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McCoy AM, Prevot TD, Sharmin D, Cook JM, Sibille EL, Lodge DJ. GL-II-73, a Positive Allosteric Modulator of α5GABA A Receptors, Reverses Dopamine System Dysfunction Associated with Pilocarpine-Induced Temporal Lobe Epilepsy. Int J Mol Sci 2023; 24:11588. [PMID: 37511346 PMCID: PMC10380722 DOI: 10.3390/ijms241411588] [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: 06/25/2023] [Revised: 07/15/2023] [Accepted: 07/16/2023] [Indexed: 07/30/2023] Open
Abstract
Although seizures are a hallmark feature of temporal lobe epilepsy (TLE), psychiatric comorbidities, including psychosis, are frequently associated with TLE and contribute to decreased quality of life. Currently, there are no defined therapeutic protocols to manage psychosis in TLE patients, as antipsychotic agents may induce epileptic seizures and are associated with severe side effects and pharmacokinetic and pharmacodynamic interactions with antiepileptic drugs. Thus, novel treatment strategies are necessary. Several lines of evidence suggest that hippocampal hyperactivity is central to the pathology of both TLE and psychosis; therefore, restoring hippocampal activity back to normal levels may be a novel therapeutic approach for treating psychosis in TLE. In rodent models, increased activity in the ventral hippocampus (vHipp) results in aberrant dopamine system function, which is thought to underlie symptoms of psychosis. Indeed, we have previously demonstrated that targeting α5-containing γ-aminobutyric acid receptors (α5GABAARs), an inhibitory receptor abundant in the hippocampus, with positive allosteric modulators (PAMs), can restore dopamine system function in rodent models displaying hippocampal hyperactivity. Thus, we posited that α5-PAMs may be beneficial in a model used to study TLE. Here, we demonstrate that pilocarpine-induced TLE is associated with increased VTA dopamine neuron activity, an effect that was completely reversed by intra-vHipp administration of GL-II-73, a selective α5-PAM. Further, pilocarpine did not alter the hippocampal α5GABAAR expression or synaptic localization that may affect the efficacy of α5-PAMs. Taken together, these results suggest augmenting α5GABAAR function as a novel therapeutic modality for the treatment of psychosis in TLE.
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Affiliation(s)
- Alexandra M McCoy
- Department of Pharmacology and Center for Biomedical Neuroscience, UT Health San Antonio, San Antonio, TX 78229, USA
- South Texas Veterans Health Care System, Audie L. Murphy Division, San Antonio, TX 78229, USA
| | - Thomas D Prevot
- Campbell Family Mental Health Research Institute of CAMH, Toronto, ON M5S 2S1, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON M5T 1R8, Canada
| | - Dishary Sharmin
- Department of Chemistry and Biochemistry, University of Wisconsin-Milwaukee, Milwaukee, WI 53201, USA
| | - James M Cook
- Department of Chemistry and Biochemistry, University of Wisconsin-Milwaukee, Milwaukee, WI 53201, USA
| | - Etienne L Sibille
- Campbell Family Mental Health Research Institute of CAMH, Toronto, ON M5S 2S1, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON M5T 1R8, Canada
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON M5T 1R8, Canada
| | - Daniel J Lodge
- Department of Pharmacology and Center for Biomedical Neuroscience, UT Health San Antonio, San Antonio, TX 78229, USA
- South Texas Veterans Health Care System, Audie L. Murphy Division, San Antonio, TX 78229, USA
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Lima MF, Sarudiansky M, Oddo S, Giagante B, Kochen S, D'Alessio L. Comorbid psychosis in temporal lobe epilepsy is associated with auditory emotion recognition impairments. Schizophr Res 2023; 254:8-10. [PMID: 36736101 DOI: 10.1016/j.schres.2023.01.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 01/05/2023] [Accepted: 01/15/2023] [Indexed: 02/04/2023]
Affiliation(s)
- Mónica Fernández Lima
- Studies of Neurosciences and Complex Systems (ENyS), National Scientific and Technical Research Council (CONICET), Florencio Varela, Argentina; Buenos Aires University, Institute of Cellular Biology and Neurosciences E de Robertis (IBCN-CONICET), Buenos Aires, Argentina; Buenos Aires University, Epilepsy Center, Ramos Mejía Hospital, Buenos Aires city, Argentina
| | | | - Silvia Oddo
- Studies of Neurosciences and Complex Systems (ENyS), National Scientific and Technical Research Council (CONICET), Florencio Varela, Argentina; Buenos Aires University, Epilepsy Center, Ramos Mejía Hospital, Buenos Aires city, Argentina
| | - Brenda Giagante
- Studies of Neurosciences and Complex Systems (ENyS), National Scientific and Technical Research Council (CONICET), Florencio Varela, Argentina
| | - Silvia Kochen
- Studies of Neurosciences and Complex Systems (ENyS), National Scientific and Technical Research Council (CONICET), Florencio Varela, Argentina; Buenos Aires University, Epilepsy Center, Ramos Mejía Hospital, Buenos Aires city, Argentina
| | - Luciana D'Alessio
- Buenos Aires University, Institute of Cellular Biology and Neurosciences E de Robertis (IBCN-CONICET), Buenos Aires, Argentina; Buenos Aires University, Epilepsy Center, Ramos Mejía Hospital, Buenos Aires city, Argentina.
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3
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Yuan T, Gao L, Zhan W, Dini D. Effect of Particle Size and Surface Charge on Nanoparticles Diffusion in the Brain White Matter. Pharm Res 2022; 39:767-781. [PMID: 35314997 PMCID: PMC9090877 DOI: 10.1007/s11095-022-03222-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 03/02/2022] [Indexed: 11/27/2022]
Abstract
Purpose Brain disorders have become a serious problem for healthcare worldwide. Nanoparticle-based drugs are one of the emerging therapies and have shown great promise to treat brain diseases. Modifications on particle size and surface charge are two efficient ways to increase the transport efficiency of nanoparticles through brain-blood barrier; however, partly due to the high complexity of brain microstructure and limited visibility of Nanoparticles (NPs), our understanding of how these two modifications can affect the transport of NPs in the brain is insufficient. Methods In this study, a framework, which contains a stochastic geometric model of brain white matter (WM) and a mathematical particle tracing model, was developed to investigate the relationship between particle size/surface charge of the NPs and their effective diffusion coefficients (D) in WM. Results The predictive capabilities of this method have been validated using published experimental tests. For negatively charged NPs, both particle size and surface charge are positively correlated with D before reaching a size threshold. When Zeta potential (Zp) is less negative than -10 mV, the difference between NPs’ D in WM and pure interstitial fluid (IF) is limited. Conclusion A deeper understanding on the relationships between particle size/surface charge of NPs and their D in WM has been obtained. The results from this study and the developed modelling framework provide important tools for the development of nano-drugs and nano-carriers to cure brain diseases.
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Affiliation(s)
- Tian Yuan
- Department of Mechanical Engineering, Imperial College London, London, SW7 2AZ, UK.
| | - Ling Gao
- School of Biomedical Engineering and Imaging Sciences, King's College London, St. Thomas Hospital, London, SE1 7EH, UK
| | - Wenbo Zhan
- School of Engineering, King's College, University of Aberdeen, Aberdeen, AB24 3UE, UK
| | - Daniele Dini
- Department of Mechanical Engineering, Imperial College London, London, SW7 2AZ, UK
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Kanemoto K. Psychotic Disorders in Epilepsy: Do They Differ from Primary Psychosis? Curr Top Behav Neurosci 2021; 55:183-208. [PMID: 34426945 DOI: 10.1007/7854_2021_234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Any attempt to compare the definitions of symptoms listed for "primary psychoses" with those adopted in studies of psychoses in patients with epilepsy (PWE) will encounter problems of heterogeneity within both conditions. In this manuscript, five psychotic illnesses listed in Diagnostic and Statistical Manual of Mental Disorders-5th Edition (DSM-5), that is, brief psychotic illness, schizophreniform disorder, schizophrenia, delusional disorder, and schizoaffective disorder are compared with postictal (or periictal) and interictal psychotic disorders in PWE. After examining definitions of primary psychoses, definitions of psychoses adopted in the papers dealing with postictal and interictal psychoses are summarized. Further, diagnostic criteria of five types of psychotic disorders in PWE proposed in 2007 by Krishnamoorthy et al. are also discussed, which include postictal psychosis, comorbid schizophrenia, iatrogenic psychosis caused by antiepileptic drugs (AEDs) (AED-induced psychotic disorder: AIPD), and forced normalization. Evidently, a comparison between postictal psychosis and schizophrenia is pointless. Likewise, schizophrenia may not be an appropriate counterpart of forced normalization and AIPD, given their acute or subacute course.Based on these preliminary examinations, three questions are selected to compare primary psychoses and psychoses in PWE: Is postictal psychosis different from a brief psychotic disorder? Does epilepsy facilitate or prevent the development of psychosis or vice versa? Is interictal psychosis of epilepsy different from process schizophrenia? In conclusion, antagonism between psychosis and epileptic seizures in a later stage of active epilepsy seems not to be realized without reorganization of the nervous system promoted during an earlier stage. Both genetic predisposition and the summated effects of epileptic activity must be taken into consideration as part of a trial to explain interictal psychosis. Interictal psychosis is an aggregate of miscellaneous disorders, that is, co-morbid schizophrenia, AED-induced psychotic disorders, forced normalization, and "epileptic" interictal psychosis. Data are lacking to conclude whether differences exist between process schizophrenia and "epileptic" interictal psychosis in terms of negative symptoms, specific personal traits, and the "bizarre-ness" of delusory-hallucinatory contents. These discussions may shed light on the essence of process schizophrenia, thus allowing it stand out and receive increased focus.
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Mishra BR, Biswas T, Nath S, Jha M, Mishra S, Mohapatra D. Electroconvulsive Therapy With Ketamine as Induction Agent in Refractory Epilepsy With Atypical Postictal Psychosis: A Case Report. J ECT 2021; 37:e5-e6. [PMID: 33093399 DOI: 10.1097/yct.0000000000000727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Biswa Ranjan Mishra
- Department of Psychiatry All India Institute of Medical Sciences (AIIMS) Bhubaneswar, Odisha, India
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de Toffol B, Trimble M, Hesdorffer DC, Taylor L, Sachdev P, Clancy M, Adachi N, Bragatti JA, Mula M, Kanemoto K. Pharmacotherapy in patients with epilepsy and psychosis. Epilepsy Behav 2018; 88:54-60. [PMID: 30241054 DOI: 10.1016/j.yebeh.2018.09.001] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2018] [Revised: 08/28/2018] [Accepted: 09/01/2018] [Indexed: 11/28/2022]
Abstract
The recognition and treatment of psychosis in persons with epilepsy (PWE) is recommended with the apparent dilemma between treating psychosis and opening the possibility of exacerbating seizures. The pooled prevalence estimate of psychosis in PWE is 5.6%. It has been proposed that a 'two hit' model, requiring both aberrant limbic activity and impaired frontal control, may account for the wide range of clinical phenotypes. The role of antiepileptic drugs in psychosis in PWE remains unclear. Alternating psychosis, the clinical phenomenon of a reciprocal relationship between psychosis and seizures, is unlikely to be an exclusively antiepileptic drug-specific phenomenon but rather, linked to the neurobiological mechanisms underlying seizure control. Reevaluation of antiepileptic treatment, including the agent/s being used and degree of epileptic seizure control is recommended. The authors found very few controlled studies to inform evidence-based treatment of psychosis in PWE. However, antipsychotics and benzodiazepines are recommended as the symptomatic clinical treatments of choice for postictal and brief interictal psychoses. The general principle of early symptomatic treatment of psychotic symptoms applies in epilepsy-related psychoses, as for primary psychotic disorders. In the authors' experience, low doses of antipsychotic medications do not significantly increase clinical risk of seizures in PWE being concurrently treated with an efficacious antiepileptic regimen.
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Affiliation(s)
- Bertrand de Toffol
- Service de Neurologie & Neurophysiologie Clinique, CHU Bretonneau, Tours, France, Service de Neurologie Hôpital de Cayenne, Guyane France et UMR 1253, iBrain, Université de Tours, Inserm, France.
| | - Michael Trimble
- Institute of Neurology, Queen Square, London WC1N 3BG, United Kingdom
| | - Dale C Hesdorffer
- Gertrude H.K Sergievsky Center and Department of Epidemiology, Columbia University, USA
| | - Lauren Taylor
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South Wales, Sydney, Australia; Neuropsychiatric Institute, Prince of Wales Hospital, Randwick, NSW, Australia
| | - Perminder Sachdev
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South Wales, Sydney, Australia; Neuropsychiatric Institute, Prince of Wales Hospital, Randwick, NSW, Australia
| | - Maurice Clancy
- Department of Liaison Psychiatry, University Hospital Waterford, Ireland
| | | | | | - Marco Mula
- Atkinson Morley Regional Neuroscience Centre, St George's University Hospitals NHS Foundation Trust and Institute of Medical and Biomedical Education, St. George's University of London, United Kingdom
| | - Kousuke Kanemoto
- Aichi Medical University, Neuropsychiatric Department, Nagakute, Japan
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Dante S, Petrelli A, Petrini EM, Marotta R, Maccione A, Alabastri A, Quarta A, De Donato F, Ravasenga T, Sathya A, Cingolani R, Proietti Zaccaria R, Berdondini L, Barberis A, Pellegrino T. Selective Targeting of Neurons with Inorganic Nanoparticles: Revealing the Crucial Role of Nanoparticle Surface Charge. ACS NANO 2017; 11:6630-6640. [PMID: 28595006 PMCID: PMC6090505 DOI: 10.1021/acsnano.7b00397] [Citation(s) in RCA: 66] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
Nanoparticles (NPs) are increasingly used in biomedical applications, but the factors that influence their interactions with living cells need to be elucidated. Here, we reveal the role of NP surface charge in determining their neuronal interactions and electrical responses. We discovered that negatively charged NPs administered at low concentration (10 nM) interact with the neuronal membrane and at the synaptic cleft, whereas positively and neutrally charged NPs never localize on neurons. This effect is shape and material independent. The presence of negatively charged NPs on neuronal cell membranes influences the excitability of neurons by causing an increase in the amplitude and frequency of spontaneous postsynaptic currents at the single cell level and an increase of both the spiking activity and synchronous firing at neural network level. The negatively charged NPs exclusively bind to excitable neuronal cells, and never to nonexcitable glial cells. This specific interaction was also confirmed by manipulating the electrophysiological activity of neuronal cells. Indeed, the interaction of negatively charged NPs with neurons is either promoted or hindered by pharmacological suppression or enhancement of the neuronal activity with tetrodotoxin or bicuculline, respectively. We further support our main experimental conclusions by using numerical simulations. This study demonstrates that negatively charged NPs modulate the excitability of neurons, revealing the potential use of NPs for controlling neuron activity.
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Affiliation(s)
- Silvia Dante
- Fondazione
Istituto Italiano di Tecnologia, via Morego 30, 16163 Genova, Italy
- E-mail:
| | - Alessia Petrelli
- Fondazione
Istituto Italiano di Tecnologia, via Morego 30, 16163 Genova, Italy
| | | | - Roberto Marotta
- Fondazione
Istituto Italiano di Tecnologia, via Morego 30, 16163 Genova, Italy
| | - Alessandro Maccione
- Fondazione
Istituto Italiano di Tecnologia, via Morego 30, 16163 Genova, Italy
| | | | - Alessandra Quarta
- Fondazione
Istituto Italiano di Tecnologia, via Morego 30, 16163 Genova, Italy
- CNR
NANOTEC, Institute of Nanotechnology, c/o Campus Ecotekne, via Monteroni, 73100 Lecce, Italy
| | - Francesco De Donato
- Fondazione
Istituto Italiano di Tecnologia, via Morego 30, 16163 Genova, Italy
| | - Tiziana Ravasenga
- Fondazione
Istituto Italiano di Tecnologia, via Morego 30, 16163 Genova, Italy
| | - Ayyappan Sathya
- Fondazione
Istituto Italiano di Tecnologia, via Morego 30, 16163 Genova, Italy
| | - Roberto Cingolani
- Fondazione
Istituto Italiano di Tecnologia, via Morego 30, 16163 Genova, Italy
| | | | - Luca Berdondini
- Fondazione
Istituto Italiano di Tecnologia, via Morego 30, 16163 Genova, Italy
| | - Andrea Barberis
- Fondazione
Istituto Italiano di Tecnologia, via Morego 30, 16163 Genova, Italy
| | - Teresa Pellegrino
- Fondazione
Istituto Italiano di Tecnologia, via Morego 30, 16163 Genova, Italy
- E-mail:
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Hilger E, Zimprich F, Pataraia E, Aull-Watschinger S, Jung R, Baumgartner C, Bonelli S. Psychoses in epilepsy: A comparison of postictal and interictal psychoses. Epilepsy Behav 2016; 60:58-62. [PMID: 27179193 DOI: 10.1016/j.yebeh.2016.04.005] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2016] [Revised: 04/01/2016] [Accepted: 04/02/2016] [Indexed: 11/30/2022]
Abstract
We retrospectively analyzed data of patients with epilepsy (n=1434) evaluated with prolonged EEG monitoring in order to estimate the prevalence of postictal psychosis (PP) and interictal psychosis (IP), to investigate a potential association of psychosis subtype with epilepsy type, and to assess differences between PP and IP. The overall prevalence of psychosis was 5.9% (N=85); prevalence of PP (N=53) and IP (N=32) was 3.7% and 2.2%, respectively. Of patients with psychosis, 97.6% had localization-related epilepsy (LRE). Prevalence of psychosis was highest (9.3%) in patients with temporal lobe epilepsy (TLE). When comparing PP with IP groups on demographic, clinical, and psychopathological variables, patients with IP were younger at occurrence of first psychosis (P=0.048), had a shorter interval between epilepsy onset and first psychosis (P=0.002), and more frequently exhibited schizophreniform traits (conceptual disorganization: P=0.008; negative symptoms: P=0.017) than those with PP. Postictal psychosis was significantly associated with a temporal seizure onset on ictal EEG (P=0.000) and a higher incidence of violent behavior during psychosis (P=0.047). To conclude, our results support the presumption of a preponderance of LRE in patients with psychosis and that of a specific association of TLE with psychosis, in particular with PP. Given the significant differences between groups, PP and IP may represent distinct clinical entities potentially with a different neurobiological background.
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Affiliation(s)
- Eva Hilger
- Department of Neurology, Medical University of Vienna, Austria.
| | | | | | | | - Rebekka Jung
- Department of Neurology, Medical University of Vienna, Austria
| | - Christoph Baumgartner
- Karl Landsteiner Institute for Clinical Epilepsy Research and Cognitive Neurology, 2nd Neurological Department, General Hospital Hietzing with Neurological Center Rosenhuegel, Vienna, Austria
| | - Silvia Bonelli
- Department of Neurology, Medical University of Vienna, Austria
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9
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D'Alessio L, Scévola L, Fernandez Lima M, Oddo S, Solís P, Seoane E, Kochen S. Psychiatric outcome of epilepsy surgery in patients with psychosis and temporal lobe drug-resistant epilepsy: a prospective case series. Epilepsy Behav 2014; 37:165-70. [PMID: 25036902 DOI: 10.1016/j.yebeh.2014.06.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2014] [Revised: 06/02/2014] [Accepted: 06/04/2014] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Temporal lobe resistant epilepsy has been associated with a high incidence of psychotic disorders; however, there are many controversies; while some patients get better after surgery from their psychiatric condition, others develop psychosis or de novo depression. The aim of this study was to determine the psychiatric and seizure outcome after epilepsy surgery in patients with a previous history of psychoses. METHODS Surgical candidates with temporal lobe drug-resistant epilepsy and a positive history of psychosis diagnosed during the presurgical psychiatric assessment were included. A two-year prospective follow-up was determined after surgery. The DSM-IV Structural Interview, GAF (global assessment of functionality, DSM-IV), Ictal Classification for psychoses, and Engel's classification were used. The Student t test and chi-square-Fisher tests were used. RESULTS During 2000-2010, 89 patients were admitted to the epilepsy surgery program, 14 patients (15.7%) presented psychoses and were included in this series. After surgery, six patients (43%) did not develop any psychiatric complications, three patients (21%) with chronic interictal psychosis continued with no exacerbation, three patients (21%) developed acute and transient psychotic symptoms, and two patients (14%) developed de novo depression. Seizure outcome was Engel class I-II in 10 patients (71%). Total GAF scores were higher after surgery in patients found to be in Engel class I-II (p<0.05). CONCLUSIONS Patients with comorbid psychosis and temporal lobe drug-resistant epilepsy may benefit from epilepsy surgery under close psychiatric supervision.
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Affiliation(s)
- Luciana D'Alessio
- Epilepsy Center, Ramos Mejía Hospital, Buenos Aires, Argentina; E de Robertis Neuroscience Institute, Epilepsy Research Laboratory, CONICET, Buenos Aires, Argentina.
| | - Laura Scévola
- Epilepsy Center, Ramos Mejía Hospital, Buenos Aires, Argentina
| | - Mónica Fernandez Lima
- Epilepsy Center, Ramos Mejía Hospital, Buenos Aires, Argentina; E de Robertis Neuroscience Institute, Epilepsy Research Laboratory, CONICET, Buenos Aires, Argentina
| | - Silvia Oddo
- Epilepsy Center, Ramos Mejía Hospital, Buenos Aires, Argentina; E de Robertis Neuroscience Institute, Epilepsy Research Laboratory, CONICET, Buenos Aires, Argentina
| | - Patricia Solís
- Epilepsy Center, Ramos Mejía Hospital, Buenos Aires, Argentina
| | - Eduardo Seoane
- Neurosurgery Center, Ramos Mejía Hospital, Buenos Aires, Argentina
| | - Silvia Kochen
- Epilepsy Center, Ramos Mejía Hospital, Buenos Aires, Argentina; E de Robertis Neuroscience Institute, Epilepsy Research Laboratory, CONICET, Buenos Aires, Argentina
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Jung S, Bang M, Kim BS, Lee S, Kotov NA, Kim B, Jeon D. Intracellular gold nanoparticles increase neuronal excitability and aggravate seizure activity in the mouse brain. PLoS One 2014; 9:e91360. [PMID: 24625829 PMCID: PMC3953378 DOI: 10.1371/journal.pone.0091360] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2013] [Accepted: 02/10/2014] [Indexed: 12/16/2022] Open
Abstract
Due to their inert property, gold nanoparticles (AuNPs) have drawn considerable attention; their biological application has recently expanded to include nanomedicine and neuroscience. However, the effect of AuNPs on the bioelectrical properties of a single neuron remains unknown. Here we present the effect of AuNPs on a single neuron under physiological and pathological conditions in vitro. AuNPs were intracellularly applied to hippocampal CA1 neurons from the mouse brain. The electrophysiological property of CA1 neurons treated with 5- or 40-nm AuNPs was assessed using the whole-cell patch-clamp technique. Intracellular application of AuNPs increased both the number of action potentials (APs) and input resistance. The threshold and duration of APs and the after hyperpolarization (AHP) were decreased by the intracellular AuNPs. In addition, intracellular AuNPs elicited paroxysmal depolarizing shift-like firing patterns during sustained repetitive firings (SRF) induced by prolonged depolarization (10 sec). Furthermore, low Mg2+-induced epileptiform activity was aggravated by the intracellular AuNPs. In this study, we demonstrated that intracellular AuNPs alter the intrinsic properties of neurons toward increasing their excitability, and may have deleterious effects on neurons under pathological conditions, such as seizure. These results provide some considerable direction on application of AuNPs into central nervous system (CNS).
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Affiliation(s)
- Seungmoon Jung
- Department of Bio and Brain Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, Republic of Korea
| | - Minji Bang
- Department of Bio and Brain Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, Republic of Korea
| | - Byung Sun Kim
- Department of Bio and Brain Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, Republic of Korea
| | - Sungmun Lee
- Department of Biomedical Engineering, Khalifa University of Science, Technology, and Research, Abu Dhabi, United Arab Emirates
| | - Nicholas A. Kotov
- Department of Chemical Engineering, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Bongsoo Kim
- Department of Chemistry, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, Republic of Korea
| | - Daejong Jeon
- Department of Bio and Brain Engineering, Korea Advanced Institute of Science and Technology (KAIST), Daejeon, Republic of Korea
- * E-mail:
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11
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Psychiatric manifestations of anti-NMDA receptor encephalitis: neurobiological underpinnings and differential diagnostic implications. PSYCHOSOMATICS 2013; 55:37-44. [PMID: 23932531 DOI: 10.1016/j.psym.2013.06.002] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2013] [Revised: 05/29/2013] [Accepted: 05/31/2013] [Indexed: 12/18/2022]
Abstract
OBJECTIVE Anti-N-methyl-d-aspartate receptor (NMDA-R) encephalitis is a recently discovered disorder with prominent psychiatric manifestations that is often misdiagnosed. The objective of this review is to raise awareness of the disorder among psychiatrists and to expand upon the diagnostic considerations that arise in the context of the neurobiology and symptomatology of this disorder. We also aim to examine the similarities in terms of symptoms and underlying neurobiology between anti-NMDA-R encephalitis and schizophrenia-spectrum illnesses. METHODS The information presented will reflect a review of the literature of the symptomatology and pathophysiology of anti-NMDA-R encephalitis and the role of the NMDA-R in both anti-NMDA-R encephalitis and schizophrenia-spectrum illnesses. RESULTS The studies reviewed highlight the role of the NMDA-R in both anti-NMDA-R encephalitis and schizophrenia in terms of symptom presentation and neurobiology. Studies have also begun to identify involvement of NMDA-R antibodies in patients diagnosed with schizophrenia. CONCLUSIONS There is an increasing need for psychiatrists to become aware of the disorder and consider it in their differential diagnosis, as they are often the first to be consulted on patients with anti-NMDA-R encephalitis. The similarities identified between anti-NMDA-R encephalitis and schizophrenia-spectrum illnesses also raise questions about a common underlying pathophysiology particularly in regard to the NMDA-R.
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12
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Abstract
BACKGROUND Epilepsy-related psychoses lie in the border zone between neurology and psychiatry. The aim of this article is to give a brief overview of current knowledge of these psychoses, and to offer recommendations for their treatment. METHOD The article is based on a discretionary selection of articles found through a search in PubMed, as well as the authors' own experience with this patient group. RESULTS Epilepsy-related psychoses may occur during, after or between seizures. In addition, psychoses may occur as a side-effect of antiepileptic drugs, and as so-called alternative psychosis. The latter may arise in patients who, with the aid of treatment (medication or surgery), have become completely seizure-free. Ictal psychoses and the majority of postictal psychoses are often of such short duration that treatment with antipsychotics is not appropriate. In these cases, optimizing antiepileptic treatment is the best prophylaxis. Treatment with antipsychotics may, however, be indicated for interictal psychoses and for some patients with especially long-lasting or recurrent postictal psychoses. INTERPRETATION Different types of epilepsy-related psychosis require different types of treatment, and some are treated with antipychotics. In those circumstances, we recommend the use of medication that is less likely to lower the seizure threshold, for example risperidone.
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Affiliation(s)
- Oliver Henning
- Avdeling for kompleks epilepsi, Klinikk for kirurgi og nevrofag, Oslo universitetssykehus, Norway.
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13
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Psychosis after epilepsy surgery: report of three cases. Epilepsy Behav 2011; 22:804-7. [PMID: 22040845 DOI: 10.1016/j.yebeh.2011.09.029] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2011] [Revised: 09/17/2011] [Accepted: 09/25/2011] [Indexed: 11/23/2022]
Abstract
Temporal lobe epilepsy surgery has become a successful alternative in patients with refractory epilepsy. However, the outcome of epilepsy surgery may be affected by the occurrence of postsurgical psychiatric symptoms, such as psychosis. This report describes three cases of refractory temporal lobe epilepsy and hippocampal sclerosis, which, after anterior temporal lobectomy, presented with acute psychosis. One of them had a history of acute psychosis, and all of them met criteria for Cluster A personality disorder (schizoid/schizotypal) during psychiatric assessment prior to surgery. The three cases had a good seizure outcome (Engel I), but, on follow-up during the first year after surgery, developed an acute psychotic episode compatible with schizoaffective disorder; brief psychotic disorder; and a delusional disorder, respectively, according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Treatment with low-dose risperidone was successful.
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Mula M. Treatment-emergent psychiatric adverse events of antiepileptic drugs in epilepsy: how can we avoid them? ACTA ACUST UNITED AC 2011. [DOI: 10.2217/npy.11.29] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Aggarwal A, Sharma DD, Sharma RC, Kumar R. Probable psychosis associated with levetiracetam: a case report. Prog Neuropsychopharmacol Biol Psychiatry 2011; 35:274-5. [PMID: 20854866 DOI: 10.1016/j.pnpbp.2010.09.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2010] [Revised: 09/06/2010] [Accepted: 09/09/2010] [Indexed: 11/18/2022]
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Walterfang M, Kornberg A, Adams S, Fietz M, Velakoulis D. Post-ictal psychosis in adolescent Niemann-Pick disease type C. J Inherit Metab Dis 2010; 33 Suppl 3:S63-5. [PMID: 20069374 DOI: 10.1007/s10545-009-9021-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2009] [Revised: 11/18/2009] [Accepted: 11/20/2009] [Indexed: 10/20/2022]
Abstract
We describe the presentation of an adolescent with juvenile-onset Niemann-Pick disease type C (NPC) who presented with post-ictal psychosis in the context of a developing seizure disorder. After demonstrating mild gait disturbance beginning at the age of 4 years, he was diagnosed with NPC at age 12 on the basis of 95% of cultured fibroblasts staining positive for filipin and a reduced fibroblast cholesterol esterification rate. He then developed a seizure disorder at age 15, where clusters of seizures produced typical psychotic symptoms, including hallucinations and delusions. His seizure disorder responded to valproate, which resulted in a settling of his psychotic symptoms. Whilst post-ictal psychosis is rarely reported prior to the age of 16, NPC in adolescents and adults is particularly psychotogenic and may increase the risk for post-ictal psychosis in the pediatric population.
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Affiliation(s)
- Mark Walterfang
- Neuropsychiatry Unit, Royal Melbourne Hospital, Melbourne, VIC, Australia.
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Lax Pericall MT, Taylor E. Psychosis and epilepsy in young people. Epilepsy Behav 2010; 18:450-4. [PMID: 20580321 DOI: 10.1016/j.yebeh.2010.05.017] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2009] [Revised: 05/17/2010] [Accepted: 05/19/2010] [Indexed: 10/19/2022]
Abstract
The aim of this study was to describe the clinical characteristics of children and young people under 19 with both epilepsy and a psychotic state (schizophrenia-like psychotic episode, organic delusional disorder, or other brief psychotic episode). In total, the clinical case notes for 17 young people with these characteristics were identified retrospectively from three different sources. Compared with a group of young people with psychosis without epilepsy, children with epilepsy and psychosis more frequently had other neuropsychological problems like learning disability and autism. Both groups had a high rate of family histories of mental illness and social disability. Contrary to the findings in adults with psychosis and epilepsy, in this group of young people, psychosis was associated neither with temporal lobe epilepsy nor with mesial temporal sclerosis. The children with psychosis and epilepsy had a variety of seizure types and structural abnormalities.
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Affiliation(s)
- M T Lax Pericall
- South London and Maudsley NHS Trust, Belgrave Department of Child Psychiatry, King's College Hospital, London, UK.
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Jones NC, Martin S, Megatia I, Hakami T, Salzberg MR, Pinault D, Morris MJ, O'Brien TJ, van den Buuse M. A genetic epilepsy rat model displays endophenotypes of psychosis. Neurobiol Dis 2010; 39:116-25. [DOI: 10.1016/j.nbd.2010.02.001] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2009] [Revised: 12/21/2009] [Accepted: 02/03/2010] [Indexed: 12/22/2022] Open
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Verhoeven WMA, Egger JIM, Gunning WB, Bevers M, de Pont BJHB. Recurrent schizophrenia-like psychosis as first manifestation of epilepsy: a diagnostic challenge in neuropsychiatry. Neuropsychiatr Dis Treat 2010; 6:227-31. [PMID: 20520786 PMCID: PMC2877604 DOI: 10.2147/ndt.s11104] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Since the 1950s, several studies have been carried out to investigate the occurrence of schizophrenia-like psychoses in epilepsy. The psychopathological profile comprises symptoms from the affective, schizophrenic, and cognitive domains and the prevalence varies between 2% to 20%. Classification of such conditions is performed according to their temporal relationship with the seizure itself. Although it is well known that epilepsy may be associated with psychotic disorders, it is less widely recognized that relapsing psychotic phenomena may be the first and only symptom of epilepsy. In this research, two patients are described who were initially referred for recurrent episodes of bipolar affective disorder and schizophrenic psychosis, respectively. In both patients, a diagnosis of relapsing postictal psychotic states due to previously undiagnosed epilepsy was made and consequently, treatment with antiepileptics was started. During follow up over several months, they remained free of both epileptic and psychotic symptoms. Given the kaleidoscopic nature of the postictal psychosis and full recovery from this, such psychoses best meet the criteria for a cycloid psychosis. These observations illustrate diagnostic and therapeutic pitfalls due to the conceptual disintegration emerging from the inadequate separation between psychiatry and neurology. Therefore, the importance of a neuropsychiatric viewpoint should be promoted.
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Affiliation(s)
- Willem M A Verhoeven
- Vincent van Gogh Institute for Psychiatry, Centre of Excellence for Neuropsychiatry, Venray, The Netherlands.
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Kerbeshian J, Peng CZ, Burd L. Tourette syndrome and comorbid early-onset schizophrenia. J Psychosom Res 2009; 67:515-23. [PMID: 19913656 DOI: 10.1016/j.jpsychores.2009.08.002] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2009] [Accepted: 08/06/2009] [Indexed: 11/29/2022]
Abstract
OBJECTIVE A study of the shared phenomenology between Tourette syndrome (TS) and schizophrenia. METHOD An illustrative case report is presented. We used a chart review of 399 clinically ascertained patients with TS to identify 10 cases meeting criteria for schizophrenia. From our 10 patients, salient clinical characteristics were then tabulated. We then extracted similar clinical characteristics from a previously published series of patients with comorbid TS and schizophrenia in order to combine cases and allow for a comparison between childhood-onset schizophrenia (COS), adolescent-onset schizophrenia (AdolOS), and adult-onset schizophrenia (AduOS) cases in these groups. RESULTS We found 10 cases of schizophrenia (all were males) in the 399 TS patients for a prevalence rate of 2.5% (95% CI 0.96-4.04). Mean age of tic onset for TS diagnostic criteria ranged from 2-14 years with a mean of 8.2 years. The mean age of diagnosis for schizophrenia was 14.2 (range 9-23 years). We found six cases of schizophrenia with onset of positive psychotic symptoms by 13 years of age, two cases with onset after 13 years of age and before 18 years of age, and two cases with onset after 18 years of age. Attention deficit hyperactivity disorder was present at a higher rate (70%) than one would expect in a clinically ascertained group of patients with TS. Comparison between COS, AdolOS and AduOS in our pooled cases noted a sex bias skewed toward males. Catatonic symptoms may be more likely in child or adolescent onset cases and negative symptoms more likely in AduOS cases. CONCLUSIONS The 2.5% prevalence of schizophrenia in our TS sample exceeds the 1% expected rate of schizophrenia in the general population (chi-square=9.14; P=.0025). The six cases of COS (before 13 years of age) exceeds the expected rate of 1-2 per 100,000 (chi-square=4499; P=.0001). The 752-fold increase in observed rates of comorbid TS and COS over expected rates suggests a role for unknown common underlying etiologic factors. Based on clinical features, patients with TS and comorbid COS, AdolOS, or AduOS do not have different conditions. We conclude with suggestions for further research.
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Affiliation(s)
- Jacob Kerbeshian
- Department of Neuroscience, University of North Dakota School of Medicine and Health Sciences, Grand Forks, ND 58202-9037, USA
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D'Alessio L, Giagante B, Papayannis C, Oddo S, Silva W, Solís P, Donnoli V, Kauffman M, Consalvo D, Zieher LM, Kochen S. Psychotic disorders in Argentine patients with refractory temporal lobe epilepsy: a case-control study. Epilepsy Behav 2009; 14:604-9. [PMID: 19236954 DOI: 10.1016/j.yebeh.2009.02.019] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2009] [Revised: 02/15/2009] [Accepted: 02/18/2009] [Indexed: 10/21/2022]
Abstract
The issue of psychotic disorders in epilepsy has given rise to great controversy among professionals; however, there are not many studies in this area and the physiopathological mechanisms remain unknown. The aim of this study was to describe the spectrum of psychotic disorders in an Argentine population with refractory temporal lobe epilepsy (RTLE) and to determine the risk factors associated with psychotic disorders. Clinical variables of the epileptic syndrome were compared among a selected population with RTLE with and without psychotic disorders (DSM-IV/Ictal Classification of psychoses). Logistic regression was performed. Sixty-three patients with psychotic disorders (Psychotic Group, PG) and 60 controls (Control Group, CG) were included. The most frequent psychotic disorders were brief psychotic episodes (35%) (DSM-IV) and interictal psychosis (50%) (Ictal Classification). Risk factors for psychotic disorders were bilateral hippocampal sclerosis, history of status epilepticus, and duration of epilepsy greater than 20 years.
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Postictal psychosis in frontal lobe complex partial seizures. PSYCHIATRY (EDGMONT (PA. : TOWNSHIP)) 2009; 6:15. [PMID: 19724725 PMCID: PMC2714812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
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Abstract
Patients who have epilepsy face many challenges resulting from their illness and have frequent psychiatric comorbidities. Recognition of these disorders is increasing and is having a positive impact on patients' quality of life. Recent recommendations about a new classification system for psychiatric disorders related specifically to epilepsy and based on the relationship of symptoms to seizures, antiepileptic medications, and EEG changes should further research and treatment. Especially insofar psychiatric syndromes specific to epilepsy can be identified, correlation of clinical phenomena with relatively well-understood pathophysiology in epilepsy will allow advances in the understanding of psychiatric illness. This progress should move the treatment of patients who have epilepsy toward a comprehensive biopsychosocial model that focuses on the whole person rather than simply on the disease process.
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Affiliation(s)
- Michael J Marcangelo
- Department of Psychiatry and Behavioral Medicine, Medical College of Wisconsin, 8701 Watertown Plank, Milwaukee, WI 53226, USA.
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