdu, China
- Evidence-Based Pharmacy Center, West China Second University Hospital of Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Sichuan University, Chengdu, China
| | - Yuzhi Fu
- Department of Pharmacy, West China Second University Hospital of Sichuan University, Chengdu, China
- Evidence-Based Pharmacy Center, West China Second University Hospital of Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Sichuan University, Chengdu, China
| | - Hongxin Shen
- Department of Pharmacy, West China Second University Hospital of Sichuan University, Chengdu, China
- Evidence-Based Pharmacy Center, West China Second University Hospital of Sichuan University, Chengdu, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Sichuan University, Chengdu, China
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Liu GY, Fu FJ, Chou YX, Ye MS, Ouyang YL, Yan MD, Pan L, Li WP, Xie W. Frontiers and hotspots in comorbid epilepsy and depression: a bibliometric analysis from 2003 to 2023. Front Neurol 2024; 15:1413582. [PMID: 38974685 PMCID: PMC11224553 DOI: 10.3389/fneur.2024.1413582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2024] [Accepted: 06/10/2024] [Indexed: 07/09/2024] Open
Abstract
Background Epilepsy ranks among the most common neurological disorders worldwide, frequently accompanied by depression as a prominent comorbidity. This study employs bibliometric analysis to reveal the research of comorbid epilepsy and depression over the past two decades, aiming to explore trends and contribute insights to ongoing investigations. Methods We conducted a comprehensive search on the Web of Science Core Collection database and downloaded relevant publications on comorbid epilepsy and depression published from 2003 to 2023. VOSviewer and CiteSpace were mainly used to analyze the authors, institutions, countries, publishing journals, reference co-citation patterns, keyword co-occurrence, keyword clustering, and other aspects to construct a knowledge atlas. Results A total of 5,586 publications related to comorbid epilepsy and depression were retrieved, with a general upward trend despite slight fluctuations in annual publications. Publications originated from 121 countries and 636 institutions, with a predominant focus on clinical research. The United States led in productivity (1,529 articles), while Melbourne University emerged as the most productive institution (135 articles). EPILEPSY & BEHAVIOR was the journal with the highest publication output (1,189 articles) and citation count. Keyword analysis highlighted emerging trends, including "recognitive impairment" and "mental health," indicating potential future research hotspots and trends. Conclusion This study is one of the first to perform a bibliometric analysis of the 20-year scientific output of comorbid epilepsy and depression. While research has trended upwards, ambiguity in pathogenesis and the absence of standardized diagnostic guidelines remain concerning. Our analysis offers valuable guidance for researchers, informing that this might be a strong area for future collaborations.
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Affiliation(s)
- Gui-Yu Liu
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, China
| | - Fan-Jia Fu
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, China
| | - Ying-Xin Chou
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, China
| | - Ming-Sha Ye
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, China
| | - Yi-Lin Ouyang
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, China
| | - Ming-De Yan
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, China
| | - Lei Pan
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, China
| | - Wei-Peng Li
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, China
- Department of Neurology, Hospital of Integrated Traditional Chinese and Western Medicine, Southern Medical University, Guangzhou, China
| | - Wei Xie
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, China
- Department of Traditional Chinese Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, China
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Irastorza-Valera L, Soria-Gómez E, Benitez JM, Montáns FJ, Saucedo-Mora L. Review of the Brain's Behaviour after Injury and Disease for Its Application in an Agent-Based Model (ABM). Biomimetics (Basel) 2024; 9:362. [PMID: 38921242 PMCID: PMC11202129 DOI: 10.3390/biomimetics9060362] [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: 05/06/2024] [Revised: 05/28/2024] [Accepted: 06/05/2024] [Indexed: 06/27/2024] Open
Abstract
The brain is the most complex organ in the human body and, as such, its study entails great challenges (methodological, theoretical, etc.). Nonetheless, there is a remarkable amount of studies about the consequences of pathological conditions on its development and functioning. This bibliographic review aims to cover mostly findings related to changes in the physical distribution of neurons and their connections-the connectome-both structural and functional, as well as their modelling approaches. It does not intend to offer an extensive description of all conditions affecting the brain; rather, it presents the most common ones. Thus, here, we highlight the need for accurate brain modelling that can subsequently be used to understand brain function and be applied to diagnose, track, and simulate treatments for the most prevalent pathologies affecting the brain.
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Affiliation(s)
- Luis Irastorza-Valera
- E.T.S. de Ingeniería Aeronáutica y del Espacio, Universidad Politécnica de Madrid, Pza. Cardenal Cisneros 3, 28040 Madrid, Spain; (L.I.-V.); (J.M.B.); (F.J.M.)
- PIMM Laboratory, ENSAM–Arts et Métiers ParisTech, 151 Bd de l’Hôpital, 75013 Paris, France
| | - Edgar Soria-Gómez
- Achúcarro Basque Center for Neuroscience, Barrio Sarriena, s/n, 48940 Leioa, Spain;
- Ikerbasque, Basque Foundation for Science, Plaza Euskadi, 5, 48009 Bilbao, Spain
- Department of Neurosciences, University of the Basque Country UPV/EHU, Barrio Sarriena, s/n, 48940 Leioa, Spain
| | - José María Benitez
- E.T.S. de Ingeniería Aeronáutica y del Espacio, Universidad Politécnica de Madrid, Pza. Cardenal Cisneros 3, 28040 Madrid, Spain; (L.I.-V.); (J.M.B.); (F.J.M.)
| | - Francisco J. Montáns
- E.T.S. de Ingeniería Aeronáutica y del Espacio, Universidad Politécnica de Madrid, Pza. Cardenal Cisneros 3, 28040 Madrid, Spain; (L.I.-V.); (J.M.B.); (F.J.M.)
- Department of Mechanical and Aerospace Engineering, Herbert Wertheim College of Engineering, University of Florida, Gainesville, FL 32611, USA
| | - Luis Saucedo-Mora
- E.T.S. de Ingeniería Aeronáutica y del Espacio, Universidad Politécnica de Madrid, Pza. Cardenal Cisneros 3, 28040 Madrid, Spain; (L.I.-V.); (J.M.B.); (F.J.M.)
- Department of Materials, University of Oxford, Parks Road, Oxford OX1 3PJ, UK
- Department of Nuclear Science and Engineering, Massachusetts Institute of Technology (MIT), 77 Massachusetts Ave, Cambridge, MA 02139, USA
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Tahmasebi E, Monsef-Esfahani H, Vazirian M, Sharafi-Badr P, Sharifzadeh M, Sadati Lamardi SN. Anticonvulsant effects of Paeonia daurica subsp. macrophylla root extracts in pentylenetetrazol-induced seizure models in mice. Neurologia 2024; 39:329-339. [PMID: 38616060 DOI: 10.1016/j.nrleng.2021.08.004] [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: 03/11/2021] [Accepted: 08/03/2021] [Indexed: 04/16/2024] Open
Abstract
INTRODUCTION In the present study, anticonvulsant effects of aqueous extract (AE), hydro-alcoholic crude extract (HE), and its fractions (F-CHCl3, F-EtOAc, F-MeOH) of Paeonia daurica subsp. macrophylla (P. daurica ssp. macrophylla) root examined by using a pentylenetetrazol-induced model (PTZ) on mice. METHODS HE and its fractions as well as AE, in concentrations of (100, 200 and 400mg/kg), valproate (Val) (100 and 200mg/kg), and saline (negative control) (10mg/kg) were injected intraperitoneally (i.p.) 30min before PTZ (80mg/kg, i.p.). The time taken before the onset of myoclonic convulsions (MC), MC duration, time taken before the onset of generalized tonic-clonic seizures (GTCS), the duration of GTCS, and the percentage of GTCS and mortality protection recorded. The plant's anticonvulsant mechanisms were assessed using flumazenil (5mg/kg, i.p.) before AE (100, 200, and 400mg/kg, i.p.) injection. GraphPad Prism software was used to compare the differences between various treatment groups with one-way analysis of variance (ANOVA) followed by Tukey-Krammer multiple comparison tests. RESULTS All the plant samples except F-EtOAc significantly delayed the onset and decreased the duration of PTZ-induced MCS and GTCS, and significantly reduced the GTCS and mortality rate. Pretreatment with flumazenil diminished the significant anticonvulsant effects of AE against PTZ-induced seizures. CONCLUSIONS It can report that extract of P. daurica ssp. macrophylla might be a helpful guide for future studies in the treatment of epilepsy.
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Affiliation(s)
- E Tahmasebi
- Department of Pharmacognosy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
| | - H Monsef-Esfahani
- Department of Pharmacognosy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
| | - M Vazirian
- Department of Pharmacognosy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
| | - P Sharafi-Badr
- Department of Pharmacognosy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
| | - M Sharifzadeh
- Department of Toxicology and Pharmacology, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
| | - S N Sadati Lamardi
- Department of Traditional Pharmacy, School of Persian Medicine, Tehran University of Medical Sciences, Tehran, Iran; Persian Medicine and Pharmacy Research Center, Tehran University of Medical Sciences, Tehran, Iran.
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Addanki S, Schleffer A, Kasarla R, Ely S. Cardiovascular Implications of Epilepsy: Unraveling the Elevated Risk of Mortality. Cureus 2024; 16:e59921. [PMID: 38854242 PMCID: PMC11161415 DOI: 10.7759/cureus.59921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Accepted: 05/07/2024] [Indexed: 06/11/2024] Open
Abstract
Introduction Epilepsy is a complex prevalent seizure disorder impacting a significant number of individuals worldwide. Those with epilepsy face the possibility of experiencing sudden unexpected death in epilepsy (SUDEP). When examining the relationship between epilepsy and SUDEP, cardiac-related deaths (CRD) may be considered a driving force. We hypothesize that patients with epilepsy are at higher risk of CRD than those without epilepsy. While utilizing the National Institutes of Health (NIH) All of Us Researcher Program (AoU) database, we also explored the relationship between epilepsy and cardiac-related deaths and propose potential connective mechanisms between the two conditions. Methods Baseline data from the National Institutes of Health All of Us Researcher Program was used to evaluate the relationship between cardiac-related deaths and epilepsy. A retrospective cohort study was conducted where individuals with epilepsy and without epilepsy were matched by inclusion and exclusion criteria including death, cardiac-related death, and epilepsy. Additionally, the prevalence of cardiac-related deaths was compared to neurological, respiratory, and hepatic-related deaths for patients with epilepsy to identify emerging causes of SUDEP. Results Among patients with a history of epilepsy, the prevalence of CRD was 45 (17.3%) compared to 305 (11%) in the control group. This difference was statistically significant by p<0.0042 with an odds ratio (OR)=1.698, 95%CI 1.214-2.379. Additionally, there was the highest number of significant cardiac-related deaths amongst patients with epilepsy compared to patients without epilepsy as opposed to different mechanisms of death such as acute respiratory failure, acute hepatic failure, and hypoxic brain injury. Conclusion This study indicates that epileptic patients have a statistically significant higher prevalence of cardiac-related deaths. Additionally, cardiac-related deaths constitute a significantly higher proportion of fatalities amongst patients with epilepsy compared to other causes of SUDEP. Potential mechanisms for these findings may include seizure-induced arrhythmias, hypoxia-induced cardiac arrest, autonomic dysregulation, and neurotransmitter disequilibrium. The results of our study suggest promising directions for future research in identifying predictors of cardiac-related deaths with proposed cardiac monitoring protocols as preventative strategies for epileptic patients in efforts to reduce the prevalence of SUDEP.
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Affiliation(s)
- Sunaina Addanki
- Medical School, Nova Southeastern University Dr. Kiran C. Patel College of Allopathic Medicine, Fort Lauderdale, USA
| | - Andrew Schleffer
- Medical School, Nova Southeastern University Dr. Kiran C. Patel College of Allopathic Medicine, Fort Lauderdale, USA
| | - Rishabh Kasarla
- Medical School, Nova Southeastern University Dr. Kiran C. Patel College of Allopathic Medicine, Fort Lauderdale, USA
| | - Stephen Ely
- Cardiothoracic Surgery, Nova Southeastern University Dr. Kiran C. Patel College of Allopathic Medicine, Fort Lauderdale, USA
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Cheng Y, Zhai Y, Yuan Y, Wang Q, Li S, Sun H. The Contributions of Thrombospondin-1 to Epilepsy Formation. Neurosci Bull 2024; 40:658-672. [PMID: 38528256 PMCID: PMC11127911 DOI: 10.1007/s12264-024-01194-2] [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: 06/27/2023] [Accepted: 01/27/2024] [Indexed: 03/27/2024] Open
Abstract
Epilepsy is a neural network disorder caused by uncontrolled neuronal hyperexcitability induced by an imbalance between excitatory and inhibitory networks. Abnormal synaptogenesis plays a vital role in the formation of overexcited networks. Recent evidence has confirmed that thrombospondin-1 (TSP-1), mainly secreted by astrocytes, is a critical cytokine that regulates synaptogenesis during epileptogenesis. Furthermore, numerous studies have reported that TSP-1 is also involved in other processes, such as angiogenesis, neuroinflammation, and regulation of Ca2+ homeostasis, which are closely associated with the occurrence and development of epilepsy. In this review, we summarize the potential contributions of TSP-1 to epilepsy development.
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Affiliation(s)
- Yao Cheng
- School of Pharmaceutical Sciences, Binzhou Medical University, Yantai, 264003, China
| | - Yujie Zhai
- School of Pharmaceutical Sciences, Binzhou Medical University, Yantai, 264003, China
| | - Yi Yuan
- School of Pharmaceutical Sciences, Binzhou Medical University, Yantai, 264003, China
| | - Qiaoyun Wang
- School of Pharmaceutical Sciences, Binzhou Medical University, Yantai, 264003, China
| | - Shucui Li
- School of Pharmaceutical Sciences, Binzhou Medical University, Yantai, 264003, China.
| | - Hongliu Sun
- School of Pharmaceutical Sciences, Binzhou Medical University, Yantai, 264003, China.
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Häussler U, Neres J, Vandenplas C, Eykens C, Kadiu I, Schramm C, Fleurance R, Stanley P, Godard P, de Mot L, van Eyll J, Knobeloch KP, Haas CA, Dedeurwaerdere S. Downregulation of Ubiquitin-Specific Protease 15 (USP15) Does Not Provide Therapeutic Benefit in Experimental Mesial Temporal Lobe Epilepsy. Mol Neurobiol 2024; 61:2367-2389. [PMID: 37874479 PMCID: PMC10973041 DOI: 10.1007/s12035-023-03692-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 10/04/2023] [Indexed: 10/25/2023]
Abstract
Structural epilepsies display complex immune activation signatures. However, it is unclear which neuroinflammatory pathways drive pathobiology. Transcriptome studies of brain resections from mesial temporal lobe epilepsy (mTLE) patients revealed a dysregulation of transforming growth factor β, interferon α/β, and nuclear factor erythroid 2-related factor 2 pathways. Since these pathways are regulated by ubiquitin-specific proteases (USP), in particular USP15, we hypothesized that USP15 blockade may provide therapeutic relief in treatment-resistant epilepsies. For validation, transgenic mice which either constitutively or inducibly lack Usp15 gene expression underwent intrahippocampal kainate injections to induce mTLE. We show that the severity of status epilepticus is unaltered in mice constitutively lacking Usp15 compared to wild types. Cell death, reactive gliosis, and changes in the inflammatory transcriptome were pronounced at 4 days after kainate injection. However, these brain inflammation signatures did not differ between genotypes. Likewise, induced deletion of Usp15 in chronic epilepsy did not affect seizure generation, cell death, gliosis, or the transcriptome. Concordantly, siRNA-mediated knockdown of Usp15 in a microglial cell line did not impact inflammatory responses in the form of cytokine release. Our data show that a lack of USP15 is insufficient to modulate the expression of relevant neuroinflammatory pathways in an mTLE mouse model and do not support targeting USP15 as a therapeutic approach for pharmacoresistant epilepsy.
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Affiliation(s)
- Ute Häussler
- Experimental Epilepsy Research, Department of Neurosurgery, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Breisacher Strasse 64, 79106, Freiburg, Germany.
- BrainLinks-BrainTools Center, University of Freiburg, Georges-Koehler-Allee 201, 79110, Freiburg, Germany.
| | - João Neres
- Early Solutions, UCB Biopharma SRL, Chemin du Foriest, 1420, Braine L'Alleud, Belgium
| | - Catherine Vandenplas
- Early Solutions, UCB Biopharma SRL, Chemin du Foriest, 1420, Braine L'Alleud, Belgium
| | - Caroline Eykens
- Early Solutions, UCB Biopharma SRL, Chemin du Foriest, 1420, Braine L'Alleud, Belgium
| | - Irena Kadiu
- Early Solutions, UCB Biopharma SRL, Chemin du Foriest, 1420, Braine L'Alleud, Belgium
| | - Carolin Schramm
- Early Solutions, UCB Biopharma SRL, Chemin du Foriest, 1420, Braine L'Alleud, Belgium
| | - Renaud Fleurance
- Early Solutions, UCB Biopharma SRL, Chemin du Foriest, 1420, Braine L'Alleud, Belgium
| | - Phil Stanley
- Early Development Statistics, UCB Celltech, 208 Bath Road, Slough, Berkshire, SL1 3WE, UK
| | - Patrice Godard
- Early Solutions, UCB Biopharma SRL, Chemin du Foriest, 1420, Braine L'Alleud, Belgium
| | - Laurane de Mot
- Early Solutions, UCB Biopharma SRL, Chemin du Foriest, 1420, Braine L'Alleud, Belgium
| | - Jonathan van Eyll
- Early Solutions, UCB Biopharma SRL, Chemin du Foriest, 1420, Braine L'Alleud, Belgium
| | - Klaus-Peter Knobeloch
- Institute for Neuropathology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Breisacher Strasse 64, 79106, Freiburg, Germany.
- CIBSS - Centre for Integrative Biological Signalling Studies, Freiburg, Germany.
| | - Carola A Haas
- Experimental Epilepsy Research, Department of Neurosurgery, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Breisacher Strasse 64, 79106, Freiburg, Germany
- BrainLinks-BrainTools Center, University of Freiburg, Georges-Koehler-Allee 201, 79110, Freiburg, Germany
- Center for Basics in NeuroModulation, Faculty of Medicine, University of Freiburg, 79106, Freiburg, Germany
- Bernstein Center Freiburg, University of Freiburg, Hansastr. 9a, 79104, Freiburg, Germany
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10
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Benghanem S, Pruvost-Robieux E, Neligan A, Walker MC. Status epilepticus: what's new for the intensivist. Curr Opin Crit Care 2024; 30:131-141. [PMID: 38441162 DOI: 10.1097/mcc.0000000000001137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2024]
Abstract
PURPOSE OF REVIEW Status epilepticus (SE) is a common neurologic emergency affecting about 36.1/100 000 person-years that frequently requires intensive care unit (ICU) admission. There have been advances in our understanding of epidemiology, pathophysiology, and EEG monitoring of SE, and there have been large-scale treatment trials, discussed in this review. RECENT FINDINGS Recent changes in the definitions of SE have helped guide management protocols and we have much better predictors of outcome. Observational studies have confirmed the efficacy of benzodiazepines and large treatment trials indicate that all routinely used second line treatments (i.e., levetiracetam, valproate and fosphenytoin) are equally effective. Better understanding of the pathophysiology has indicated that nonanti-seizure medications aimed at underlying pathological processes should perhaps be considered in the treatment of SE; already immunosuppressant treatments are being more widely used in particular for new onset refractory status epilepticus (NORSE) and Febrile infection-related epilepsy syndrome (FIRES) that sometimes revealed autoimmune or paraneoplastic encephalitis. Growing evidence for ICU EEG monitoring and major advances in automated analysis of the EEG could help intensivist to assess the control of electrographic seizures. SUMMARY Research into the morbi-mortality of SE has highlighted the potential devastating effects of this condition, emphasizing the need for rapid and aggressive treatment, with particular attention to cardiorespiratory and neurological complications. Although we now have a good evidence-base for the initial status epilepticus management, the best treatments for the later stages are still unclear and clinical trials of potentially disease-modifying therapies are long overdue.
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Affiliation(s)
- Sarah Benghanem
- Medical Intensive Care Unit, Cochin hospital, APHP.Centre
- University of Paris cite - Medical School
- INSERM 1266, psychiatry and neurosciences institute of Paris (IPNP)
| | - Estelle Pruvost-Robieux
- University of Paris cite - Medical School
- INSERM 1266, psychiatry and neurosciences institute of Paris (IPNP)
- Neurophysiology and epileptology department, Sainte Anne hospital, Paris, France
| | - Aidan Neligan
- Homerton University Hospital NHS Foundation Trust, Homerton Row
- UCL Queen Square Institute of Neurology, Queen Square, London
- Centre for Preventive Neurology, Wolfson Institute of Population Health, QMUL, UK
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11
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Yilgor A, Demir C. Determination of oxidative stress level and some antioxidant activities in refractory epilepsy patients. Sci Rep 2024; 14:6688. [PMID: 38509121 PMCID: PMC10954705 DOI: 10.1038/s41598-024-57224-6] [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: 03/15/2022] [Accepted: 03/15/2024] [Indexed: 03/22/2024] Open
Abstract
The aim of this study was to determine the levels of superoxide dismutase (SOD), catalase (CAT), reduced glutathione (GSH) and malondialdehyde (MDA) in patients with refractory epilepsy. Serum superoxide dismutase (SOD), catalase (CAT), reduced glutathione (GSH) and malondialdehyde (MDA) levels were determined using the spectrophotometer method. Refractory epilepsy patients' serum superoxide dismutase (SOD), catalase (CAT), reduced glutathione (GSH) and malondialdehyde (MDA) levels were statistically significant compared to the healthy control group (p < 0.05). In conclusion, superoxide dismutase (SOD), catalase (CAT), reduced glutathione (GSH) and malondialdehyde (MDA) levels may play an important role in the etiopathogenesis of refractory epilepsy. This study was the first to investigate some parameters in refractory epilepsy disease.
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Affiliation(s)
- Abdullah Yilgor
- Department of Neurology, Faculty of Medicine, Van YuzuncuYil University, 65200, Van, Turkey.
| | - Canan Demir
- Vocational School of Health Services, Van, Turkey
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12
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Alene TD, Engidaye GT, Birhane T, Gedamu S. Epilepsy Treatment Outcome and Its Predictors Among Children Who Had Chronic Follow Up at Dessie Comprehensive Specialized Hospital. Patient Relat Outcome Meas 2024; 15:71-80. [PMID: 38410831 PMCID: PMC10895992 DOI: 10.2147/prom.s431242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 02/16/2024] [Indexed: 02/28/2024] Open
Abstract
Introduction Epilepsy is a chronic non-communicable disease of the brain that affects millions of people worldwide. A significant number of children are affected globally, and most live in developing countries, often with physical and cognitive disabilities. Regardless of these factors, epilepsy is poorly controlled, particularly in the developing countries. Thus, this study aimed to assess the magnitude of treatment outcomes and its predictors among pediatrics patients with epilepsy who were followed-up at the Dessie Comprehensive Specialized Hospital, Northeast Ethiopia. Methods Hospital-based cross-sectional study was conducted from 1 June 2022 to 30 August 2022. A total of 200 patients with epilepsy were included in this study. Data were collected through face-to-face interviews, and by reviewing medical records. The collected data were entered into Epi-data version 4.6 and exported to SPSS version 25.0. Descriptive statistics such as frequencies, percentages, means and standard deviations were computed. Binary and multivariate logistic regression analyses were performed. Variables with p < 0.25 in bivariate analysis were entered into multivariable logistic regression. In multivariable analysis, adjusted odd ratio with 95% CI and p-value less than 0.05 were considered statistically significant. Results Of 200 pediatric patients with epilepsy, 66 (34.5%) had poor treatment outcomes. In the multivariate analysis, 11-15 years of age (AOR = 4.08; 95% CI = 1.202, 13.848), poor treatment adherence (AOR = 3.21; 95% CI = 1.421, 7.249), history of more seizure frequency before starting treatment (AOR = 4.19; 95% CI = 1.984, 8.834) and history of head injury (AOR = 3.03; 95% CI = 1.502, 6.112) were significantly associated with poor treatment outcomes in pediatric patients with epilepsy. Conclusion Significant proportion of pediatric patients with epilepsy had poor treatment outcomes. Therefore, health-care workers should strictly follow patient treatment especially for pediatric epileptic patients' who have poor treatment adherence, more seizure frequency history, head injury history and whose age were 11-15 years old.
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Affiliation(s)
- Tilahun Dessie Alene
- Department of Pediatrics and Child Health, Wollo University, Dessie, Amhara, Ethiopia
| | | | - Tesfaye Birhane
- Department of Reproductive and Family Health, Wollo University, Dessie, Amhara, Ethiopia
| | - Sisay Gedamu
- Department of Comprehensive Nursing, Wollo University, Dessie, Amhara, Ethiopia
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13
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Davidson TL, Stevenson RJ. Vulnerability of the Hippocampus to Insults: Links to Blood-Brain Barrier Dysfunction. Int J Mol Sci 2024; 25:1991. [PMID: 38396670 PMCID: PMC10888241 DOI: 10.3390/ijms25041991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 01/25/2024] [Accepted: 01/29/2024] [Indexed: 02/25/2024] Open
Abstract
The hippocampus is a critical brain substrate for learning and memory; events that harm the hippocampus can seriously impair mental and behavioral functioning. Hippocampal pathophysiologies have been identified as potential causes and effects of a remarkably diverse array of medical diseases, psychological disorders, and environmental sources of damage. It may be that the hippocampus is more vulnerable than other brain areas to insults that are related to these conditions. One purpose of this review is to assess the vulnerability of the hippocampus to the most prevalent types of insults in multiple biomedical domains (i.e., neuroactive pathogens, neurotoxins, neurological conditions, trauma, aging, neurodegenerative disease, acquired brain injury, mental health conditions, endocrine disorders, developmental disabilities, nutrition) and to evaluate whether these insults affect the hippocampus first and more prominently compared to other brain loci. A second purpose is to consider the role of hippocampal blood-brain barrier (BBB) breakdown in either causing or worsening the harmful effects of each insult. Recent research suggests that the hippocampal BBB is more fragile compared to other brain areas and may also be more prone to the disruption of the transport mechanisms that act to maintain the internal milieu. Moreover, a compromised BBB could be a factor that is common to many different types of insults. Our analysis indicates that the hippocampus is more vulnerable to insults compared to other parts of the brain, and that developing interventions that protect the hippocampal BBB may help to prevent or ameliorate the harmful effects of many insults on memory and cognition.
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Affiliation(s)
- Terry L. Davidson
- Department of Neuroscience, Center for Neuroscience and Behavior, American University, 4400 Massachusetts Avenue, NW, Washington, DC 20016, USA
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14
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Finn S, Aliyianis T, Beattie B, Boissé Lomax L, Shukla G, Scott SH, Winston GP. Robotic assessment of sensorimotor and cognitive deficits in patients with temporal lobe epilepsy. Epilepsy Behav 2024; 151:109613. [PMID: 38183928 DOI: 10.1016/j.yebeh.2023.109613] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 12/22/2023] [Accepted: 12/23/2023] [Indexed: 01/08/2024]
Abstract
OBJECTIVE Individuals with temporal lobe epilepsy (TLE) frequently demonstrate impairments in executive function, working memory, and/or declarative memory. It is recommended that screening for cognitive impairment is undertaken in all people newly diagnosed with epilepsy. However, standard neuropsychological assessments are a limited resource and thus not available to all. Our study investigated the use of robotic technology (the Kinarm robot) for cognitive screening. METHODS 27 participants with TLE (17 left) underwent both a brief neuropsychological screening and a robotic (Kinarm) assessment. The degree of impairments and correlations between standardized scores from both approaches to assessments were analysed across different neurocognitive domains. Performance was compared between people with left and right TLE to look for laterality effects. Finally, the association between the duration of epilepsy and performance was assessed. RESULTS Across the 6 neurocognitive domains (attention, executive function, language, memory, motor and visuospatial) assessed by our neuropsychological screening, all showed scores that significantly correlated with Kinarm tasks assessing the same cognitive domains except language and memory that were not adequately assessed with Kinarm. Participants with right TLE performed worse on most tasks than those with left TLE, including both visuospatial (typically considered right hemisphere), and verbal memory and language tasks (typically considered left hemisphere). No correlations were found between the duration of epilepsy and either the neuropsychological screening or Kinarm assessment. SIGNIFICANCE Our findings suggest that Kinarm may be a useful tool in screening for neurocognitive impairment in people with TLE. Further development may facilitate an easier and more rapid screening of cognition in people with epilepsy and distinguishing patterns of cognitive impairment.
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Affiliation(s)
- Spencer Finn
- Centre for Neuroscience Studies, Queen's University, Kingston, Canada.
| | | | - Brooke Beattie
- Centre for Neuroscience Studies, Queen's University, Kingston, Canada.
| | - Lysa Boissé Lomax
- Centre for Neuroscience Studies, Queen's University, Kingston, Canada; Division of Neurology, Department of Medicine, Queen's University, Kingston, Canada.
| | - Garima Shukla
- Centre for Neuroscience Studies, Queen's University, Kingston, Canada; Division of Neurology, Department of Medicine, Queen's University, Kingston, Canada.
| | - Stephen H Scott
- Centre for Neuroscience Studies, Queen's University, Kingston, Canada.
| | - Gavin P Winston
- Centre for Neuroscience Studies, Queen's University, Kingston, Canada; Division of Neurology, Department of Medicine, Queen's University, Kingston, Canada.
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Armstrong OJ, Neal ES, Vidovic D, Xu W, Borges K. Transient anticonvulsant effects of time-restricted feeding in the 6-Hz mouse model. Epilepsy Behav 2024; 151:109618. [PMID: 38184948 DOI: 10.1016/j.yebeh.2023.109618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 12/23/2023] [Accepted: 12/27/2023] [Indexed: 01/09/2024]
Abstract
INTRODUCTION Intermittent fasting enhances neural bioenergetics, is neuroprotective, and elicits antioxidant effects in various animal models. There are conflicting findings on seizure protection, where intermittent fasting regimens often cause severe weight loss resembling starvation which is unsustainable long-term. Therefore, we tested whether a less intensive intermittent fasting regimen such as time-restricted feeding (TRF) may confer seizure protection. METHODS Male CD1 mice were assigned to either ad libitum-fed control, continuous 8 h TRF, or 8 h TRF with weekend ad libitum food access (2:5 TRF) for one month. Body weight, food intake, and blood glucose levels were measured. Seizure thresholds were determined at various time points using 6-Hz and maximal electroshock seizure threshold (MEST) tests. Protein levels and mRNA expression of genes, enzyme activity related to glucose metabolism, as well as mitochondrial dynamics were assessed in the cortex and hippocampus. Markers of antioxidant defence were evaluated in the plasma, cortex, and liver. RESULTS Body weight gain was similar in the ad libitum-fed and TRF mouse groups. In both TRF regimens, blood glucose levels did not change between the fed and fasted state and were higher during fasting than in the ad libitum-fed groups. Mice in the TRF group had increased seizure thresholds in the 6-Hz test on day 15 and on day 19 in a second cohort of 2:5 TRF mice, but similar seizure thresholds at other time points compared to ad libitum-fed mice. Continuous TRF did not alter MEST seizure thresholds on day 28. Mice in the TRF group showed increased maximal activity of pyruvate dehydrogenase in the cortex, which was accompanied by increased protein levels of mitochondrial pyruvate carrier 1 in the cortex and hippocampus. There were no other major changes in protein or mRNA levels associated with energy metabolism and mitochondrial dynamics in the brain, nor markers of antioxidant defence in the brain, liver, or plasma. CONCLUSIONS Both continuous and 2:5 TRF regimens transiently increased seizure thresholds in the 6-Hz model at around 2 weeks, which coincided with stability of blood glucose levels during the fed and fasted periods. Our findings suggest that the lack of prolonged anticonvulsant effects in the acute electrical seizure models employed may be attributed to only modest metabolic and antioxidant adaptations found in the brain and liver. Our findings underscore the potential therapeutic value of TRF in managing seizure-related conditions.
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Affiliation(s)
- Oliver J Armstrong
- School of Biomedical Sciences, Skerman Building 65, The University of Queensland, St. Lucia, QLD 4072, Australia
| | - Elliott S Neal
- School of Biomedical Sciences, Skerman Building 65, The University of Queensland, St. Lucia, QLD 4072, Australia
| | - Diana Vidovic
- School of Biomedical Sciences, Medical Building 181, The University of Melbourne, Parkville, VIC 3010, Australia
| | - Weizhi Xu
- School of Biomedical Sciences, Skerman Building 65, The University of Queensland, St. Lucia, QLD 4072, Australia
| | - Karin Borges
- School of Biomedical Sciences, Skerman Building 65, The University of Queensland, St. Lucia, QLD 4072, Australia.
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16
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Fayaz A, Raza M, Khan A, Mohandas P, Getnet Ayalew H, Perswani P, Wei CR, Abdelbaki MA. Comparison of Cardiovascular Outcomes and All-Cause Mortality Between Patients With and Without Epilepsy: A Systematic Review and Meta-Analysis of Observational Studies. Cureus 2024; 16:e54706. [PMID: 38523952 PMCID: PMC10960613 DOI: 10.7759/cureus.54706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/20/2024] [Indexed: 03/26/2024] Open
Abstract
This meta-analysis aimed to assess the all-cause mortality and cardiovascular outcomes among patients diagnosed with epilepsy. The entire process of this systematic review and meta-analysis adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to ensure transparency and reporting completeness. A comprehensive search strategy was employed to identify relevant studies in electronic databases, including PubMed, Embase, and the Cumulative Index of Nursing and Allied Health Literature (CINAHL), from January 1, 2010, to January 15, 2024. Outcomes assessed in this meta-analysis included all-cause mortality, cardiovascular mortality, stroke, myocardial infarction, and arrhythmias. A total of 12 studies were included in this meta-analysis with a pooled sample size of 7,026,313. The majority of included studies were conducted in Taiwan (n=4). Our study revealed that individuals with epilepsy faced a higher risk of all-cause mortality, cardiovascular mortality, and stroke. Although there was a higher incidence of myocardial infarction and arrhythmias among epilepsy patients, this disparity did not reach statistical significance. There is a need for future research to explore the impact of epilepsy types, antiepileptic drugs, and lifestyle factors on cardiovascular outcomes.
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Affiliation(s)
- Azrung Fayaz
- Internal Medicine, College of Physicians and Surgeons, Peshawar, PAK
- Internal Medicine, Hayatabad Medical Complex Peshawar, Peshawar, PAK
| | - Mehnahil Raza
- Medicine, King Edward Medical University, Lahore, PAK
| | - Areeba Khan
- Critical Care Medicine, United Medical and Dental College, Karachi, PAK
| | | | | | - Prinka Perswani
- Internal Medicine, Liaquat University of Medical and Health Sciences, Hyderabad, PAK
| | - Calvin R Wei
- Research and Development, Shing Huei Group, Taipei, TWN
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17
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Choi T, Koo M, Joo J, Kim T, Shon Y, Park J. Bidirectional Neuronal Control of Epileptiform Activity by Repetitive Transcranial Focused Ultrasound Stimulations. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2024; 11:e2302404. [PMID: 37997163 PMCID: PMC10787102 DOI: 10.1002/advs.202302404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Revised: 10/30/2023] [Indexed: 11/25/2023]
Abstract
Repetitive stimulation procedures are used in neuromodulation techniques to induce persistent excitatory or inhibitory brain activity. The directivity of modulation is empirically regulated by modifying the stimulation length, interval, and strength. However, bidirectional neuronal modulations using ultrasound stimulations are rarely reported. This study presents bidirectional control of epileptiform activities with repetitive transcranial-focused ultrasound stimulations in a rat model of drug-induced acute epilepsy. It is found that repeated transmission of elongated (40 s), ultra-low pressure (0.25 MPa) ultrasound can fully suppress epileptic activities in electro-encephalography and cerebral blood volume measurements, while the change in bursting intervals from 40 to 20 s worsens epileptic activities even with the same burst length. Furthermore, the suppression induced by 40 s long bursts is transformed to excitatory states by a subsequent transmission. Bidirectional modulation of epileptic seizures with repeated ultrasound stimulation is achieved by regulating the changes in glutamate and γ-Aminobutyric acid levels, as confirmed by measurements of expressed c-Fos and GAD65 and multitemporal analysis of neurotransmitters in the interstitial fluid obtained via microdialysis.
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Affiliation(s)
- Taewon Choi
- Department of Intelligent Precision Healthcare ConvergenceSungkyunkwan UniversitySuwon16419South Korea
| | - Minseok Koo
- Department of Intelligent Precision Healthcare ConvergenceSungkyunkwan UniversitySuwon16419South Korea
| | - Jaesoon Joo
- Department of Health Sciences and TechnologySamsung Advanced Institute for Health Science and TechnologySungkyunkwan UniversitySeoul06351South Korea
- Department of NeurologySamsung Medical CenterSungkyunkwan University School of MedicineSeoul06351South Korea
| | - Taekyung Kim
- Biomedical Engineering Research CenterSamsung Medical CenterSeoul06351South Korea
- Department of Medical Device Management and ResearchSamsung Advanced Institute for Health Science and TechnologySungkyunkwan UniversitySeoul06351South Korea
| | - Young‐Min Shon
- Department of Health Sciences and TechnologySamsung Advanced Institute for Health Science and TechnologySungkyunkwan UniversitySeoul06351South Korea
- Department of NeurologySamsung Medical CenterSungkyunkwan University School of MedicineSeoul06351South Korea
- Biomedical Engineering Research CenterSamsung Medical CenterSeoul06351South Korea
- Department of Medical Device Management and ResearchSamsung Advanced Institute for Health Science and TechnologySungkyunkwan UniversitySeoul06351South Korea
| | - Jinhyoung Park
- Department of Intelligent Precision Healthcare ConvergenceSungkyunkwan UniversitySuwon16419South Korea
- Department of Biomedical EngineeringSungkyunkwan UniversitySuwon16419South Korea
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18
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Cui Y, Zhai Y, Yuan Y, Wang X, Xu Q, Wu X, Xu L, Ren T, Wang Q, Sun H. Inhibition of PTEN-induced kinase 1 autophosphorylation may assist in preventing epileptogenesis induced by pentylenetetrazol. Neurochem Int 2024; 172:105644. [PMID: 38029887 DOI: 10.1016/j.neuint.2023.105644] [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: 10/13/2023] [Revised: 11/15/2023] [Accepted: 11/21/2023] [Indexed: 12/01/2023]
Abstract
PTEN-induced kinase 1 (PINK1) autophosphorylation-triggered mitophagy is the main mitophagic pathway in the nervous system. Moreover, multiple studies have confirmed that mitophagy is closely related to the occurrence and development of epilepsy. Therefore, we speculated that the PINK1 autophosphorylation may be involved in epileptogenesis by mediating mitophagic pathway. This study aimed to explore the contribution of activated PINK1 to epileptogenesis induced by pentylenetetrazol (PTZ) in Sprague‒Dawley rats. During PTZ-induced epileptogenesis, the levels of phosphorylated PINK1 were increased, accompanied by elevated mitophagy, mitochondria oxidative stress and neuronal damage. After microRNA intervention targeting translocase outer mitochondrial membrane 7 (TOM7) or overlapping with the m-AAA protease 1 homolog (OMA1), the levels of PINK1 phosphorylation, mitophagy, mitochondrial oxidative stress, neuronal injury were observed in the rats with induced epileptogenesis. Furthermore, inhibiting of the expression of TOM7, a positive regulator of PINK1 autophosphorylation, reversed the increase in PINK1 phosphorylation and alleviated mitophagy, neuronal injury, thereby preventing epileptogenesis. In contrast, reducing the levels of OMA1, a negative regulator of PINK1 autophosphorylation, led to increased phosphorylation of PINK1, accompanied by aggravated neuronal injury and ultimately, epileptogenesis. This study confirmed the contribution of activated PINK1 to PTZ-induced epileptogenesis and suggested that the inhibition of PINK1 autophosphorylation may assist in preventing epileptogenesis.
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Affiliation(s)
- Yaru Cui
- School of Pharmaceutical Sciences, Binzhou Medical University, Yantai, 264003, China
| | - Yujie Zhai
- School of Pharmaceutical Sciences, Binzhou Medical University, Yantai, 264003, China
| | - Yi Yuan
- School of Pharmaceutical Sciences, Binzhou Medical University, Yantai, 264003, China
| | - Xiaoqian Wang
- School of Pharmaceutical Sciences, Binzhou Medical University, Yantai, 264003, China
| | - Qianqian Xu
- School of Pharmaceutical Sciences, Binzhou Medical University, Yantai, 264003, China
| | - Xiangdong Wu
- School of Pharmaceutical Sciences, Binzhou Medical University, Yantai, 264003, China
| | - Linlin Xu
- Department of Neurology, The Second Hospital of Shandong University, Jinan, 250033, China
| | - Tianpu Ren
- School of Pharmaceutical Sciences, Binzhou Medical University, Yantai, 264003, China
| | - Qiaoyun Wang
- School of Pharmaceutical Sciences, Binzhou Medical University, Yantai, 264003, China.
| | - Hongliu Sun
- School of Pharmaceutical Sciences, Binzhou Medical University, Yantai, 264003, China.
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Nasir M, Abebaw E, Ahmed M, Ketema DB. Clinical Characteristics, Treatment Outcome and Associated Factors of Epilepsy Among Children at Hospitals of North-West Ethiopia. Pediatric Health Med Ther 2023; 14:385-404. [PMID: 37927397 PMCID: PMC10625381 DOI: 10.2147/phmt.s436022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 10/26/2023] [Indexed: 11/07/2023] Open
Abstract
Background Epilepsy is an important cause of neurological morbidity in children and adolescents. Clinical parameters are the main diagnostic tools, especially in developing countries. Although cost-effective treatments for epilepsy are available, studies have shown that uncontrolled seizures can occur in many patients. Objective To assess clinical characteristics, treatment outcomes, and associated factors for controlled epilepsy among children with epilepsy who underwent follow-up at the Debre Markos Comprehensive Specialized Hospital, North-west Ethiopia from October 28, 2020, to April 28, 2021. Methods An institutional-based retrospective cohort study was conducted from October 28, 2020, to April 28, 2021. A total of 385 participants who fulfilled the inclusion criteria were included in the study. A pretested, structured, interviewer-administered questionnaire with a chart review was used to collect data. The data were entered into the Epi-data software version 4.4.2.1 and then exported to the Stata version 14 statistical package for analysis. Descriptive statistics were used to describe the sociodemographic and clinical characteristics, treatment profiles, and treatment outcomes of patients with epilepsy. Bivariate and multivariate analyses were used to identify factors associated with treatment outcomes. Results The most frequent type of seizure among the 385 respondents was Generalized-tonic-clonic seizures (88.1%). The proximate cause of seizures was identified in 15% of patients, of whom 45 had a perinatal history (8.8%), head injury (3.6%), and CNS infection (2.3%). One-third of patients had poor seizure control. Caregiver relationship (father AOR=0.58; 95th CI:0.35,0.97) and poor adherence (AOR=2.97; 95th CI:1.82, 4.86) were significantly associated with treatment outcome. Conclusion One-third of children with epilepsy have poor seizure control. Poor adherence to treatment is implicated in poor control. Counseling caregivers on proper treatment and adherence to anti-epileptic medication is recommended to improve treatment outcome in children.
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Affiliation(s)
- Mohammed Nasir
- Pediatrics Department, Hawassa University, Hawassa, Ethiopia
| | - Ermias Abebaw
- Pediatrics Department, ALERT Comprehensive Specialized Hospital, Addis Ababa, Ethiopia
| | - Muluken Ahmed
- Pediatrics Department, Arba Minch University, Arba Minch, Ethiopia
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Guo X, Zhu Y, Ying C, Xu K, Hong Y. The impact of serum magnesium and calcium on the risk of epilepsy: A mendelian randomization study. CNS Neurosci Ther 2023; 29:3062-3067. [PMID: 37144591 PMCID: PMC10493656 DOI: 10.1111/cns.14248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 02/18/2023] [Accepted: 04/19/2023] [Indexed: 05/06/2023] Open
Abstract
AIMS To investigate the causal role of serum magnesium and calcium in epilepsy or any of its subtypes through Mendelian randomization (MR) approach. METHODS Single nucleotide polymorphisms (SNPs) associated with serum magnesium and calcium were used as the instrumental variables. MR analyses were performed using the summary-level data for epilepsy extracted from International League Against Epilepsy Consortium (15,212 cases and 29,677 controls) to obtain the causal estimates. The analyses were replicated using FinnGen data (7224 epilepsy cases and 208,845 controls), and a meta-analysis was then conducted. RESULTS The result of combined analyses showed that higher serum magnesium concentrations was associated with a reduced risk of overall epilepsy (odds ratios [OR] = 0.28, 95% confidence interval [CI], 0.12-0.62, p = 0.002). In ILAE, higher serum magnesium was suggestively associated with reduced risks of focal epilepsy (OR = 0.25, 95% CI 0.10-0.62, p = 0.003). However, the results cannot be repeated in sensitivity analyses. As for serum calcium, the results did not reach statistical significance with overall epilepsy (OR = 0.60, 95% CI, 0.31-1.17, p = 0.134). However, genetically predicted serum calcium concentrations showed an inverse association with risk of generalized epilepsy (OR = 0.35, 95% CI, 0.17-0.74, p = 0.006). CONCLUSION The current MR analysis did not support a causal relationship between serum magnesium and epilepsy, but showed a causally negative association between genetically determined serum calcium and generalized epilepsy.
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Affiliation(s)
- Xiaoming Guo
- Department of NeurosurgeryThe Second Affiliated Hospital, Zhejiang University School of MedicineHangzhouChina
- Department of NeurosurgeryTongde Hospital of Zhejiang ProvinceHangzhouChina
| | - Yueli Zhu
- Department of GeriatricsThe First Affiliated Hospital, Zhejiang University School of MedicineHangzhouChina
| | - Caidi Ying
- Department of NeurosurgeryThe Second Affiliated Hospital, Zhejiang University School of MedicineHangzhouChina
| | - Ke Xu
- Department of NeurosurgeryThe Second Affiliated Hospital, Zhejiang University School of MedicineHangzhouChina
| | - Yuan Hong
- Department of NeurosurgeryThe Second Affiliated Hospital, Zhejiang University School of MedicineHangzhouChina
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21
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Mueller JS, Tescarollo FC, Huynh T, Brenner DA, Valdivia DJ, Olagbegi K, Sangappa S, Chen SC, Sun H. Ictogenesis proceeds through discrete phases in hippocampal CA1 seizures in mice. Nat Commun 2023; 14:6010. [PMID: 37752179 PMCID: PMC10522592 DOI: 10.1038/s41467-023-41711-x] [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: 03/07/2023] [Accepted: 09/15/2023] [Indexed: 09/28/2023] Open
Abstract
Epilepsy is characterized by spontaneous non-provoked seizures, yet the mechanisms that trigger a seizure and allow its evolution remain underexplored. To dissect out phases of ictogenesis, we evoked hypersynchronous activity with optogenetic stimulation. Focal optogenetic activation of putative excitatory neurons in the mouse hippocampal CA1 reliably evoked convulsive seizures in awake mice. A time-vs-time pulsogram plot characterized the evolution of the EEG pulse response from a light evoked response to induced seizure activity. Our results depict ictogenesis as a stepwise process comprised of three distinctive phases demarcated by two transition points. The induction phase undergoes the first transition to reverberant phase activity, followed by the second transition into the paroxysmal phase or a seizure. Non-seizure responses are confined to either induction or reverberant phases. The pulsogram was then constructed in seizures recorded from a murine model of temporal lobe epilepsy and it depicted a similar reverberance preceding spontaneous seizures. The discovery of these distinct phases of ictogenesis may offer means to abort a seizure before it develops.
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Affiliation(s)
- John-Sebastian Mueller
- Department of Neurosurgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, 08854, USA
| | - Fabio C Tescarollo
- Department of Neurosurgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, 08854, USA
| | - Trong Huynh
- Department of Neurosurgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, 08854, USA
- Department of Surgery, Rutgers New Jersey Medical School, Newark, NJ, 07103, USA
| | - Daniel A Brenner
- Department of Neurosurgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, 08854, USA
| | - Daniel J Valdivia
- Department of Neurosurgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, 08854, USA
| | - Kanyin Olagbegi
- Department of Neurosurgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, 08854, USA
| | - Sahana Sangappa
- Department of Neurosurgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, 08854, USA
| | - Spencer C Chen
- Department of Neurosurgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, 08854, USA
| | - Hai Sun
- Department of Neurosurgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, 08854, USA.
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22
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Ghosh S, Sinha JK, Ghosh S, Sharma H, Bhaskar R, Narayanan KB. A Comprehensive Review of Emerging Trends and Innovative Therapies in Epilepsy Management. Brain Sci 2023; 13:1305. [PMID: 37759906 PMCID: PMC10527076 DOI: 10.3390/brainsci13091305] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 09/09/2023] [Accepted: 09/10/2023] [Indexed: 09/29/2023] Open
Abstract
Epilepsy is a complex neurological disorder affecting millions worldwide, with a substantial number of patients facing drug-resistant epilepsy. This comprehensive review explores innovative therapies for epilepsy management, focusing on their principles, clinical evidence, and potential applications. Traditional antiseizure medications (ASMs) form the cornerstone of epilepsy treatment, but their limitations necessitate alternative approaches. The review delves into cutting-edge therapies such as responsive neurostimulation (RNS), vagus nerve stimulation (VNS), and deep brain stimulation (DBS), highlighting their mechanisms of action and promising clinical outcomes. Additionally, the potential of gene therapies and optogenetics in epilepsy research is discussed, revealing groundbreaking findings that shed light on seizure mechanisms. Insights into cannabidiol (CBD) and the ketogenic diet as adjunctive therapies further broaden the spectrum of epilepsy management. Challenges in achieving seizure control with traditional therapies, including treatment resistance and individual variability, are addressed. The importance of staying updated with emerging trends in epilepsy management is emphasized, along with the hope for improved therapeutic options. Future research directions, such as combining therapies, AI applications, and non-invasive optogenetics, hold promise for personalized and effective epilepsy treatment. As the field advances, collaboration among researchers of natural and synthetic biochemistry, clinicians from different streams and various forms of medicine, and patients will drive progress toward better seizure control and a higher quality of life for individuals living with epilepsy.
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Affiliation(s)
- Shampa Ghosh
- GloNeuro, Sector 107, Vishwakarma Road, Noida 201301, India
- ICMR—National Institute of Nutrition, Tarnaka, Hyderabad 500007, India
| | | | - Soumya Ghosh
- GloNeuro, Sector 107, Vishwakarma Road, Noida 201301, India
| | | | - Rakesh Bhaskar
- School of Chemical Engineering, Yeungnam University, 280 Daehak-Ro, Gyeongsan, Gyeongbuk 38541, Republic of Korea
| | - Kannan Badri Narayanan
- School of Chemical Engineering, Yeungnam University, 280 Daehak-Ro, Gyeongsan, Gyeongbuk 38541, Republic of Korea
- Research Institute of Cell Culture, Yeungnam University, 280 Daehak-Ro, Gyeongsan, Gyeongbuk 38541, Republic of Korea
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23
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Doubovikov ED, Serdyukova NA, Greenberg SB, Gascoigne DA, Minhaj MM, Aksenov DP. Electric Field Effects on Brain Activity: Implications for Epilepsy and Burst Suppression. Cells 2023; 12:2229. [PMID: 37759452 PMCID: PMC10527339 DOI: 10.3390/cells12182229] [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: 06/23/2023] [Revised: 08/07/2023] [Accepted: 09/04/2023] [Indexed: 09/29/2023] Open
Abstract
Electric fields are now considered a major mechanism of epileptiform activity. However, it is not clear if another electrophysiological phenomenon, burst suppression, utilizes the same mechanism for its bursting phase. Thus, the purpose of this study was to compare the role of ephaptic coupling-the recruitment of neighboring cells via electric fields-in generating bursts in epilepsy and burst suppression. We used local injections of the GABA-antagonist picrotoxin to elicit epileptic activity and a general anesthetic, sevoflurane, to elicit burst suppression in rabbits. Then, we applied an established computational model of pyramidal cells to simulate neuronal activity in a 3-dimensional grid, with an additional parameter to trigger a suppression phase based on extra-cellular calcium dynamics. We discovered that coupling via electric fields was sufficient to produce bursting in scenarios where inhibitory control of excitatory neurons was sufficiently low. Under anesthesia conditions, bursting occurs with lower neuronal recruitment in comparison to seizures. Our model predicts that due to the effect of electric fields, the magnitude of bursts during seizures should be roughly 2-3 times the magnitude of bursts that occur during burst suppression, which is consistent with our in vivo experimental results. The resulting difference in magnitude between bursts during anesthesia and epileptiform bursts reflects the strength of the electric field effect, which suggests that burst suppression and epilepsy share the same ephaptic coupling mechanism.
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Affiliation(s)
- Evan D. Doubovikov
- Department of Radiology, NorthShore University HealthSystem, Evanston, IL 60201, USA
| | - Natalya A. Serdyukova
- Department of Biomedical Engineering, Northwestern University, Evanston, IL 60208, USA
- Department of Pediatrics, NorthShore University HealthSystem, Evanston, IL 60201, USA
| | - Steven B. Greenberg
- Department of Anesthesiology, NorthShore University HealthSystem, Evanston, IL 60201, USA
| | - David A. Gascoigne
- Department of Radiology, NorthShore University HealthSystem, Evanston, IL 60201, USA
| | - Mohammed M. Minhaj
- Department of Anesthesiology, NorthShore University HealthSystem, Evanston, IL 60201, USA
| | - Daniil P. Aksenov
- Department of Radiology, NorthShore University HealthSystem, Evanston, IL 60201, USA
- Department of Biomedical Engineering, Northwestern University, Evanston, IL 60208, USA
- Department of Anesthesiology, NorthShore University HealthSystem, Evanston, IL 60201, USA
- Pritzker School of Medicine, University of Chicago, Chicago, IL 60637, USA
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24
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Cockle E, Rayner G, Malpas C, Alpitsis R, Rheims S, O'Brien TJ, Neal A. An international survey of SEEG cortical stimulation practices. Epilepsia Open 2023; 8:1084-1095. [PMID: 37437189 PMCID: PMC10472359 DOI: 10.1002/epi4.12790] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 07/02/2023] [Indexed: 07/14/2023] Open
Abstract
OBJECTIVE Cortical stimulation is an important component of stereoelectroencephalography (SEEG). Despite this, there is currently no standardized approach and significant heterogeneity in the literature regarding cortical stimulation practices. Via an international survey of SEEG clinicians, we sought to examine the spectrum of cortical stimulation practices to reveal areas of consensus and variability. METHODS A 68-item questionnaire was developed to understand cortical stimulation practices including neurostimulation parameters, interpretation of epileptogenicity, functional and cognitive assessment and subsequent surgical decisions. Multiple recruitment pathways were pursued, with the questionnaire distributed directly to 183 clinicians. RESULTS Responses were received from 56 clinicians across 17 countries with experience ranging from 2 to 60 years (M = 10.73, SD = 9.44). Neurostimulation parameters varied considerably, with maximum current ranging from 3 to 10 mA (M = 5.33, SD = 2.29) for 1 Hz and from 2 to 15 mA (M = 6.54, SD = 3.68) for 50 Hz stimulation. Charge density ranged from 8 to 200 μC/cm2 , with up to 43% of responders utilizing charge densities higher than recommended upper safety limits, i.e. 55 μC/cm2 . North American responders reported statistically significant higher maximum current (P < 0.001) for 1 Hz stimulation and lower pulse width for 1 and 50 Hz stimulation (P = 0.008, P < 0.001, respectively) compared to European responders. All clinicians evaluated language, speech, and motor function during cortical stimulation; in contrast, 42% assessed visuospatial or visual function, 29% memory, and 13% executive function. Striking differences were reported in approaches to assessment, classification of positive sites, and surgical decisions guided by cortical stimulation. Patterns of consistency were observed for interpretation of the localizing capacity of stimulated electroclinical seizures and auras, with habitual electroclinical seizures induced by 1 Hz stimulation considered the most localizing. SIGNIFICANCE SEEG cortical stimulation practices differed vastly across clinicians internationally, highlighting the need for consensus-based clinical guidelines. In particular, an internationally standardized approach to assessment, classification, and functional prognostication will provide a common clinical and research framework for optimizing outcomes for people with drug-resistant epilepsy.
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Affiliation(s)
- Emily Cockle
- Department of NeurologyAlfred HospitalMelbourneVictoriaAustralia
- Department of NeuroscienceMonash UniversityMelbourneVictoriaAustralia
| | - Genevieve Rayner
- Department of NeurologyAlfred HospitalMelbourneVictoriaAustralia
- Department of NeuroscienceMonash UniversityMelbourneVictoriaAustralia
- Melbourne School of Psychological SciencesUniversity of MelbourneParkvilleVictoriaAustralia
| | - Charles Malpas
- Department of NeurologyAlfred HospitalMelbourneVictoriaAustralia
- Department of NeuroscienceMonash UniversityMelbourneVictoriaAustralia
- Melbourne School of Psychological SciencesUniversity of MelbourneParkvilleVictoriaAustralia
- Department of Medicine, Royal Melbourne HospitalUniversity of MelbourneParkvilleVictoriaAustralia
| | - Rubina Alpitsis
- Department of NeurologyAlfred HospitalMelbourneVictoriaAustralia
- Department of NeuroscienceMonash UniversityMelbourneVictoriaAustralia
| | - Sylvain Rheims
- Lyon Neurosciences Research Center (Inserm U1028, CNRS UMR5292, Lyon 1 University)LyonFrance
- Department of Functional Neurology and EpileptologyHospices Civils de Lyon and Lyon 1 UniversityLyonFrance
- Epilepsy Institute and member of the ERN EpiCARELyonFrance
| | - Terence J O'Brien
- Department of NeurologyAlfred HospitalMelbourneVictoriaAustralia
- Department of NeuroscienceMonash UniversityMelbourneVictoriaAustralia
| | - Andrew Neal
- Department of NeurologyAlfred HospitalMelbourneVictoriaAustralia
- Department of NeuroscienceMonash UniversityMelbourneVictoriaAustralia
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25
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Knap B, Nieoczym D, Kundap U, Kusio-Targonska K, Kukula-Koch W, Turski WA, Gawel K. Zebrafish as a robust preclinical platform for screening plant-derived drugs with anticonvulsant properties-a review. Front Mol Neurosci 2023; 16:1221665. [PMID: 37701853 PMCID: PMC10493295 DOI: 10.3389/fnmol.2023.1221665] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 07/25/2023] [Indexed: 09/14/2023] Open
Abstract
Traditionally, selected plant sources have been explored for medicines to treat convulsions. This continues today, especially in countries with low-income rates and poor medical systems. However, in the low-income countries, plant extracts and isolated drugs are in high demand due to their good safety profiles. Preclinical studies on animal models of seizures/epilepsy have revealed the anticonvulsant and/or antiepileptogenic properties of, at least some, herb preparations or plant metabolites. Still, there is a significant number of plants known in traditional medicine that exert anticonvulsant activity but have not been evaluated on animal models. Zebrafish is recognized as a suitable in vivo model of epilepsy research and is increasingly used as a screening platform. In this review, the results of selected preclinical studies are summarized to provide credible information for the future development of effective screening methods for plant-derived antiseizure/antiepileptic therapeutics using zebrafish models. We compared zebrafish vs. rodent data to show the translational value of the former in epilepsy research. We also surveyed caveats in methodology. Finally, we proposed a pipeline for screening new anticonvulsant plant-derived drugs in zebrafish ("from tank to bedside and back again").
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Affiliation(s)
- Bartosz Knap
- Department of Experimental and Clinical Pharmacology, Medical University of Lublin, Lublin, Poland
| | - Dorota Nieoczym
- Department of Animal Physiology and Pharmacology, Institute of Biological Sciences, Maria Curie-Skłodowska University, Lublin, Poland
| | - Uday Kundap
- Canada East Spine Center, Saint John Regional Hospital, Horizon Health Center, Saint John, NB, Canada
| | - Kamila Kusio-Targonska
- Department of Experimental and Clinical Pharmacology, Medical University of Lublin, Lublin, Poland
| | - Wirginia Kukula-Koch
- Department of Pharmacognosy with Medicinal Plants Garden, Medical University, Lublin, Poland
| | - Waldemar A. Turski
- Department of Experimental and Clinical Pharmacology, Medical University of Lublin, Lublin, Poland
| | - Kinga Gawel
- Department of Experimental and Clinical Pharmacology, Medical University of Lublin, Lublin, Poland
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26
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Melin E, Andersson M, Gøtzsche CR, Wickham J, Huang Y, Szczygiel JA, Boender A, Christiansen SH, Pinborg L, Woldbye DPD, Kokaia M. Combinatorial gene therapy for epilepsy: Gene sequence positioning and AAV serotype influence expression and inhibitory effect on seizures. Gene Ther 2023; 30:649-658. [PMID: 37029201 PMCID: PMC10457185 DOI: 10.1038/s41434-023-00399-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 02/24/2023] [Accepted: 03/16/2023] [Indexed: 04/09/2023]
Abstract
Gene therapy with AAV vectors carrying genes for neuropeptide Y and its receptor Y2 has been shown to inhibit seizures in multiple animal models of epilepsy. It is however unknown how the AAV serotype or the sequence order of these two transgenes in the expression cassette affects the actual parenchymal gene expression levels and the seizure-suppressant efficacy. To address these questions, we compared three viral vector serotypes (AAV1, AAV2 and AAV8) and two transgene sequence orders (NPY-IRES-Y2 and Y2-IRES-NPY) in a rat model of acutely induced seizures. Wistar male rats were injected bilaterally with viral vectors and 3 weeks later acute seizures were induced by a subcutaneous injection of kainate. The latency until 1st motor seizure, time spent in motor seizure and latency to status epilepticus were measured to evaluate the seizure-suppressing efficacy of these vectors compared to an empty cassette control vector. Based on the results, the effect of the AAV1-NPY-IRES-Y2 vector was further investigated by in vitro electrophysiology, and its ability to achieve transgene overexpression in resected human hippocampal tissue was evaluated. The AAV1-NPY-IRES-Y2 proved to be better to any other serotype or gene sequence considering both transgene expression and ability to suppress induced seizures in rats. The vector also demonstrated transgene-induced decrease of glutamate release from excitatory neuron terminals and significantly increased both NPY and Y2 expression in resected human hippocampal tissue from patients with drug-resistant temporal lobe epilepsy. These results validate the feasibility of NPY/Y2 receptor gene therapy as a therapeutic opportunity in focal epilepsies.
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Affiliation(s)
- Esbjörn Melin
- Experimental Epilepsy Group, Epilepsy Centre, Lund University Hospital, 17 Sölvegatan, 221 84, Lund, Sweden.
| | - My Andersson
- Experimental Epilepsy Group, Epilepsy Centre, Lund University Hospital, 17 Sölvegatan, 221 84, Lund, Sweden
| | - Casper R Gøtzsche
- CombiGene AB, Medicon Village, 2 Scheelevägen, 223 81, Lund, Sweden
- Department of Neuroscience, Panum Institute, University of Copenhagen, 3B Blegdamsvej, DK-2200, Copenhagen N, Denmark
| | - Jenny Wickham
- Experimental Epilepsy Group, Epilepsy Centre, Lund University Hospital, 17 Sölvegatan, 221 84, Lund, Sweden
| | - Yuzhe Huang
- Department of Neuroscience, Panum Institute, University of Copenhagen, 3B Blegdamsvej, DK-2200, Copenhagen N, Denmark
| | - Julia Alicja Szczygiel
- Department of Neuroscience, Panum Institute, University of Copenhagen, 3B Blegdamsvej, DK-2200, Copenhagen N, Denmark
| | - Arnie Boender
- Experimental Epilepsy Group, Epilepsy Centre, Lund University Hospital, 17 Sölvegatan, 221 84, Lund, Sweden
| | - Søren H Christiansen
- Department of Neuroscience, Panum Institute, University of Copenhagen, 3B Blegdamsvej, DK-2200, Copenhagen N, Denmark
| | - Lars Pinborg
- Department of Neurology and Neurobiology Research Unit, Copenhagen University Hospital, Rigshospitalet, 9 Blegdamsvej, DK-2100, Copenhagen, Denmark
| | - David P D Woldbye
- Department of Neuroscience, Panum Institute, University of Copenhagen, 3B Blegdamsvej, DK-2200, Copenhagen N, Denmark
| | - Merab Kokaia
- Experimental Epilepsy Group, Epilepsy Centre, Lund University Hospital, 17 Sölvegatan, 221 84, Lund, Sweden
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27
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Asadi-Pooya AA, Brigo F, Lattanzi S, Blumcke I. Adult epilepsy. Lancet 2023; 402:412-424. [PMID: 37459868 DOI: 10.1016/s0140-6736(23)01048-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 05/15/2023] [Accepted: 05/19/2023] [Indexed: 07/31/2023]
Abstract
Epilepsy is a common medical condition that affects people of all ages, races, social classes, and geographical regions. Diagnosis of epilepsy remains clinical, and ancillary investigations (electroencephalography, imaging, etc) are of aid to determine the type, cause, and prognosis. Antiseizure medications represent the mainstay of epilepsy treatment: they aim to suppress seizures without adverse events, but they do not affect the underlying predisposition to generate seizures. Currently available antiseizure medications are effective in around two-thirds of patients with epilepsy. Neurosurgical resection is an effective strategy to reach seizure control in selected individuals with drug-resistant focal epilepsy. Non-pharmacological treatments such as palliative surgery (eg, corpus callosotomy), neuromodulation techniques (eg, vagus nerve stimulation), and dietary interventions represent therapeutic options for patients with drug-resistant epilepsy who are not suitable for resective brain surgery.
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Affiliation(s)
- Ali A Asadi-Pooya
- Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran; Jefferson Comprehensive Epilepsy Center, Department of Neurology, Thomas Jefferson University, Philadelphia, PA, USA.
| | - Francesco Brigo
- Department of Neurology, Hospital of Merano (SABES-ASDAA), Merano, Italy; Lehrkrankenhaus der Paracelsus Medizinischen Privatuniversität, Salzburg, Austria
| | - Simona Lattanzi
- Neurological Clinic, Department of Experimental and Clinical Medicine, Marche Polytechnic University, Ancona, Italy
| | - Ingmar Blumcke
- Institute of Neuropathology, University Hospitals Erlangen, Erlangen, Germany; Charles Shor Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA
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28
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Sadoun MSN, Ur Rahman MM, Al-Naffouri T, Laleg-Kirati TM. EEG Epileptic Data Classification Using the Schrodinger Operator's Spectrum. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2023; 2023:1-6. [PMID: 38083329 DOI: 10.1109/embc40787.2023.10340881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
Epilepsy is a common brain disorder characterized by recurrent, unprovoked seizures which affects over 65 million people. Visual inspection of Electroencephalograms (EEG) is common for diagnosis; however, it requires time and expertise. Therefore, an accurate computer-aided epileptic seizure diagnosis system would be valuable. A new research tendency when tackling epileptic seizure detection tends towards minimizing human manual intervention by designing frameworks with autonomous feature engineering. In this optic, this paper proposes a new approach for EEG epileptic data classification. Features derived from the Semi-Classical Signal Analysis (SCSA) method, a quantum-inspired signal processing method well-suited for the characterization of pulse-shaped physiological signals, are proposed. In addition nonlinear dynamical features that proved efficient in characterizing nonlinear dynamics of neural activity have been extracted. Moreover, hyperparameters' optimization, correlation analysis and feature selection have been performed. The selected features are fed into five different machine learning classifiers. The performance of the proposed approach has been analyzed using Bonn university database. The results show that all classifiers yield a performance accuracy of 93% and above.Clinical relevance- The paper contributes to the design of methods and algorithms to build reliable software solutions to assist medical experts and reduce epilepsy disease's diagnosis time and errors.
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29
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Ryazanova MA, Plekanchuk VS, Prokudina OI, Makovka YV, Alekhina TA, Redina OE, Markel AL. Animal Models of Hypertension (ISIAH Rats), Catatonia (GC Rats), and Audiogenic Epilepsy (PM Rats) Developed by Breeding. Biomedicines 2023; 11:1814. [PMID: 37509453 PMCID: PMC10376947 DOI: 10.3390/biomedicines11071814] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 06/06/2023] [Accepted: 06/21/2023] [Indexed: 07/30/2023] Open
Abstract
Research into genetic and physiological mechanisms of widespread disorders such as arterial hypertension as well as neuropsychiatric and other human diseases is urgently needed in academic and practical medicine and in the field of biology. Nevertheless, such studies have many limitations and pose difficulties that can be overcome by using animal models. To date, for the purposes of creating animal models of human pathologies, several approaches have been used: pharmacological/chemical intervention; surgical procedures; genetic technologies for creating transgenic animals, knockouts, or knockdowns; and breeding. Although some of these approaches are good for certain research aims, they have many drawbacks, the greatest being a strong perturbation (in a biological system) that, along with the expected effect, exerts side effects in the study. Therefore, for investigating the pathogenesis of a disease, models obtained using genetic selection for a target trait are of high value as this approach allows for the creation of a model with a "natural" manifestation of the pathology. In this review, three rat models are described: ISIAH rats (arterial hypertension), GC rats (catatonia), and PM rats (audiogenic epilepsy), which are developed by breeding in the Laboratory of Evolutionary Genetics at the Institute of Cytology and Genetics (the Siberian Branch of the Russian Academy of Sciences).
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Affiliation(s)
- Marina A Ryazanova
- Federal Research Center, Institute of Cytology and Genetics, Siberian Branch of Russian Academy of Sciences, Novosibirsk 630090, Russia
| | - Vladislava S Plekanchuk
- Federal Research Center, Institute of Cytology and Genetics, Siberian Branch of Russian Academy of Sciences, Novosibirsk 630090, Russia
| | - Olga I Prokudina
- Federal Research Center, Institute of Cytology and Genetics, Siberian Branch of Russian Academy of Sciences, Novosibirsk 630090, Russia
| | - Yulia V Makovka
- Federal Research Center, Institute of Cytology and Genetics, Siberian Branch of Russian Academy of Sciences, Novosibirsk 630090, Russia
- Department of Natural Sciences, Novosibirsk State University, Novosibirsk 630090, Russia
| | - Tatiana A Alekhina
- Federal Research Center, Institute of Cytology and Genetics, Siberian Branch of Russian Academy of Sciences, Novosibirsk 630090, Russia
| | - Olga E Redina
- Federal Research Center, Institute of Cytology and Genetics, Siberian Branch of Russian Academy of Sciences, Novosibirsk 630090, Russia
| | - Arcady L Markel
- Federal Research Center, Institute of Cytology and Genetics, Siberian Branch of Russian Academy of Sciences, Novosibirsk 630090, Russia
- Department of Natural Sciences, Novosibirsk State University, Novosibirsk 630090, Russia
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30
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Uher D, Drenthen GS, Schijns OEMG, Colon AJ, Hofman PAM, van Lanen RHGJ, Hoeberigs CM, Jansen JFA, Backes WH. Advances in Image Processing for Epileptogenic Zone Detection with MRI. Radiology 2023; 307:e220927. [PMID: 37129491 DOI: 10.1148/radiol.220927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Focal epilepsy is a common and severe neurologic disorder. Neuroimaging aims to identify the epileptogenic zone (EZ), preferably as a macroscopic structural lesion. For approximately a third of patients with chronic drug-resistant focal epilepsy, the EZ cannot be precisely identified using standard 3.0-T MRI. This may be due to either the EZ being undetectable at imaging or the seizure activity being caused by a physiologic abnormality rather than a structural lesion. Computational image processing has recently been shown to aid radiologic assessments and increase the success rate of uncovering suspicious regions by enhancing their visual conspicuity. While structural image analysis is at the forefront of EZ detection, physiologic image analysis has also been shown to provide valuable information about EZ location. This narrative review summarizes and explains the current state-of-the-art computational approaches for image analysis and presents their potential for EZ detection. Current limitations of the methods and possible future directions to augment EZ detection are discussed.
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Affiliation(s)
- Daniel Uher
- From the Department of Radiology and Nuclear Medicine (D.U., G.S.D., P.A.M.H., C.M.H., J.F.A.J., W.H.B.) and Department of Neurosurgery (O.E.M.G.S., R.H.G.J.v.L.), Maastricht University Medical Centre, P. Debyelaan 25, NL-6229 HX Maastricht, the Netherlands; School for Mental Health and Neuroscience (MHeNs), Maastricht University, Maastricht, the Netherlands (D.U., G.S.D., O.E.M.G.S., R.H.G.J.v.L., J.F.A.J., W.H.B.); Academic Center for Epileptology, Kempenhaeghe and Maastricht University Medical Centre, Heeze/Maastricht, the Netherlands (O.E.M.G.S., A.J.C., P.A.M.H., C.M.H., J.F.A.J.); and Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands (J.F.A.J.)
| | - Gerhard S Drenthen
- From the Department of Radiology and Nuclear Medicine (D.U., G.S.D., P.A.M.H., C.M.H., J.F.A.J., W.H.B.) and Department of Neurosurgery (O.E.M.G.S., R.H.G.J.v.L.), Maastricht University Medical Centre, P. Debyelaan 25, NL-6229 HX Maastricht, the Netherlands; School for Mental Health and Neuroscience (MHeNs), Maastricht University, Maastricht, the Netherlands (D.U., G.S.D., O.E.M.G.S., R.H.G.J.v.L., J.F.A.J., W.H.B.); Academic Center for Epileptology, Kempenhaeghe and Maastricht University Medical Centre, Heeze/Maastricht, the Netherlands (O.E.M.G.S., A.J.C., P.A.M.H., C.M.H., J.F.A.J.); and Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands (J.F.A.J.)
| | - Olaf E M G Schijns
- From the Department of Radiology and Nuclear Medicine (D.U., G.S.D., P.A.M.H., C.M.H., J.F.A.J., W.H.B.) and Department of Neurosurgery (O.E.M.G.S., R.H.G.J.v.L.), Maastricht University Medical Centre, P. Debyelaan 25, NL-6229 HX Maastricht, the Netherlands; School for Mental Health and Neuroscience (MHeNs), Maastricht University, Maastricht, the Netherlands (D.U., G.S.D., O.E.M.G.S., R.H.G.J.v.L., J.F.A.J., W.H.B.); Academic Center for Epileptology, Kempenhaeghe and Maastricht University Medical Centre, Heeze/Maastricht, the Netherlands (O.E.M.G.S., A.J.C., P.A.M.H., C.M.H., J.F.A.J.); and Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands (J.F.A.J.)
| | - Albert J Colon
- From the Department of Radiology and Nuclear Medicine (D.U., G.S.D., P.A.M.H., C.M.H., J.F.A.J., W.H.B.) and Department of Neurosurgery (O.E.M.G.S., R.H.G.J.v.L.), Maastricht University Medical Centre, P. Debyelaan 25, NL-6229 HX Maastricht, the Netherlands; School for Mental Health and Neuroscience (MHeNs), Maastricht University, Maastricht, the Netherlands (D.U., G.S.D., O.E.M.G.S., R.H.G.J.v.L., J.F.A.J., W.H.B.); Academic Center for Epileptology, Kempenhaeghe and Maastricht University Medical Centre, Heeze/Maastricht, the Netherlands (O.E.M.G.S., A.J.C., P.A.M.H., C.M.H., J.F.A.J.); and Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands (J.F.A.J.)
| | - Paul A M Hofman
- From the Department of Radiology and Nuclear Medicine (D.U., G.S.D., P.A.M.H., C.M.H., J.F.A.J., W.H.B.) and Department of Neurosurgery (O.E.M.G.S., R.H.G.J.v.L.), Maastricht University Medical Centre, P. Debyelaan 25, NL-6229 HX Maastricht, the Netherlands; School for Mental Health and Neuroscience (MHeNs), Maastricht University, Maastricht, the Netherlands (D.U., G.S.D., O.E.M.G.S., R.H.G.J.v.L., J.F.A.J., W.H.B.); Academic Center for Epileptology, Kempenhaeghe and Maastricht University Medical Centre, Heeze/Maastricht, the Netherlands (O.E.M.G.S., A.J.C., P.A.M.H., C.M.H., J.F.A.J.); and Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands (J.F.A.J.)
| | - Rick H G J van Lanen
- From the Department of Radiology and Nuclear Medicine (D.U., G.S.D., P.A.M.H., C.M.H., J.F.A.J., W.H.B.) and Department of Neurosurgery (O.E.M.G.S., R.H.G.J.v.L.), Maastricht University Medical Centre, P. Debyelaan 25, NL-6229 HX Maastricht, the Netherlands; School for Mental Health and Neuroscience (MHeNs), Maastricht University, Maastricht, the Netherlands (D.U., G.S.D., O.E.M.G.S., R.H.G.J.v.L., J.F.A.J., W.H.B.); Academic Center for Epileptology, Kempenhaeghe and Maastricht University Medical Centre, Heeze/Maastricht, the Netherlands (O.E.M.G.S., A.J.C., P.A.M.H., C.M.H., J.F.A.J.); and Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands (J.F.A.J.)
| | - Christianne M Hoeberigs
- From the Department of Radiology and Nuclear Medicine (D.U., G.S.D., P.A.M.H., C.M.H., J.F.A.J., W.H.B.) and Department of Neurosurgery (O.E.M.G.S., R.H.G.J.v.L.), Maastricht University Medical Centre, P. Debyelaan 25, NL-6229 HX Maastricht, the Netherlands; School for Mental Health and Neuroscience (MHeNs), Maastricht University, Maastricht, the Netherlands (D.U., G.S.D., O.E.M.G.S., R.H.G.J.v.L., J.F.A.J., W.H.B.); Academic Center for Epileptology, Kempenhaeghe and Maastricht University Medical Centre, Heeze/Maastricht, the Netherlands (O.E.M.G.S., A.J.C., P.A.M.H., C.M.H., J.F.A.J.); and Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands (J.F.A.J.)
| | - Jacobus F A Jansen
- From the Department of Radiology and Nuclear Medicine (D.U., G.S.D., P.A.M.H., C.M.H., J.F.A.J., W.H.B.) and Department of Neurosurgery (O.E.M.G.S., R.H.G.J.v.L.), Maastricht University Medical Centre, P. Debyelaan 25, NL-6229 HX Maastricht, the Netherlands; School for Mental Health and Neuroscience (MHeNs), Maastricht University, Maastricht, the Netherlands (D.U., G.S.D., O.E.M.G.S., R.H.G.J.v.L., J.F.A.J., W.H.B.); Academic Center for Epileptology, Kempenhaeghe and Maastricht University Medical Centre, Heeze/Maastricht, the Netherlands (O.E.M.G.S., A.J.C., P.A.M.H., C.M.H., J.F.A.J.); and Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands (J.F.A.J.)
| | - Walter H Backes
- From the Department of Radiology and Nuclear Medicine (D.U., G.S.D., P.A.M.H., C.M.H., J.F.A.J., W.H.B.) and Department of Neurosurgery (O.E.M.G.S., R.H.G.J.v.L.), Maastricht University Medical Centre, P. Debyelaan 25, NL-6229 HX Maastricht, the Netherlands; School for Mental Health and Neuroscience (MHeNs), Maastricht University, Maastricht, the Netherlands (D.U., G.S.D., O.E.M.G.S., R.H.G.J.v.L., J.F.A.J., W.H.B.); Academic Center for Epileptology, Kempenhaeghe and Maastricht University Medical Centre, Heeze/Maastricht, the Netherlands (O.E.M.G.S., A.J.C., P.A.M.H., C.M.H., J.F.A.J.); and Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands (J.F.A.J.)
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Zhang X, Gu Y, Ma Y, Wu J, Chen Y, Tao K, Sun H, Liu Z, Wang X, Tian X. The Apelin/APJ system modulates seizure activity and endocytosis of the NMDA receptor GluN2B subunit. Neurochem Int 2023; 167:105545. [PMID: 37169180 DOI: 10.1016/j.neuint.2023.105545] [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: 12/07/2022] [Revised: 04/16/2023] [Accepted: 05/08/2023] [Indexed: 05/13/2023]
Abstract
In the central nervous system (CNS), the apelin/APJ system is broadly expressed. According to some studies, activation of this system protects against excitotoxicity mediated by N-methyl-D-aspartate (NMDA) receptors and exerts neuroprotective effects. However, the role of this system in epilepsy remains unclear. In the present study, immunofluorescence staining and western blotting were used to assess APJ localization and expression in the brains of mice with recurrent spontaneous seizures induced by kainic acid (KA). Behavior and local field potentials (LFPs) were assessed in mice with KA-induced seizures. Susceptibility to seizures was assessed in a pentylenetetrazole (PTZ)-induced seizure model. Whole-cell patch-clamp recordings were used to evaluate the role of the apelin/APJ system in regulating synaptic transmission in brain slices from mice in which Mg2+-free medium was used to induce seizures. NMDA receptor GluN2B subunit expression and phosphorylation of GluN2B at Ser1480 were measured in the mouse hippocampus. APJ was primarily localized in neurons, and its expression was upregulated in the epileptic brain. APJ activation after KA-induced status epilepticus (SE) reduced epileptic activity, whereas APJ inhibition aggravated epileptic activity. In the PTZ model, APJ activation was reduced, and APJ inhibition increased susceptibility to seizures. The apelin/APJ system affected NMDA receptor-mediated postsynaptic currents in patch-clamp recordings. Moreover, APJ regulated the levels of GluN2B phosphorylated at Ser1480 and the abundance of cell-surface GluN2B in neurons. Furthermore, endocytosis of the NMDA receptor GluN2B subunit was regulated by the apelin/APJ system. Together, our findings indicate that the apelin/APJ system modulates seizure activity and may be a novel therapeutic target for epilepsy.
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Affiliation(s)
- Xiaogang Zhang
- Department of Neurology, Chongqing Key Laboratory of Neurology, The First Affiliated Hospital of Chongqing Medical University, 1 Youyi Road, Chongqing, 400016, China; Department of Neurology, Chongqing General Hospital, Chongqing Key Laboratory of Neurodegenerative Diseases, Chongqing, 401147, China
| | - Yixue Gu
- Department of Neurology, Chongqing Key Laboratory of Neurology, The First Affiliated Hospital of Chongqing Medical University, 1 Youyi Road, Chongqing, 400016, China
| | - Yuanlin Ma
- Department of Neurology, Chongqing Key Laboratory of Neurology, The First Affiliated Hospital of Chongqing Medical University, 1 Youyi Road, Chongqing, 400016, China
| | - Junhong Wu
- Department of Neurology, Chongqing Key Laboratory of Neurology, The First Affiliated Hospital of Chongqing Medical University, 1 Youyi Road, Chongqing, 400016, China
| | - Yuanyuan Chen
- Department of Neurology, Chongqing Key Laboratory of Neurology, The First Affiliated Hospital of Chongqing Medical University, 1 Youyi Road, Chongqing, 400016, China
| | - Kaiyan Tao
- Department of Neurology, Chongqing Key Laboratory of Neurology, The First Affiliated Hospital of Chongqing Medical University, 1 Youyi Road, Chongqing, 400016, China
| | - Houchao Sun
- Department of Neurology, Chongqing General Hospital, Chongqing Key Laboratory of Neurodegenerative Diseases, Chongqing, 401147, China
| | - Zhao Liu
- Department of Neurology, Chongqing General Hospital, Chongqing Key Laboratory of Neurodegenerative Diseases, Chongqing, 401147, China
| | - Xuefeng Wang
- Department of Neurology, Chongqing Key Laboratory of Neurology, The First Affiliated Hospital of Chongqing Medical University, 1 Youyi Road, Chongqing, 400016, China.
| | - Xin Tian
- Department of Neurology, Chongqing Key Laboratory of Neurology, The First Affiliated Hospital of Chongqing Medical University, 1 Youyi Road, Chongqing, 400016, China.
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Li J, Cossette-Roberge H, Toffa DH, Deacon C, Keezer MR. Sudden unexpected death in epilepsy (SUDEP): A bibliometric analysis. Epilepsy Res 2023; 193:107159. [PMID: 37167883 DOI: 10.1016/j.eplepsyres.2023.107159] [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: 01/12/2023] [Revised: 04/19/2023] [Accepted: 05/01/2023] [Indexed: 05/13/2023]
Abstract
OBJECTIVE The literature on sudden unexpected death in epilepsy (SUDEP) has been evolving at a staggering rate. We conducted a bibliometric analysis of the SUDEP literature with the aim of presenting its structure, performance, and trends. METHODS The Scopus database was searched in April 2023 for documents explicitly detailing SUDEP in their title, abstract, or keywords. After the removal of duplicate documents, bibliometric analysis was performed using the R package bibliometrix and the program VOSviewer. Performance metrics were computed to describe the literature's annual productivity, most relevant authors and countries, and most important publications. Science mapping was performed to visualize the relationships between research constituents by constructing a country collaboration network, co-authorship network, keyword co-occurrence network, and document co-citation network. RESULTS A total of 2140 documents were analyzed. These documents were published from 1989 onward, with an average number of citations per document of 25.78. Annual productivity had been on the rise since 2006. Out of 6502 authors, five authors were in both the list of the ten most productive and the list of the ten most cited authors: Devinsky O, Sander JW, Tomson T, Ryvlin P, and Lhatoo SD. The USA and the United Kingdom were the most productive and cited countries. Collaborations between American authors and European authors were particularly rich. Prominent themes in the literature included those related to pathophysiology (e.g., cardiac arrhythmia, apnea, autonomic dysfunction), epilepsy characteristics (e.g., epilepsy type, refractoriness, antiseizure medications), and epidemiology (e.g., incidence, age, sex). Emerging themes included sleep, genetics, epilepsy refractoriness, and non-human studies. SIGNIFICANCE The body of literature on SUDEP is rich, fast-growing, and benefiting from frequent international collaborations. Some research themes such as sleep, genetics, and animal studies have become more prevalent over recent years.
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Affiliation(s)
- Jimmy Li
- Neurology Division, Centre Hospitalier de l'Université de Sherbrooke (CHUS), Sherbrooke, QC, Canada; Centre de recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montreal, QC, Canada
| | - Hélène Cossette-Roberge
- Centre de recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montreal, QC, Canada; Faculty of Medicine, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Dènahin Hinnoutondji Toffa
- Centre de recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montreal, QC, Canada; Department of Neurosciences, Université de Montréal, Montreal, QC, Canada
| | - Charles Deacon
- Neurology Division, Centre Hospitalier de l'Université de Sherbrooke (CHUS), Sherbrooke, QC, Canada
| | - Mark Robert Keezer
- Centre de recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montreal, QC, Canada; Department of Neurosciences, Université de Montréal, Montreal, QC, Canada; School of Public Health, Université de Montréal, Montreal, QC, Canada; Neurology Division, Centre Hospitalier de l'Université de Montréal (CHUM), Montreal, QC, Canada.
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Stöber TM, Batulin D, Triesch J, Narayanan R, Jedlicka P. Degeneracy in epilepsy: multiple routes to hyperexcitable brain circuits and their repair. Commun Biol 2023; 6:479. [PMID: 37137938 PMCID: PMC10156698 DOI: 10.1038/s42003-023-04823-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 04/06/2023] [Indexed: 05/05/2023] Open
Abstract
Due to its complex and multifaceted nature, developing effective treatments for epilepsy is still a major challenge. To deal with this complexity we introduce the concept of degeneracy to the field of epilepsy research: the ability of disparate elements to cause an analogous function or malfunction. Here, we review examples of epilepsy-related degeneracy at multiple levels of brain organisation, ranging from the cellular to the network and systems level. Based on these insights, we outline new multiscale and population modelling approaches to disentangle the complex web of interactions underlying epilepsy and to design personalised multitarget therapies.
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Affiliation(s)
- Tristan Manfred Stöber
- Frankfurt Institute for Advanced Studies, 60438, Frankfurt am Main, Germany
- Institute for Neural Computation, Faculty of Computer Science, Ruhr University Bochum, 44801, Bochum, Germany
- Epilepsy Center Frankfurt Rhine-Main, Department of Neurology, Goethe University, 60590, Frankfurt, Germany
| | - Danylo Batulin
- Frankfurt Institute for Advanced Studies, 60438, Frankfurt am Main, Germany
- CePTER - Center for Personalized Translational Epilepsy Research, Goethe University, 60590, Frankfurt, Germany
- Faculty of Computer Science and Mathematics, Goethe University, 60486, Frankfurt, Germany
| | - Jochen Triesch
- Frankfurt Institute for Advanced Studies, 60438, Frankfurt am Main, Germany
| | - Rishikesh Narayanan
- Cellular Neurophysiology Laboratory, Molecular Biophysics Unit, Indian Institute of Science, Bangalore, 560012, India
| | - Peter Jedlicka
- ICAR3R - Interdisciplinary Centre for 3Rs in Animal Research, Faculty of Medicine, Justus Liebig University Giessen, 35390, Giessen, Germany.
- Institute of Clinical Neuroanatomy, Neuroscience Center, Goethe University, 60590, Frankfurt am Main, Germany.
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Darwish A, Ahmed OEF, Ebrahim KS, Shata MO, Abouelmaaty EH, Hamada SM. Re-appraisal of callosotomy: rates and predictors of short-term seizure outcome in pediatric epileptic encephalopathy. THE EGYPTIAN JOURNAL OF NEUROLOGY, PSYCHIATRY AND NEUROSURGERY 2023. [DOI: 10.1186/s41983-023-00620-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023] Open
Abstract
Abstract
Background
Epilepsy is a chronic debilitating disease especially in pediatric population. Most of reported studies for corpus callosotomy as a palliative surgery in drug-resistant cases are on limited number of cases and there is scarcity in literature for outcomes reported from developing countries. Here, we present our study on a large series of cases with analysis of potential predicators outcomes in the era of more expensive devices like vagal nerve stimulation to give a litany on a universal epilepsy surgery procedure which had been missed in the literature through the last decade.
Results
An observational retrospective study was done reviewing 129 patients with PEE underwent open microscopic corpus callosotomy. Total and drop attack seizure outcomes were studied after surgery. Potential outcomes predictors studied are: preoperative EEG and MRI. Preoperative IQ impairment epilepsy duration, age at diagnosis, MRI finding, IQ score, EEG findings, history of infantile spasm and extent of callosotomy done. All the recorded outcomes were substantially improved after callosotomy in our study population of 129 pediatric patients. The median (IQR) preoperative drop attack frequency was 70 (21–140) which decreased to 3 (0–14) postoperatively. Similarly, the number of anti-epileptics used by patients had a median of 3 (2–4) which decreased to 2 (2–3) after the surgery. All patients were experiencing status epilepticus which disappeared in 72% of the patients after callosotomy. Preoperative normal MRI was a predictor for drop attack favorable outcome and mild preoperative impairment of IQ was a predictor of favorable total seizure and drop attack outcome.
Conclusions
Corpus callosotomy is a well-tolerated palliative procedure for drug-resistant generalized epilepsy notably, drop attacks which had its notorious effect on quality of life of pediatric patients and their families, no appreciable prognostic factors for favorable outcome were clearly observed except for normal preoperative MRI, mild preoperative IQ affection, and complete callosotomy.
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Potes Y, Cachán-Vega C, Antuña E, García-González C, Menéndez-Coto N, Boga JA, Gutiérrez-Rodríguez J, Bermúdez M, Sierra V, Vega-Naredo I, Coto-Montes A, Caballero B. Benefits of the Neurogenic Potential of Melatonin for Treating Neurological and Neuropsychiatric Disorders. Int J Mol Sci 2023; 24:ijms24054803. [PMID: 36902233 PMCID: PMC10002978 DOI: 10.3390/ijms24054803] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 02/28/2023] [Accepted: 03/01/2023] [Indexed: 03/06/2023] Open
Abstract
There are several neurological diseases under which processes related to adult brain neurogenesis, such cell proliferation, neural differentiation and neuronal maturation, are affected. Melatonin can exert a relevant benefit for treating neurological disorders, given its well-known antioxidant and anti-inflammatory properties as well as its pro-survival effects. In addition, melatonin is able to modulate cell proliferation and neural differentiation processes in neural stem/progenitor cells while improving neuronal maturation of neural precursor cells and newly created postmitotic neurons. Thus, melatonin shows relevant pro-neurogenic properties that may have benefits for neurological conditions associated with impairments in adult brain neurogenesis. For instance, the anti-aging properties of melatonin seem to be linked to its neurogenic properties. Modulation of neurogenesis by melatonin is beneficial under conditions of stress, anxiety and depression as well as for the ischemic brain or after a brain stroke. Pro-neurogenic actions of melatonin may also be beneficial for treating dementias, after a traumatic brain injury, and under conditions of epilepsy, schizophrenia and amyotrophic lateral sclerosis. Melatonin may represent a pro-neurogenic treatment effective for retarding the progression of neuropathology associated with Down syndrome. Finally, more studies are necessary to elucidate the benefits of melatonin treatments under brain disorders related to impairments in glucose and insulin homeostasis.
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Affiliation(s)
- Yaiza Potes
- Department of Morphology and Cell Biology, Faculty of Medicine, University of Oviedo, 33006 Oviedo, Asturias, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Asturias, Spain
- Instituto de Neurociencias del Principado de Asturias (INEUROPA), 33006 Oviedo, Asturias, Spain
- Correspondence: (Y.P.); (B.C.); Tel.: +34-985102767 (Y.P.); +34-985102784 (B.C.)
| | - Cristina Cachán-Vega
- Department of Morphology and Cell Biology, Faculty of Medicine, University of Oviedo, 33006 Oviedo, Asturias, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Asturias, Spain
| | - Eduardo Antuña
- Department of Morphology and Cell Biology, Faculty of Medicine, University of Oviedo, 33006 Oviedo, Asturias, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Asturias, Spain
| | - Claudia García-González
- Department of Morphology and Cell Biology, Faculty of Medicine, University of Oviedo, 33006 Oviedo, Asturias, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Asturias, Spain
| | - Nerea Menéndez-Coto
- Department of Morphology and Cell Biology, Faculty of Medicine, University of Oviedo, 33006 Oviedo, Asturias, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Asturias, Spain
| | - Jose Antonio Boga
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Asturias, Spain
| | - José Gutiérrez-Rodríguez
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Asturias, Spain
| | - Manuel Bermúdez
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Asturias, Spain
| | - Verónica Sierra
- Servicio Regional de Investigación y Desarrollo Agroalimentario (SERIDA), 33300 Villaviciosa, Asturias, Spain
| | - Ignacio Vega-Naredo
- Department of Morphology and Cell Biology, Faculty of Medicine, University of Oviedo, 33006 Oviedo, Asturias, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Asturias, Spain
- Instituto de Neurociencias del Principado de Asturias (INEUROPA), 33006 Oviedo, Asturias, Spain
| | - Ana Coto-Montes
- Department of Morphology and Cell Biology, Faculty of Medicine, University of Oviedo, 33006 Oviedo, Asturias, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Asturias, Spain
- Instituto de Neurociencias del Principado de Asturias (INEUROPA), 33006 Oviedo, Asturias, Spain
| | - Beatriz Caballero
- Department of Morphology and Cell Biology, Faculty of Medicine, University of Oviedo, 33006 Oviedo, Asturias, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Asturias, Spain
- Instituto de Neurociencias del Principado de Asturias (INEUROPA), 33006 Oviedo, Asturias, Spain
- Correspondence: (Y.P.); (B.C.); Tel.: +34-985102767 (Y.P.); +34-985102784 (B.C.)
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Meng J, Yan Z, Tao X, Wang W, Wang F, Xue T, Liu Y, Wang Z. The efficacy and safety of ganaxolone for the treatment of refractory epilepsy: A meta-analysis from randomized controlled trials. Epilepsia Open 2023; 8:90-99. [PMID: 36333279 PMCID: PMC9978077 DOI: 10.1002/epi4.12669] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Accepted: 11/02/2022] [Indexed: 11/07/2022] Open
Abstract
OBJECTIVE Epilepsy is one of the most common and refractory neurological disorders globally. Ganaxolone, a neuroactive steroid that enhances GABAergic inhibition, has been tested in many trials for the resolution of refractory epilepsy. Based on these, our study implemented a meta-analysis to evaluate the general benefit of ganaxolone for refractory epilepsy. METHODS EMBASE, Medline, Scopus, Cochrane Library, and Clinicaltrials.gov were searched for relevant randomized controlled trials (RCTs) up to June 20, 2022. The risk ratio (RR) and standard mean difference (SMD) were analyzed using dichotomous and continuous outcomes, respectively with a random effect model. Trial sequential analysis (TSA) was also performed to judge the reliability of results. RESULTS We totally collected 659 patients from four RCTs to evaluate the efficacy and safety of ganaxolone. As results showed, ≥50% reduction in mean seizure frequency has improved significantly compared with placebo (RR = 1.60, 95%CI: 1.02-2.49, p = 0.04, I2 = 30%), which is supported by TSA. However, the percentage of seizure-free days shows no statistical significance (p = 0.36). For safety outcomes, adverse events (AEs), serious adverse events, and AE leading to study drug discontinuation all revealed no obvious difference between ganaxolone and placebo (p > 0.05). SIGNIFICANCE Based on our research, we have observed that ganaxolone is safe and has potential efficacy in the treatment of refractory epilepsy, waiting for further studies.
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Affiliation(s)
- Jiahao Meng
- Department of Neurosurgery & Brain and Nerve Research Laboratory, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China
| | - Zeya Yan
- Department of Neurosurgery & Brain and Nerve Research Laboratory, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China
| | - Xinyu Tao
- Department of Neurosurgery & Brain and Nerve Research Laboratory, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China
| | - Wei Wang
- Department of Neurosurgery & Brain and Nerve Research Laboratory, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China
| | - Fei Wang
- Department of Neurosurgery & Brain and Nerve Research Laboratory, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China
| | - Tao Xue
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yanfei Liu
- Department of Neurosurgery, Suzhou Integrated Traditional Chinese and Western Medicine Hospital, Suzhou, Jiangsu Province, China
| | - Zhong Wang
- Department of Neurosurgery & Brain and Nerve Research Laboratory, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China
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Zeng ML, Kong S, Chen TX, Peng BW. Transient Receptor Potential Vanilloid 4: a Double-Edged Sword in the Central Nervous System. Mol Neurobiol 2023; 60:1232-1249. [PMID: 36434370 DOI: 10.1007/s12035-022-03141-6] [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: 08/09/2022] [Accepted: 11/17/2022] [Indexed: 11/26/2022]
Abstract
Transient receptor potential vanilloid 4 (TRPV4) is a nonselective cation channel that can be activated by diverse stimuli, such as heat, mechanical force, hypo-osmolarity, and arachidonic acid metabolites. TRPV4 is widely expressed in the central nervous system (CNS) and participates in many significant physiological processes. However, accumulative evidence has suggested that deficiency, abnormal expression or distribution, and overactivation of TRPV4 are involved in pathological processes of multiple neurological diseases. Here, we review the latest studies concerning the known features of this channel, including its expression, structure, and its physiological and pathological roles in the CNS, proposing an emerging therapeutic strategy for CNS diseases.
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Affiliation(s)
- Meng-Liu Zeng
- Department of Physiology, Hubei Provincial Key Laboratory of Developmentally Originated Disease, Taikang Medical School (School of Basic Medical Sciences), Wuhan University, Donghu Rd185#, Wuhan, 430071, Hubei, China.,Medical Science Research Center, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China
| | - Shuo Kong
- Department of Physiology, Hubei Provincial Key Laboratory of Developmentally Originated Disease, Taikang Medical School (School of Basic Medical Sciences), Wuhan University, Donghu Rd185#, Wuhan, 430071, Hubei, China
| | - Tao-Xiang Chen
- Department of Physiology, Hubei Provincial Key Laboratory of Developmentally Originated Disease, Taikang Medical School (School of Basic Medical Sciences), Wuhan University, Donghu Rd185#, Wuhan, 430071, Hubei, China
| | - Bi-Wen Peng
- Department of Physiology, Hubei Provincial Key Laboratory of Developmentally Originated Disease, Taikang Medical School (School of Basic Medical Sciences), Wuhan University, Donghu Rd185#, Wuhan, 430071, Hubei, China.
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Liu W, Xu Y, Lin Y, Wang L, Zhou M, Yin P, Zhao G. Burden of epilepsy in China and its provinces, 1990 to 2019: findings from the Global Burden of Disease Study 2019. Chin Med J (Engl) 2023; 136:305-312. [PMID: 36752807 PMCID: PMC10106145 DOI: 10.1097/cm9.0000000000002526] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Indexed: 02/09/2023] Open
Abstract
BACKGROUND Epilepsy accounts for a significant portion of the global disease burden. However, little is known about the disease burden of epilepsy in China and its provinces. METHODS We assessed the burden of epilepsy in China and its provinces, municipalities, and autonomous regions from 1990 to 2019. Burden was measured as incidence, prevalence, deaths, years lived with disability, years of life lost, and disability-adjusted life years (DALYs), by age, sex, year, and province. We used the Socio-Demographic Index (SDI) to determine the association between the provincial development level and age-standardized DALY rates of epilepsy from 1990 to 2019. RESULTS In 2019, epilepsy caused 1367.51 thousand (95% uncertainty interval [UI]: 979.92-1837.61 thousand) DALYs, and the age-standardized DALY rate was 99.77 (95% UI: 71.33-133.52)/100,000. The age-standardized incidence and prevalence rates for epilepsy in China were 24.65/100,000 and 219.69/100,000, increased by 45.00% (95% UI: 8.03-98.74%) and 35.72% (95% UI: 0.47-86.19%) compared with that in 1990, respectively. From 1990 to 2019, the proportion of DALY caused by epilepsy in the age group under 25 years steadily decreased. The proportion of DALYs caused by epilepsy in people aged 50 years and over increased from 9.45% and 10.22% in 1990 to 29.01% and 32.72% for male and female individuals in 2019, respectively. The highest age-standardized mortality rates were seen in Tibet (4.26 [95% UI: 1.43-5.66]/100,000), Qinghai (1.80 [95% UI: 1.15-2.36]/100,000), and Yunnan (1.30 [95% UI: 0.88-1.62]/100,000), and the lowest mortality rates were in Guangdong (0.48 [95% UI: 0.39-0.64]/100,000), Zhejiang (0.56 [95% UI: 0.44-0.70]/100,000), and Shanghai (0.57 [95% UI: 0.41-0.73]/100,000). The age-standardized DALY rates across the country and in provinces, municipalities, and autonomous regions generally decreased as their SDI increased. CONCLUSIONS The disease burden of epilepsy is still heavy in China, especially in the western provinces. The incidence and prevalence of epilepsy increased between 1990 and 2019, and the burden of epilepsy in the elderly increases gradually. This study provides evidence on epilepsy prevention and care of different regions in China.
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Affiliation(s)
- Wei Liu
- National Center for Chronic and Non-Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Yangyang Xu
- National Center for Chronic and Non-Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Yicong Lin
- Department of Neurology, Xuanwu Hospital, Capital Medical University, National Center for Neurological Disorders, Beijing 100053, China
| | - Lijun Wang
- National Center for Chronic and Non-Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Maigeng Zhou
- National Center for Chronic and Non-Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Peng Yin
- National Center for Chronic and Non-Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
| | - Guoguang Zhao
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, National Center for Neurological Disorders, Beijing 100053, China
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The Impact of Epilepsy on Complication Rates After Total Joint Arthroplasty: A Propensity Score-Matched Cohort Study. J Arthroplasty 2023; 38:209-214.e1. [PMID: 35988826 DOI: 10.1016/j.arth.2022.08.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 08/10/2022] [Accepted: 08/12/2022] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND It is unclear how epilepsy may affect total joint arthroplasty outcomes. The purpose of this study is to analyze the impact of epilepsy on prosthesis-related complications following primary total hip arthroplasty (THA) and total knee arthroplasty (TKA). METHODS A retrospective cohort study was conducted using a national database. Patients who have epilepsy underwent a primary THA (n = 6,981) and TKA (n = 4,987) and were matched 1:4 (THA, n = 27,924; TKA, n = 19,948). Rates of low-energy falls and prosthesis-related complications within 2 years postoperatively were compared for patients who did and did not have epilepsy with multivariable logistic regression. RESULTS After primary TKA, patients who have epilepsy exhibited significantly higher rates of aseptic revision (4.3% versus 3.5%, odds ratio [OR] 1.21, P = .017) and revision for prosthetic joint infection (1.8% versus 1.3%, OR 1.29, P = .041). THA patients who have epilepsy exhibited significantly higher rates of prosthetic dislocation (3.2% versus 1.9%, OR 1.54, P < .001), periprosthetic fracture (2.2% versus 0.8%, OR 2.39, P < .001), and aseptic loosening (1.7% versus 1.1%, OR 1.40, P = .002). Rates of low-energy falls within 2 years after TKA (14.1% versus 6.4%, OR 2.19, P < .001) and THA (33.6% versus 7.5%, OR 5.95, P < .001) were also significantly higher for patients who have epilepsy. CONCLUSION Epilepsy was associated with significantly higher rates of falls (P < .001) and prosthesis-related complications after primary THA (P < .05) and TKA (P < .05). Precautions should be implemented in this population during intraoperative and perioperative decision-making to reduce complication risk. LEVEL OF EVIDENCE Level III.
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Polymorphisms Affecting the Response to Novel Antiepileptic Drugs. Int J Mol Sci 2023; 24:ijms24032535. [PMID: 36768858 PMCID: PMC9917302 DOI: 10.3390/ijms24032535] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 01/25/2023] [Accepted: 01/26/2023] [Indexed: 02/03/2023] Open
Abstract
Epilepsy is one of the most frequent chronic neurologic disorders that affects nearly 1% of the population worldwide, especially in developing countries. Currently, several antiepileptic drugs (AEDs) are available for its therapy, and although the prognosis is good for most patients, 20%-30% amongst them do not reach seizure freedom. Numerous factors may explain AED-resistance such as sex, age, ethnicity, type of seizure, early epilepsy onset, suboptimal dosing, poor drug compliance, alcohol abuse, and in particular, genetic factors. Specifically, the interindividual differences in drug response can be caused by single nucleotide polymorphisms (SNPs) in genes encoding for drug efflux transporters, for the brain targets of AEDs, and for enzymes involved in drug metabolism. In this review, we used the PubMed database to retrieve studies that assessed the influence of SNPs on the pharmacokinetic (PK), pharmacodynamic (PD), and efficacy of new antiepileptic drugs. Our results showed that polymorphisms in the ABCB1, ABCC2, UGT1A4, UGT2B7, UGT2B15, CYP2C9, and CYP2C19 genes have an influence on the PK and efficacy of AEDs, suggesting that a genetic pre-evaluation of epileptic patients could help clinicians in prescribing a personalized treatment to improve the efficacy and the safety of the therapy.
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Sandouka S, Saadi A, Singh PK, Olowe R, Shekh-Ahmad T. Nrf2 is predominantly expressed in hippocampal neurons in a rat model of temporal lobe epilepsy. Cell Biosci 2023; 13:3. [PMID: 36600279 DOI: 10.1186/s13578-022-00951-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 12/28/2022] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Drug resistance is a particular problem in patients with temporal lobe epilepsy, where seizures originate mainly from the hippocampus. Many of these epilepsies are acquired conditions following an insult to the brain such as a prolonged seizure. Such conditions are characterized by pathophysiological mechanisms including massive oxidative stress that synergistically mediate the secondary brain damage, contributing to the development of epilepsy. The transcription factor nuclear factor (erythroid-derived 2)-like 2 (Nrf2) has emerged in recent years as an attractive therapeutic approach targeting to upregulate the antioxidative defenses in the cell, to ameliorate the oxidative stress-induced damage. Thus, it is important to understand the characteristics of Nrf2 activation during epileptogenesis and epilepsy. Here, we studied the temporal, regional, and cell-type specific expression of Nrf2 in the brain, in a rat model of temporal lobe epilepsy. RESULTS Early after status-epilepticus, Nrf2 is mainly activated in the hippocampus and maintained during the whole period of epileptogenesis. Only transient expression of Nrf2 was observed in the cortex. Nevertheless, the expression of several Nrf2 antioxidant target genes was increased within 24 h after status-epilepticus in both the cortex and the hippocampus. We demonstrated that after status-epilepticus in rats, Nrf2 is predominantly expressed in neurons in the CA1 and CA3 regions of the hippocampus, and only astrocytes in the CA1 increase their Nrf2 expression. CONCLUSIONS In conclusion, our data identify previously unrecognized spatial and cell-type dependent activation of Nrf2 during epilepsy development, highlighting the need for a time-controlled, and cell-type specific activation of the Nrf2 pathway for mediating anti-oxidant response after brain insult, to modify the development of epilepsy.
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Affiliation(s)
- Sereen Sandouka
- The Institute for Drug Research, The School of Pharmacy, Faculty of Medicine, The Hebrew University of Jerusalem, 91120, Jerusalem, Israel
| | - Aseel Saadi
- The Institute for Drug Research, The School of Pharmacy, Faculty of Medicine, The Hebrew University of Jerusalem, 91120, Jerusalem, Israel
| | - Prince Kumar Singh
- The Institute for Drug Research, The School of Pharmacy, Faculty of Medicine, The Hebrew University of Jerusalem, 91120, Jerusalem, Israel
| | - Rhoda Olowe
- The Institute for Drug Research, The School of Pharmacy, Faculty of Medicine, The Hebrew University of Jerusalem, 91120, Jerusalem, Israel
| | - Tawfeeq Shekh-Ahmad
- The Institute for Drug Research, The School of Pharmacy, Faculty of Medicine, The Hebrew University of Jerusalem, 91120, Jerusalem, Israel.
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Tong F, Lin J, Zeng Z, Wang Q, Yang Z, Lv Y. Sudden unexpected death in epilepsy: A bibliometric overview. Front Neurol 2023; 14:1139521. [PMID: 36908594 PMCID: PMC9995761 DOI: 10.3389/fneur.2023.1139521] [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: 01/07/2023] [Accepted: 01/30/2023] [Indexed: 02/25/2023] Open
Abstract
The mechanism of sudden unexpected death in epilepsy (SUDEP) is elusive and many questions remain unanswered. Autopsy is generally unhelpful in providing evidence for the cause of death, as pathological changes may be on the molecular level. Although histopathological examination occasionally demonstrates pathology such as vascular malformation, old traumatic injury, and tumor, in most cases of SUDEP, the examination is negative. We examined the current status of SUDEP research by performing a bibliometric analysis of studies in the Web of Science Core Collection database published between 2002 and 2022. Our aim was to demonstrate areas of interest and frontiers of SUDEP research. A total of 1803 papers were included in the analysis. The number of published papers focused on SUDEP has been increasing since 2002. Main areas of interest include clinical manifestations, prevalence, treatment, and underlying mechanisms. Research teams from the United States and Europe are leading the way in SUDEP research, while Asia trails behind. Future studies regarding the mechanism and neuropathology of SUDEP are warranted.
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Affiliation(s)
- Fang Tong
- School of Basic Medical Sciences, Shanghai University of Medicine and Health Sciences, Shanghai, China.,Institute of Wound Prevention and Treatment, Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Jian Lin
- Institute of Wound Prevention and Treatment, Shanghai University of Medicine and Health Sciences, Shanghai, China.,Chongming Hospital Affiliated to Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Zixuan Zeng
- School of Basic Medical Sciences, Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Qi Wang
- Department of Adult Internal Medicine, Hubei Maternity and Child Health Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhifang Yang
- School of Basic Medical Sciences, Shanghai University of Medicine and Health Sciences, Shanghai, China.,Institute of Wound Prevention and Treatment, Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Yehui Lv
- School of Basic Medical Sciences, Shanghai University of Medicine and Health Sciences, Shanghai, China.,Institute of Wound Prevention and Treatment, Shanghai University of Medicine and Health Sciences, Shanghai, China
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Doege C, Luedde M, Kostev K. Association Between Angiotensin Receptor Blocker Therapy and Incidence of Epilepsy in Patients With Hypertension. JAMA Neurol 2022; 79:1296-1302. [PMID: 36251288 PMCID: PMC9577879 DOI: 10.1001/jamaneurol.2022.3413] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Accepted: 08/18/2022] [Indexed: 01/14/2023]
Abstract
Importance Arterial hypertension is associated with an increased incidence of epilepsy. Results from animal studies suggest that angiotensin receptor blocker (ARB) therapy could inhibit epileptic seizures. However, there is a lack of clinical data to support the use of ARB therapy in humans. Objective To assess whether ARB therapy is associated with a decreased incidence of epilepsy in patients with hypertension. Design, Setting, and Participants This cohort study obtained data from the Disease Analyzer database (IQVIA) on patients aged 18 years or older who had hypertension and at least 1 antihypertensive drug prescription. Patients were treated at 1274 general practices between January 2010 and December 2020 in Germany. Data were available for 1 553 875 patients who had been prescribed at least 1 antihypertensive drug. Patients diagnosed with epilepsy before or up to 3 months after the index date were excluded. A total of 168 612 patients were included in propensity score matching. Patients treated with 1 of 4 antihypertensive drug classes (β-blockers, ARBs, angiotensin-converting enzyme inhibitors, and calcium channel blockers [CCBs]) were matched to each other using propensity scores. Main Outcomes and Measures The main outcome of the study was the incidence of epilepsy associated with ARB therapy compared with other antihypertensive drug classes. Cox regression models were used to study the association between the incidence of epilepsy and ARBs compared with all other antihypertensive drug classes as a group. Results The study included a total of 168 612 patients, with 42 153 in each antihypertensive drug class. The mean [SD] age of patients was 62.3 [13.5] years, and 21 667 (51.4%) were women. The incidence of epilepsy within 5 years was lowest among patients treated with ARBs (0.27% at 1 year, 0.63% at 3 years, 0.99% at 5 years) and highest among patients receiving β-blockers and CCBs (0.38% for both β-blockers and CCBs at 1 year; 0.91% for β-blockers and 0.93% for CCBs at 3 years; β-blockers, 1.47%; and CCBs, 1.48% at 5 years). Angiotensin receptor blocker therapy was associated with a significantly decreased incidence of epilepsy (hazard ratio, 0.77; 95% CI, 0.65-0.90) compared with the other drug classes as a group. Conclusions and Relevance In this cohort study of patients with hypertension, ARB therapy was associated with a significantly decreased incidence of epilepsy. The findings suggest antihypertensive drugs could be used as a novel approach for preventing epilepsy in patients with arterial hypertension.
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Affiliation(s)
- Corinna Doege
- Department of Pediatric Neurology, Center of Pediatrics and Adolescent Medicine, Central Hospital Bremen, Bremen, Germany
| | - Mark Luedde
- Department of Cardiology, Christian-Albrechts-University of Kiel, Kiel, Germany
- Cardiology Practice Bremerhaven, Bremerhaven, Germany
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Garg VK, Supriya, Shree R, Prakash A, Takkar A, Khullar M, Saikia B, Medhi B, Modi M. Genetic abnormality of cytochrome-P2C9*3 allele predisposes to epilepsy and phenytoin-induced adverse drug reactions: genotyping findings of cytochrome-alleles in the North Indian population. FUTURE JOURNAL OF PHARMACEUTICAL SCIENCES 2022. [DOI: 10.1186/s43094-022-00432-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
This research aims to study the association of genetic polymorphism in genes coding for CYP2C9 and CYP2C19 in phenytoin-induced dose-related toxicity and to assess if the presence of allele CYP2C9*3 plays a role in phenytoin-induced idiosyncratic adverse effects. Current observational case control study included 142 patients with phenytoin-induced adverse drug reactions (ADRs) and 100 controls. All these patients underwent genotyping to determine the type of CYP2C9 allele [CYP2C9*1, CYP2C9*2 or CYP2C9*3) and CYP2C19 allele (CYP2C19*1, CYP2C19*2 or CYP2C19*3] by real-time polymerase chain reaction (RT-PCR) using Applied Biosystems (ABI) 7500 Real-Time PCR System (USA).
Results
Presence of homozygous status for allele CYP2C9*3 was associated with significantly higher risk of phenytoin-induced dose-dependent ADRs, dose-independent ADRs, gum hyperplasia, and skin rash. Presence of heterozygous status for allele CYP2C9*3 was associated with significantly higher risk of phyenytoin-induced dose-dependent ADRs and dose-independent ADRs. Presence of either heterozygous or homozygous status for CYP2C9*2 and CYP2C19*2 did not have any bearing on dose-related side effects. None of the patients showed CYP2C19*3 allele.
Conclusion
Variant alleles of CYP2C9*3 are significantly overexpressed among patients with phenytoin-induced ADRs, thereby suggesting the role for CYP2C9 genotype testing to predict risk of phenytoin-related ADRs.
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XAI4EEG: spectral and spatio-temporal explanation of deep learning-based seizure detection in EEG time series. Neural Comput Appl 2022. [DOI: 10.1007/s00521-022-07809-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
AbstractIn clinical practice, algorithmic predictions may seriously jeopardise patients’ health and thus are required to be validated by medical experts before a final clinical decision is met. Towards that aim, there is need to incorporate explainable artificial intelligence techniques into medical research. In the specific field of epileptic seizure detection there are several machine learning algorithms but less methods on explaining them in an interpretable way. Therefore, we introduce XAI4EEG: an application-aware approach for an explainable and hybrid deep learning-based detection of seizures in multivariate EEG time series. In XAI4EEG, we combine deep learning models and domain knowledge on seizure detection, namely (a) frequency bands, (b) location of EEG leads and (c) temporal characteristics. XAI4EEG encompasses EEG data preparation, two deep learning models and our proposed explanation module visualizing feature contributions that are obtained by two SHAP explainers, each explaining the predictions of one of the two models. The resulting visual explanations provide an intuitive identification of decision-relevant regions in the spectral, spatial and temporal EEG dimensions. To evaluate XAI4EEG, we conducted a user study, where users were asked to assess the outputs of XAI4EEG, while working under time constraints, in order to emulate the fact that clinical diagnosis is done - more often than not - under time pressure. We found that the visualizations of our explanation module (1) lead to a substantially lower time for validating the predictions and (2) leverage an increase in interpretability, trust and confidence compared to selected SHAP feature contribution plots.
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Wang S, Li Z, Ding X, Zhao Z, Zhang M, Xu H, Lu J, Dai L. Integrative Analyses Identify KCNJ15 as a Candidate Gene in Patients with Epilepsy. Neurol Ther 2022; 11:1767-1776. [PMID: 36168094 DOI: 10.1007/s40120-022-00407-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 09/09/2022] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Although there is accumulating evidence that genetic factors play a vital role in the pathogenesis of epilepsy, few epilepsy-associated genes have been identified. Additionally, the role of KCNJ15 in epilepsy has not been evaluated so far. METHODS Here, we performed differentially expressed gene analysis, expression quantitative trait loci analysis, gene co-expression analysis, and protein-protein interaction analysis to evaluate the role of KCNJ15 in epilepsy. RESULTS Analysis of gene expression and expression quantitative trait loci data revealed that KCNJ15 was significantly downregulated in patients with epilepsy (adjusted P = 0.0146 and log2 Fold change = - 1.0025), and an epilepsy-associated polymorphism (rs2833098) was linked to altered KCNJ15 expression level in human temporal lobe brain tissue (P = 0.0036). Gene co-expression analysis revealed that KCNJ15 was co-expressed with genes that have been reported to be associated with epilepsy in human brain tissue. Furthermore, protein-protein interaction analysis revealed strong supportive evidence for the role of KCNJ15 in epilepsy. CONCLUSION Our results show that KCNJ15 may be a candidate target for epilepsy. Functional analysis of KCNJ15 may provide novel insights for epilepsy treatment.
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Affiliation(s)
- Shitao Wang
- Department of Neurology, Affiliated Fuyang People's Hospital of Anhui Medical University, Fuyang, Anhui, China.
| | - Zongyou Li
- Department of Neurology, Affiliated Fuyang People's Hospital of Anhui Medical University, Fuyang, Anhui, China
| | - Xiangqian Ding
- Department of Neurosurgery, Qilu Hospital of Shandong University, Shandong, China
| | - Zongyou Zhao
- Department of Neurology, Funan County People's Hospital, Funan, Anhui, China
| | - Mengen Zhang
- Department of Neurology, Affiliated Fuyang People's Hospital of Anhui Medical University, Fuyang, Anhui, China
| | - Hui Xu
- Department of Neurology, Affiliated Fuyang People's Hospital of Anhui Medical University, Fuyang, Anhui, China
| | - Jinghong Lu
- Department of Neurology, Affiliated Fuyang People's Hospital of Anhui Medical University, Fuyang, Anhui, China
| | - Lili Dai
- Department of Geriatrics, Funan County People's Hospital, Funan, Anhui, China.
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Shoeibi A, Moridian P, Khodatars M, Ghassemi N, Jafari M, Alizadehsani R, Kong Y, Gorriz JM, Ramírez J, Khosravi A, Nahavandi S, Acharya UR. An overview of deep learning techniques for epileptic seizures detection and prediction based on neuroimaging modalities: Methods, challenges, and future works. Comput Biol Med 2022; 149:106053. [DOI: 10.1016/j.compbiomed.2022.106053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Revised: 08/17/2022] [Accepted: 08/17/2022] [Indexed: 02/01/2023]
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Intrathecal application of ethosuximide is highly efficient in suppressing seizures in a genetic model of absence epilepsy. Epilepsy Res 2022; 184:106967. [DOI: 10.1016/j.eplepsyres.2022.106967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 05/29/2022] [Accepted: 06/11/2022] [Indexed: 11/21/2022]
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Girma B, Nigussie J, Tamir T, Bekele E. Public knowledge toward Epilepsy and its determinants in Ethiopia: A systematic review and meta-analysis. Epilepsy Behav 2022; 133:108764. [PMID: 35690571 DOI: 10.1016/j.yebeh.2022.108764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 05/11/2022] [Accepted: 05/17/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND Epilepsy is a global problem that affects all countries and people of all ages. However, the disease burden is high in low- and middle-income countries. Poor public knowledge of epilepsy increases the rate of stigma and discrimination. However, in our country, there is a scarcity of summarized evidence about the level of public knowledge toward epilepsy. Therefore, to fill this gap, conducting this review and meta-analysis has a preponderant significance. METHODS Articles were explored from PubMed, PsycINFO, Hinari, Science Direct, web of science, and African journal of online (AJOL) databases, Google, and Google scholar. For data extraction and analysis purposes, Microsoft Excel spreadsheet and STATA software version 16 were used. To write this report, we used the Preferred Reporting Items for systematic reviews and Meta-Analysis. To assess the pooledmagnitudeof public knowledge toward epilepsy, we used arandom-effects meta-analysis model. We checked the Heterogeneity by I2. To detect publication bias, Begg's test, Egger's test, and funnel plot were conducted. Furthermore, subgroup analysis was conducted. Association was expressed through a pooled odds ratio with a 95% confidence interval. RESULT Our review and meta-analysis included 9 studies with 5658 participants. The pooled magnitude of poor knowledge toward epilepsy was 48.54% [95% CI (33.57, 63.51)]. I2 was 99.4% (P < 0.01). Begg's and Egger's test results were 0.92 and 0.06, respectively. Cannot read and write OR: 2.86 [95 CI (2.04, 4.00]) and not witnessing seizure episode OR: 3.00 [95% CI (2.46, 3.66)]) were significant determinants of poor knowledge. CONCLUSION In this review and meta-analysis, around half of the participants had poor knowledge about epilepsy. Individuals who cannot read and write, and could not witness seizure episodes had more likely to have poor knowledge toward epilepsy as compared to their counterparts. Health education through different methods should be provided to the public, and our educational system should focus on this global problem. Furthermore, it is better to give training for community key informants.
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Affiliation(s)
- Bekahegn Girma
- Dilla University, College of Medicine and Health Science, Department of Nursing, Dilla, Ethiopia.
| | - Jemberu Nigussie
- Dilla University, College of Medicine and Health Science, Department of Nursing, Dilla, Ethiopia
| | - Takla Tamir
- Dilla University, College of Medicine and Health Science, Department of Nursing, Dilla, Ethiopia
| | - Etaferaw Bekele
- Dilla University, College of Medicine and Health Science, Department of Nursing, Dilla, Ethiopia
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Regulation of Inflammation-Related Genes through Fosl1 Suppression in a Levetiracetam-Treated Pilocarpine-Induced Status Epilepticus Mouse Model. Int J Mol Sci 2022; 23:ijms23147608. [PMID: 35886955 PMCID: PMC9317701 DOI: 10.3390/ijms23147608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 06/28/2022] [Accepted: 07/07/2022] [Indexed: 11/17/2022] Open
Abstract
Levetiracetam (LEV) suppresses the upregulation of proinflammatory molecules that occurs during epileptogenesis after status epilepticus (SE). Based on previous studies, LEV likely helps prevent the onset of epilepsy after insults to the brain, unlike other conventional anti-epileptic drugs. Recently, we discovered that the increase in Fosl1 expression that occurs after lipopolysaccharide (LPS) stimulation is suppressed by LEV and that Fosl1 inhibition suppresses inflammation in BV-2 microglial cells. These data indicate that Fosl1 is an important target of LEV and a key factor in preventing epilepsy onset. In this study, we examined the effects of LEV on Fosl1 expression and neuroinflammation in vivo. During epileptogenesis, the post-SE upregulation of hippocampal levels of Fosl1 and many inflammatory factors were suppressed by LEV. Fosl1 expression showed a characteristic pattern different from that of the expression of Fos, an immediate-early gene belonging to the same Fos family. At 2 days after SE, Fosl1 was predominantly expressed in astrocytes but was rarely detected in microglia, whereas Fos expression was distributed in various brain cell types. The expression of A2 astrocyte markers was similar to that of Fosl1 and was significantly suppressed by LEV. These results suggest that LEV may regulate astrocyte reactivity through regulation of Fosl1.
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