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Bosco DB, Kremen V, Haruwaka K, Zhao S, Wang L, Ebner BA, Zheng J, Xie M, Dheer A, Perry JF, Barath A, Nguyen AT, Worrell GA, Wu LJ. Microglial TREM2 promotes phagocytic clearance of damaged neurons after status epilepticus. Brain Behav Immun 2024:S0889-1591(24)00637-8. [PMID: 39353548 DOI: 10.1016/j.bbi.2024.09.034] [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: 05/06/2024] [Revised: 09/15/2024] [Accepted: 09/28/2024] [Indexed: 10/04/2024] Open
Abstract
In the central nervous system, triggering receptor expressed on myeloid cells 2 (TREM2) is exclusively expressed by microglia and is critical for microglial proliferation, migration, and phagocytosis. Microglial TREM2 plays an important role in neurodegenerative diseases, such as Alzheimer's disease and amyotrophic lateral sclerosis. However, little is known about how TREM2 affects microglial function within epileptogenesis. To investigate this, we utilized male TREM2 knockout (KO) mice within the murine intra-amygdala kainic acid seizure model. Electroencephalographic analysis, immunocytochemistry, and RNA sequencing revealed that TREM2 deficiency significantly promoted seizure-induced pathology. We found that TREM2 KO increased both the severity of acute status epilepticus and the number of spontaneous recurrent seizures characteristic of chronic focal epilepsy. Phagocytic clearance of damaged neurons by microglia was also impaired by TREM2 KO and reduced phagocytic activity correlated with increased spontaneous seizures. Analysis of human tissue from patients who underwent surgical resection for drug resistant temporal lobe epilepsy also showed a negative correlation between expression of the microglial phagocytic marker CD68 and focal to bilateral tonic-clonic generalized seizure history. These results indicate that microglial TREM2 and phagocytic activity are important to epileptogenic pathology.
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Affiliation(s)
- Dale B Bosco
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - Vaclav Kremen
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - Koichiro Haruwaka
- Center for Neuroimmunology and Glial Biology, Institute of Molecular Medicine, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Shunyi Zhao
- Department of Neurology, Mayo Clinic, Rochester, MN, USA; Center for Neuroimmunology and Glial Biology, Institute of Molecular Medicine, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Lingxiao Wang
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - Blake A Ebner
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Jiaying Zheng
- Center for Neuroimmunology and Glial Biology, Institute of Molecular Medicine, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Manling Xie
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - Aastha Dheer
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - Jadyn F Perry
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - Abhijeet Barath
- Department of Neurology, Mayo Clinic, Rochester, MN, USA; Center for Neuroimmunology and Glial Biology, Institute of Molecular Medicine, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Aivi T Nguyen
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | | | - Long-Jun Wu
- Department of Neurology, Mayo Clinic, Rochester, MN, USA; Center for Neuroimmunology and Glial Biology, Institute of Molecular Medicine, University of Texas Health Science Center at Houston, Houston, TX, USA.
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Wu W, Song W, Zhao J, Guo S, Hong M, Zheng J, Hua Y, Cao P, Liu R, Duan JA. Saiga antelope horn suppresses febrile seizures in rats by regulating neurotransmitters and the arachidonic acid pathway. Chin Med 2024; 19:78. [PMID: 38831318 PMCID: PMC11149251 DOI: 10.1186/s13020-024-00949-3] [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: 04/11/2024] [Accepted: 05/21/2024] [Indexed: 06/05/2024] Open
Abstract
BACKGROUND Saiga antelope horn (SAH) is a traditional Chinese medicine for treating febrile seizure (FS) with precise efficacy, but its mechanism of action and functional substances are still unclear. Given the need for further research on SAH, our group conducted studies to elucidate its mechanisms and active substances. METHODS An FS rat pup model was constructed through intraperitoneal injection of LPS and hyperthermia induction. Behavioural indicators of seizures, hippocampal histopathological alterations, serum levels of inflammatory cytokines and hippocampal levels of neurotransmitters were observed and measured to investigate the effects of SAH on FS model rats. Hippocampal metabolomics and network pharmacology analyses were conducted to reveal the differential metabolites, key peptides and pathways involved in the suppression of FS by SAH. RESULTS SAH suppressed FS, decreased the inflammatory response and regulated the Glu-GABA balance. Metabolomic analysis revealed 13 biomarkers of FS, of which SAH improved the levels of 8 differential metabolites. Combined with network pharmacology, a "biomarker-core target-key peptide" network was constructed. The peptides of SAH, such as YGQL and LTGGF, could exert therapeutic effects via the arachidonic acid pathway. Molecular docking and ELISA results indicated that functional peptides of SAH could bind to PTGS2 target, inhibiting the generation of AA and its metabolites in hippocampal samples. CONCLUSION In summary, the functional peptides contained in SAH are the main material basis for the treatment of FS, potentially acting through neurotransmitter regulation and the arachidonic acid pathway.
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Affiliation(s)
- Wenxing Wu
- National and Local Collaborative Engineering Center of Chinese Medicinal Resources Industrialization and Formulae Innovative Medicine, Jiangsu Collaborative Innovation Center of Chinese Medicinal Resources Industrialization, and Jiangsu Key Laboratory for High Technology Research of Traditional Chinese Medicine Formulae, Nanjing University of Chinese Medicine, No 138 Xianlin Road, Nanjing, 210023, China
- School of Pharmacy, Nanjing University of Chinese Medicine, Nanjing, 210023, China
- Animal-Derived Chinese Medicine and Functional Peptides International Collaboration Joint Laboratory, Nanjing, 210023, China
| | - Wencong Song
- National and Local Collaborative Engineering Center of Chinese Medicinal Resources Industrialization and Formulae Innovative Medicine, Jiangsu Collaborative Innovation Center of Chinese Medicinal Resources Industrialization, and Jiangsu Key Laboratory for High Technology Research of Traditional Chinese Medicine Formulae, Nanjing University of Chinese Medicine, No 138 Xianlin Road, Nanjing, 210023, China
- School of Pharmacy, Nanjing University of Chinese Medicine, Nanjing, 210023, China
| | - Jingjing Zhao
- National and Local Collaborative Engineering Center of Chinese Medicinal Resources Industrialization and Formulae Innovative Medicine, Jiangsu Collaborative Innovation Center of Chinese Medicinal Resources Industrialization, and Jiangsu Key Laboratory for High Technology Research of Traditional Chinese Medicine Formulae, Nanjing University of Chinese Medicine, No 138 Xianlin Road, Nanjing, 210023, China
- School of Pharmacy, Nanjing University of Chinese Medicine, Nanjing, 210023, China
| | - Sheng Guo
- National and Local Collaborative Engineering Center of Chinese Medicinal Resources Industrialization and Formulae Innovative Medicine, Jiangsu Collaborative Innovation Center of Chinese Medicinal Resources Industrialization, and Jiangsu Key Laboratory for High Technology Research of Traditional Chinese Medicine Formulae, Nanjing University of Chinese Medicine, No 138 Xianlin Road, Nanjing, 210023, China
- School of Pharmacy, Nanjing University of Chinese Medicine, Nanjing, 210023, China
| | - Min Hong
- School of Pharmacy, Nanjing University of Chinese Medicine, Nanjing, 210023, China
| | - Jie Zheng
- School of Pharmacy, Nanjing University of Chinese Medicine, Nanjing, 210023, China
| | - Yongqing Hua
- School of Pharmacy, Nanjing University of Chinese Medicine, Nanjing, 210023, China
| | - Peng Cao
- National and Local Collaborative Engineering Center of Chinese Medicinal Resources Industrialization and Formulae Innovative Medicine, Jiangsu Collaborative Innovation Center of Chinese Medicinal Resources Industrialization, and Jiangsu Key Laboratory for High Technology Research of Traditional Chinese Medicine Formulae, Nanjing University of Chinese Medicine, No 138 Xianlin Road, Nanjing, 210023, China
- Animal-Derived Chinese Medicine and Functional Peptides International Collaboration Joint Laboratory, Nanjing, 210023, China
| | - Rui Liu
- National and Local Collaborative Engineering Center of Chinese Medicinal Resources Industrialization and Formulae Innovative Medicine, Jiangsu Collaborative Innovation Center of Chinese Medicinal Resources Industrialization, and Jiangsu Key Laboratory for High Technology Research of Traditional Chinese Medicine Formulae, Nanjing University of Chinese Medicine, No 138 Xianlin Road, Nanjing, 210023, China.
- School of Pharmacy, Nanjing University of Chinese Medicine, Nanjing, 210023, China.
- Animal-Derived Chinese Medicine and Functional Peptides International Collaboration Joint Laboratory, Nanjing, 210023, China.
| | - Jin-Ao Duan
- National and Local Collaborative Engineering Center of Chinese Medicinal Resources Industrialization and Formulae Innovative Medicine, Jiangsu Collaborative Innovation Center of Chinese Medicinal Resources Industrialization, and Jiangsu Key Laboratory for High Technology Research of Traditional Chinese Medicine Formulae, Nanjing University of Chinese Medicine, No 138 Xianlin Road, Nanjing, 210023, China.
- School of Pharmacy, Nanjing University of Chinese Medicine, Nanjing, 210023, China.
- Animal-Derived Chinese Medicine and Functional Peptides International Collaboration Joint Laboratory, Nanjing, 210023, China.
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Bosco DB, Kremen V, Haruwaka K, Zhao S, Wang L, Ebner BA, Zheng J, Dheer A, Perry JF, Xie M, Nguyen AT, Worrell GA, Wu LJ. Impaired microglial phagocytosis promotes seizure development. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2023.12.31.573794. [PMID: 38260601 PMCID: PMC10802340 DOI: 10.1101/2023.12.31.573794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
Abstract
In the central nervous system, triggering receptor expressed on myeloid cells 2 (TREM2) is exclusively expressed by microglia and is critical for microglial proliferation, migration, and phagocytosis. TREM2 plays an important role in neurodegenerative diseases, such as Alzheimer's disease and amyotrophic lateral sclerosis. However, little is known about the role TREM2 plays in epileptogenesis. To investigate this, we utilized TREM2 knockout (KO) mice within the murine intra-amygdala kainic acid seizure model. Electroencephalographic analysis, immunocytochemistry, and RNA sequencing revealed that TREM2 deficiency significantly promoted seizure-induced pathology. We found that TREM2 KO increased both acute status epilepticus and spontaneous recurrent seizures characteristic of chronic focal epilepsy. Mechanistically, phagocytic clearance of damaged neurons by microglia was impaired in TREM2 KO mice and the reduced phagocytic capacity correlated with increased spontaneous seizures. Analysis of human tissue from patients who underwent surgical resection for drug resistant temporal lobe epilepsy also showed a negative correlation between microglial phagocytic activity and focal to bilateral tonic-clonic generalized seizure history. These results indicate that microglial TREM2 and phagocytic activity may be important to epileptogenesis and the progression of focal temporal lobe epilepsy.
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Affiliation(s)
- Dale B. Bosco
- Department of Neurology, Mayo Clinic; Rochester, MN, USA
| | - Vaclav Kremen
- Department of Neurology, Mayo Clinic; Rochester, MN, USA
| | | | - Shunyi Zhao
- Department of Neurology, Mayo Clinic; Rochester, MN, USA
| | - Lingxiao Wang
- Department of Neurology, Mayo Clinic; Rochester, MN, USA
| | - Blake A. Ebner
- Department of Laboratory Medicine and Pathology, Mayo Clinic; Rochester, MN, USA
| | - Jiaying Zheng
- Department of Neurology, Mayo Clinic; Rochester, MN, USA
| | - Aastha Dheer
- Department of Neurology, Mayo Clinic; Rochester, MN, USA
| | - Jadyn F. Perry
- Department of Immunology, Mayo Clinic; Rochester, MN, USA
| | - Manling Xie
- Department of Neurology, Mayo Clinic; Rochester, MN, USA
| | - Aivi T. Nguyen
- Department of Laboratory Medicine and Pathology, Mayo Clinic; Rochester, MN, USA
| | | | - Long-Jun Wu
- Department of Neurology, Mayo Clinic; Rochester, MN, USA
- Department of Immunology, Mayo Clinic; Rochester, MN, USA
- Department of Neuroscience, Mayo Clinic; Jacksonville, FL, USA
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Asadi‐Pooya AA, Fattahi D, Abolpour N, Boostani R, Farazdaghi M, Sharifi M. Epilepsy classification using artificial intelligence: A web-based application. Epilepsia Open 2023; 8:1362-1368. [PMID: 37565252 PMCID: PMC10690646 DOI: 10.1002/epi4.12800] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Accepted: 07/29/2023] [Indexed: 08/12/2023] Open
Abstract
OBJECTIVE The purpose of the current endeavor was to evaluate the feasibility of using easily accessible and applicable clinical information (based on history taking and physical examination) in order to make a reliable differentiation between idiopathic generalized epilepsy (IGE) versus focal epilepsy using machine learning (ML) methods. METHODS The first phase of the study was a retrospective study of a prospectively developed and maintained database. All patients with an electro-clinical diagnosis of IGE or focal epilepsy, at the outpatient epilepsy clinic at Shiraz University of Medical Sciences, Shiraz, Iran, from 2008 until 2022, were included. The first author selected a set of clinical features. Using the stratified random portioning method, the dataset was divided into the train (70%) and test (30%) subsets. Different types of classifiers were assessed and the final classification was made based on their best results using the stacking method. RESULTS A total number of 1445 patients were studied; 964 with focal epilepsy and 481 with IGE. The stacking classifier led to better results than the base classifiers in general. This algorithm has the following characteristics: precision: 0.81, sensitivity: 0.81, and specificity: 0.77. SIGNIFICANCE We developed a pragmatic algorithm aimed at facilitating epilepsy classification for individuals whose epilepsy begins at age 10 years and older. Also, in order to enable and facilitate future external validation studies by other peers and professionals, the developed and trained ML model was implemented and published via an online web-based application that is freely available at http://www.epiclass.ir/f-ige.
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Affiliation(s)
- Ali A. Asadi‐Pooya
- Epilepsy Research CenterShiraz University of Medical SciencesShirazIran
- Department of Neurology, Jefferson Comprehensive Epilepsy CenterThomas Jefferson UniversityPhiladelphiaPennsylvaniaUSA
| | - Davood Fattahi
- Epilepsy Research CenterShiraz University of Medical SciencesShirazIran
| | - Nahid Abolpour
- Epilepsy Research CenterShiraz University of Medical SciencesShirazIran
| | - Reza Boostani
- Department of Computer Science Engineering and Information TechnologyShiraz UniversityShirazIran
| | - Mohsen Farazdaghi
- Epilepsy Research CenterShiraz University of Medical SciencesShirazIran
| | - Mehrdad Sharifi
- Vice‐Chancellery for Treatment AffairsShiraz University of Medical SciencesShirazIran
- Emergency Medicine Department, School of MedicineShiraz University of Medical SciencesShirazIran
- Emergency Medicine Research CenterShiraz University of Medical SciencesShirazIran
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Postnikova TY, Griflyuk AV, Zhigulin AS, Soboleva EB, Barygin OI, Amakhin DV, Zaitsev AV. Febrile Seizures Cause a Rapid Depletion of Calcium-Permeable AMPA Receptors at the Synapses of Principal Neurons in the Entorhinal Cortex and Hippocampus of the Rat. Int J Mol Sci 2023; 24:12621. [PMID: 37628802 PMCID: PMC10454714 DOI: 10.3390/ijms241612621] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Revised: 08/01/2023] [Accepted: 08/09/2023] [Indexed: 08/27/2023] Open
Abstract
Febrile seizures (FSs) are a relatively common early-life condition that can cause CNS developmental disorders, but the specific mechanisms of action of FS are poorly understood. In this work, we used hyperthermia-induced FS in 10-day-old rats. We demonstrated that the efficiency of glutamatergic synaptic transmission decreased rapidly after FS by recording local field potentials. This effect was transient, and after two days there were no differences between control and post-FS groups. During early ontogeny, the proportion of calcium-permeable (CP)-AMPA receptors in the synapses of the principal cortical and hippocampal neurons is high. Therefore, rapid internalization of CP-AMPA receptors may be one of the mechanisms underlying this phenomenon. Using the whole-cell patch-clamp method and the selective CP-AMPA receptor blocker IEM-1460, we tested whether the proportion of CP-AMPA receptors changed. We have demonstrated that FS rapidly reduces synaptic CP-AMPA receptors in both the hippocampus and the entorhinal cortex. This process was accompanied by a sharp decrease in the calcium permeability of the membrane of principal neurons, which we revealed in experiments with kainate-induced cobalt uptake. Our experiments show that FSs cause rapid changes in the function of the glutamatergic system, which may have compensatory effects that prevent excessive excitotoxicity and neuronal death.
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Affiliation(s)
| | | | | | | | | | | | - Aleksey V. Zaitsev
- Sechenov Institute of Evolutionary Physiology and Biochemistry of RAS, 44, Toreza Prospekt, Saint Petersburg 194223, Russia; (T.Y.P.); (A.V.G.); (A.S.Z.); (E.B.S.); (O.I.B.); (D.V.A.)
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Kim MJ, Hwang B, Mampre D, Negoita S, Tsehay Y, Sair H, Kang JY, Anderson WS. Ablation of apparent diffusion coefficient hyperintensity clusters in mesial temporal lobe epilepsy improves seizure outcomes after laser interstitial thermal therapy. Epilepsia 2023; 64:654-666. [PMID: 36196769 DOI: 10.1111/epi.17432] [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: 04/01/2022] [Revised: 10/01/2022] [Accepted: 10/03/2022] [Indexed: 01/14/2023]
Abstract
OBJECTIVE Laser interstitial thermal therapy (LiTT) is a minimally invasive surgical procedure for intractable mesial temporal epilepsy (mTLE). LiTT is safe and effective, but seizure outcomes are highly variable due to patient variability, suboptimal targeting, and incomplete ablation of the epileptogenic zone. Apparent diffusion coefficient (ADC) is a magnetic resonance imaging (MRI) sequence that can identify potential epileptogenic foci in the mesial temporal lobe to improve ablation and seizure outcomes. The objective of this study was to investigate whether ablation of tissue clusters with high ADC values in the mesial temporal structures is associated with seizure outcome in mTLE after LiTT. METHODS Twenty-seven patients with mTLE who underwent LiTT at our institution were analyzed. One-year seizure outcome was categorized as complete seizure freedom (International League Against Epilepsy [ILAE] Class I) and residual seizures (ILAE Class II-VI). Volumes of hippocampus and amygdala were segmented from the preoperative T1 MRI sequence. Spatially distinct hyperintensity clusters were identified in the preoperative ADC map. Proportion of cluster volume and number ablated were associated with seizure outcomes. RESULTS The mean age at surgery was 37.5 years and the mean follow-up duration was 1.9 years. Proportions of hippocampal cluster volume (p = .013) and number (p = .03) ablated were significantly higher in patients with seizure freedom. For amygdala clusters, the proportion of cluster number ablated was significantly associated with seizure outcome (p = .026). In the combined amygdalohippocampal complex, ablation of amygdalohippocampal clusters reliably predicted seizure outcome by their volume ablated (area under the curve [AUC] = 0.7670, p = .02). SIGNIFICANCE Seizure outcome after LiTT in patients with mTLE was associated significantly with the extent of cluster ablation in the amygdalohippocampal complex. The results suggest that preoperative ADC analysis may help identify high-yield pathological tissue clusters that represent epileptogenic foci. ADC-based cluster analysis can potentially assist ablation targeting and improve seizure outcome after LiTT in mTLE.
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Affiliation(s)
- Min Jae Kim
- Department of Neurosurgery, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
- Department of Biomedical Engineering, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Brian Hwang
- Department of Neurosurgery, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - David Mampre
- Department of Neurosurgery, University of Florida College of Medicine, Gainesville, Florida, USA
| | - Serban Negoita
- Department of Neurosurgery, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Yohannes Tsehay
- Department of Neurosurgery, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Haris Sair
- Department of Radiology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Joon Y Kang
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - William S Anderson
- Department of Neurosurgery, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
- Department of Biomedical Engineering, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
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Leifeld J, Förster E, Reiss G, Hamad MIK. Considering the Role of Extracellular Matrix Molecules, in Particular Reelin, in Granule Cell Dispersion Related to Temporal Lobe Epilepsy. Front Cell Dev Biol 2022; 10:917575. [PMID: 35733853 PMCID: PMC9207388 DOI: 10.3389/fcell.2022.917575] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 05/23/2022] [Indexed: 11/13/2022] Open
Abstract
The extracellular matrix (ECM) of the nervous system can be considered as a dynamically adaptable compartment between neuronal cells, in particular neurons and glial cells, that participates in physiological functions of the nervous system. It is mainly composed of carbohydrates and proteins that are secreted by the different kinds of cell types found in the nervous system, in particular neurons and glial cells, but also other cell types, such as pericytes of capillaries, ependymocytes and meningeal cells. ECM molecules participate in developmental processes, synaptic plasticity, neurodegeneration and regenerative processes. As an example, the ECM of the hippocampal formation is involved in degenerative and adaptive processes related to epilepsy. The role of various components of the ECM has been explored extensively. In particular, the ECM protein reelin, well known for orchestrating the formation of neuronal layer formation in the cerebral cortex, is also considered as a player involved in the occurrence of postnatal granule cell dispersion (GCD), a morphologically peculiar feature frequently observed in hippocampal tissue from epileptic patients. Possible causes and consequences of GCD have been studied in various in vivo and in vitro models. The present review discusses different interpretations of GCD and different views on the role of ECM protein reelin in the formation of this morphological peculiarity.
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Affiliation(s)
- Jennifer Leifeld
- Department of Neuroanatomy and Molecular Brain Research, Medical Faculty, Ruhr University Bochum, Bochum, Germany
- Department of Biochemistry I—Receptor Biochemistry, Faculty of Chemistry and Biochemistry, Ruhr University Bochum, Bochum, Germany
- *Correspondence: Jennifer Leifeld, ; Eckart Förster,
| | - Eckart Förster
- Department of Neuroanatomy and Molecular Brain Research, Medical Faculty, Ruhr University Bochum, Bochum, Germany
- *Correspondence: Jennifer Leifeld, ; Eckart Förster,
| | - Gebhard Reiss
- Institute for Anatomy and Clinical Morphology, School of Medicine, Faculty of Health, Witten/ Herdecke University, Witten, Germany
| | - Mohammad I. K. Hamad
- Institute for Anatomy and Clinical Morphology, School of Medicine, Faculty of Health, Witten/ Herdecke University, Witten, Germany
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Multi-omics in mesial temporal lobe epilepsy with hippocampal sclerosis: Clues into the underlying mechanisms leading to disease. Seizure 2021; 90:34-50. [DOI: 10.1016/j.seizure.2021.03.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Revised: 02/26/2021] [Accepted: 03/02/2021] [Indexed: 02/07/2023] Open
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Postnikova TY, Griflyuk AV, Amakhin DV, Kovalenko AA, Soboleva EB, Zubareva OE, Zaitsev AV. Early Life Febrile Seizures Impair Hippocampal Synaptic Plasticity in Young Rats. Int J Mol Sci 2021; 22:8218. [PMID: 34360983 PMCID: PMC8347828 DOI: 10.3390/ijms22158218] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 07/27/2021] [Accepted: 07/28/2021] [Indexed: 01/04/2023] Open
Abstract
Febrile seizures (FSs) in early life are significant risk factors of neurological disorders and cognitive impairment in later life. However, existing data about the impact of FSs on the developing brain are conflicting. We aimed to investigate morphological and functional changes in the hippocampus of young rats exposed to hyperthermia-induced seizures at postnatal day 10. We found that FSs led to a slight morphological disturbance. The cell numbers decreased by 10% in the CA1 and hilus but did not reduce in the CA3 or dentate gyrus areas. In contrast, functional impairments were robust. Long-term potentiation (LTP) in CA3-CA1 synapses was strongly reduced, which we attribute to the insufficient activity of N-methyl-D-aspartate receptors (NMDARs). Using whole-cell recordings, we found higher desensitization of NMDAR currents in the FS group. Since the desensitization of NMDARs depends on subunit composition, we analyzed NMDAR current decays and gene expression of subunits, which revealed no differences between control and FS rats. We suggest that an increased desensitization is due to insufficient activation of the glycine site of NMDARs, as the application of D-serine, the glycine site agonist, allows the restoration of LTP to a control value. Our results reveal a new molecular mechanism of FS impact on the developing brain.
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Affiliation(s)
| | | | | | | | | | | | - Aleksey V. Zaitsev
- Sechenov Institute of Evolutionary Physiology and Biochemistry of RAS, 44, Toreza Prospekt, 194223 Saint Petersburg, Russia; (T.Y.P.); (A.V.G.); (D.V.A.); (A.A.K.); (E.B.S.); (O.E.Z.)
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Sair A, Şair YB, Saracoğlu İ, Sevincok L, Akyol A. The relation of major depression, OCD, personality disorders and affective temperaments with Temporal lobe epilepsy. Epilepsy Res 2021; 171:106565. [PMID: 33535159 DOI: 10.1016/j.eplepsyres.2021.106565] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 12/22/2020] [Accepted: 01/18/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND In patients with temporal lobe epilepsy (TLE), studies demonstrate frequent comorbidity with mood disorders, personality disorders (especially obsessive-compulsive disorder) and major depression, but there are conflicting findings. This study aimed to investigate psychiatric comorbidities and affective temperament among TLE patients and to explore the relationships between obsessive compulsive disorder, other personality disorders, major depression and affective temperament in order to clarify the mediator effect of TLE in these relationships. METHODS Thirty patients with TLE and 30 healthy volunteers were included. The Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I), the Structured Clinical Interview for DSM III-R Axis II Disorders (SCID-II), Hamilton Anxiety (HAM-A) scale, Hamilton Depression (HAM-D) scale, Beck Suicidal Ideation Scale (BSSI) and Yale Brown Obsession Compulsion Scale (YBOCS) were applied and evaluated by a psychiatrist. Additionally, all individuals completed The Temperament Evaluation of Memphis, Pisa, Paris and San Diego (TEMPS-A). RESULTS Patients with temporal lobe epilepsy had higher scores in TEMPS-A, HAM-A, HAM-D, YBOCS and BSSI. Major depression, obsessive compulsive disorder and dependent and antisocial personality disorders were prevalent in patients. With respect to affective temperaments, depressive, cyclothymic and anxious temperaments were associated with obsessive compulsive disorder comorbidity; whereas, depressive and anxious temperaments were found to be associated with major depression comorbidity in patients with TLE. Furthermore, cluster A and cluster C personality disorders were associated with affective temperaments in patients with TLE. Affective temperaments had no correlation with illness duration, seizure frequency, depression severity and suicidal thoughts, but obsessions and compulsions. Suicidal thoughts were associated with obsessions and compulsions. CONCLUSION Affective temperaments are core personality traits with biological background and they may provide a foundation for psychiatric disorders, especially mood disorders. Considering that TLE originates from abnormalities in brain circuitry, it may form a basis for psychiatric disorders. Therefore, psychiatric evaluation to determine comorbidities may be beneficial to increase the quality of life of patients with TLE.
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Affiliation(s)
- Ahmet Sair
- Neurology Depertment, Aydın Adnan Menderes University Medicine Faculty, Turkey.
| | - Yaşan Bilge Şair
- Psychiatry Depertment, Aydın Adnan Menderes University Medicine Faculty, Turkey.
| | - İrem Saracoğlu
- Residant at Psychiatry Department, Aydın Adnan Menderes University Medicine Faculty, Turkey.
| | - Levent Sevincok
- Psychiatry Depertment, Aydın Adnan Menderes University Medicine Faculty, Turkey.
| | - Ali Akyol
- Neurology Depertment, Aydın Adnan Menderes University Medicine Faculty, Turkey.
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Yu Y, Yang Z, Jin B, Qin X, Zhu X, Sun J, Huo L, Wang R, Shi Y, Jia Z, Shi YS, Chu S, Kong D, Zhang W. Cannabidiol inhibits febrile seizure by modulating AMPA receptor kinetics through its interaction with the N-terminal domain of GluA1/GluA2. Pharmacol Res 2020; 161:105128. [DOI: 10.1016/j.phrs.2020.105128] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 07/30/2020] [Accepted: 08/05/2020] [Indexed: 12/15/2022]
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12
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M H B, R J, A HM. New MRI Finding in Migraineurs: Mesial Temporal Sclerosis. J Biomed Phys Eng 2020; 10:459-466. [PMID: 32802794 PMCID: PMC7416088 DOI: 10.31661/jbpe.v0i0.887] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Accepted: 03/14/2018] [Indexed: 01/03/2023]
Abstract
Background: Based on our experience, a noticeable number of migraineurs without history of epilepsy disclose mesial temporal sclerosis (MTS) on their brain MRI. Objective: This prospective study was conducted to assess the frequency of MTS in migraineurs and also determine the ratio of unilateral and bilateral cases. Material and Methods: In this cross sectional study, the frequency of MTS in MRI of 84 migraine patients, who had symptoms for at least 2 years,
assessed. Brain MRI was done with T1 and T2 weighted protocols. Two radiologists separately interpreted findings, defining MTS
as presence of any of hippocampal atrophy, increased T2 signal of hippocampus, decreased T1 signal of hippocampus or loss
of internal architecture. Patients who radiologists had not agreement on their diagnoses excluded. Stat analysis done using ‘N - 1’ chi squared test. Results: Eleven patients were excluded due to non-accordant interpretation of MRI findings by the two examining radiologists.
MTS was detected in 14 out of 73 patients (19%). Bilateral involvement of mesial temporal lobe was seen in 6 (8%) patients
(M 67%, F 33%). Five cases (7%) had unilateral left MTS (M 67%, F 33%) while 3 (4%) were affected with right-sided MTS (M 33%, F 67%).
These findings highly suggest association of MTS and Migraine (P-value <0.0001). Conclusion: While MTS is a prevalent finding in migraineurs, incidental finding of MTS in MRI should suspect physicians of migraine as well as temporal lobe epilepsy. MTS can be proposed as an etiology of migraine but most likely, consequence of it.
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Affiliation(s)
- Bagheri M H
- MD, Medical Imaging Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
- MD, Department of Radiology and Imaging Sciences (A.P., R.S., D.S.R., M.B., T.E.C., D.A.B.), National Institutes of Health Clinical Center, Bethesda, Maryland
| | - Jalli R
- MD, Medical Imaging Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hoseyni Moghadam A
- MD, Medical Imaging Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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Singh G, Sander JW. Neurocysticercosis as a probable risk factor for hippocampal sclerosis. ARQUIVOS DE NEURO-PSIQUIATRIA 2018; 76:783-790. [DOI: 10.1590/0004-282x20180130] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Accepted: 08/09/2018] [Indexed: 11/22/2022]
Abstract
ABSTRACT Neurocysticercosis is one of the most common risk factors for epilepsy but its association with drug-resistant epilepsy remains uncertain. Conjectures of an association with drug-resistant epilepsy have been fueled by reports of an association between calcific neurocysticercosis lesions (CNL) and hippocampal sclerosis (HS) from specialized epilepsy centers in Taenia solium-endemic regions. The debate arising from these reports is whether the association is causal. Evidence for the association is not high quality but sufficiently persuasive to merit further investigation with longitudinal imaging studies in population-based samples from geographically-diverse regions. The other controversial point is the choice of a surgical approach for drug-resistant epilepsy associated with CNL-HS. Three approaches have been described: standard anteromesial temporal lobectomy, lesionectomy involving a CNL alone and lesionectomy with anteromesial temporal lobectomy (for dual pathology); reports of the latter two approaches are limited. Presurgical evaluation should consider possibilities of delineating the epileptogenic zone/s in accordance with all three approaches.
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Affiliation(s)
- Gagandeep Singh
- Dayanand Medical College, India; NIHR University College London Hospitals Biomedical Research Centre, United Kingdom
| | - Josemir W. Sander
- NIHR University College London Hospitals Biomedical Research Centre, United Kingdom; Stichting Epilepsie Instellingen Nederland (SEIN), Netherlands
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14
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Sociodemographic risk factors for febrile seizures: A school-based study from Izmir, Turkey. Seizure 2018; 61:45-49. [PMID: 30081300 DOI: 10.1016/j.seizure.2018.07.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Revised: 07/23/2018] [Accepted: 07/25/2018] [Indexed: 12/16/2022] Open
Abstract
PURPOSE Despite the fact that socioeconomic and environmental factors of a population are changing over time, there are few studies focusing on the effects of sociodemographic factors on the prevalence of febrile seizures (FS). This study was designed to find out the prevalence of FS and to investigate the effect of socio-cultural and economic factors on this prevalence among the Turkish school children. METHODS A school-based, cross-sectional study was conducted in first and second-class children. Data were collected through a questionnaire from the parents who agreed to be involved in the study. The survey had questions about some socioeconomic and demographic features of the children and febrile seizure episodes. RESULTS 3806 children and parent pairs accepted to participate in the survey. Febrile seizure prevalence was 4.8%. It was found that the prevalence of FS was significantly associated with the chronic illnesses of a child that requires continuous medication, developmental delay of a child, NICU history, gestational hypertension history of a mother, and lower educational level of a mother. Recurrence of FS was observed in 32.9% of children. Children whose first FS was seen below the 39 °C had 1.9 times more recurrence risk. CONCLUSION FS prevalence rate has declined from 9.7% to 4.3% in our study population within ten years. It was thought that advancing healthcare systems in our country might be decreased the prevalence. Our study enabled us to find out sociodemographic risk factors of FS, but further studies are needed in order to confirm the effect of sociodemographic factors on FS prevalence.
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15
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Fabres RB, da Rosa LA, de Souza SK, Cecconello AL, Azambuja AS, Sanches EF, Ribeiro MFM, de Fraga LS. Effects of progesterone on the neonatal brain following hypoxia-ischemia. Metab Brain Dis 2018; 33:813-821. [PMID: 29363039 DOI: 10.1007/s11011-018-0193-7] [Citation(s) in RCA: 6] [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: 11/07/2017] [Accepted: 01/17/2018] [Indexed: 11/25/2022]
Abstract
Progesterone displays a strong potential for the treatment of neonatal hypoxic-ischemic encephalopathy since it has been shown to be beneficial in the treatment of the central nervous system injuries in adult animals. Here, we evaluated the effects of the administration of progesterone (10 mg/kg) in seven-days-old male Wistar rats submitted to neonatal hypoxia-ischemia (HI). Progesterone was administered immediately before ischemia and/or 6 and 24 h after the onset of hypoxia. The body weight of the animals, the volume of brain lesion and the expression of p-Akt and procaspase-3 in the hippocampus were evaluated. All animals submitted to HI showed a reduction in the body weight. However, this reduction was more remarkable in those animals which received progesterone before surgery. Administration of progesterone was unable to reduce the volume of brain damage caused by HI. Moreover, no significant differences were observed in the expression of p-Akt and procaspase-3 in animals submitted to HI and treated with either progesterone or vehicle. In summary, progesterone did not show a neuroprotective effect on the volume of brain lesion in neonatal rats submitted to hypoxia-ischemia. Furthermore, progesterone was unable to modulate p-Akt and procaspase-3 signaling pathways, which may explain the absence of neuroprotection. On the other hand, it seems that administration of progesterone before ischemia exerts some systemic effect, leading to a remarkable reduction in the body weight.
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Affiliation(s)
- Rafael Bandeira Fabres
- Laboratory of Neurohumoral Interaction, Department of Physiology, Universidade Federal do Rio Grande do Sul (UFRGS), Sarmento Leite, 500, Porto Alegre, RS, 90050-170, Brazil
- Laboratory of Comparative Metabolism and Endocrinology, Department of Physiology, Universidade Federal do Rio Grande do Sul (UFRGS), Sarmento Leite, 500, Porto Alegre, RS, 90050-170, Brazil
- Programa de Pós-Graduação em Ciências Biológicas: Fisiologia, Universidade Federal do Rio Grande do Sul (UFRGS), Sarmento Leite, 500, Porto Alegre, RS, 90050-170, Brazil
- Hospital de Clínicas de Porto Alegre (HCPA), Ramiro Barcelos, 2350, Porto Alegre, RS, 90035-903, Brazil
| | - Luciana Abreu da Rosa
- Programa de Pós-Graduação em Ciências Biológicas: Fisiologia, Universidade Federal do Rio Grande do Sul (UFRGS), Sarmento Leite, 500, Porto Alegre, RS, 90050-170, Brazil
| | - Samir Khal de Souza
- Laboratory of Comparative Metabolism and Endocrinology, Department of Physiology, Universidade Federal do Rio Grande do Sul (UFRGS), Sarmento Leite, 500, Porto Alegre, RS, 90050-170, Brazil
- Programa de Pós-Graduação em Ciências Biológicas: Fisiologia, Universidade Federal do Rio Grande do Sul (UFRGS), Sarmento Leite, 500, Porto Alegre, RS, 90050-170, Brazil
| | - Ana Lucia Cecconello
- Laboratory of Neurohumoral Interaction, Department of Physiology, Universidade Federal do Rio Grande do Sul (UFRGS), Sarmento Leite, 500, Porto Alegre, RS, 90050-170, Brazil
- Programa de Pós-Graduação em Ciências Biológicas: Fisiologia, Universidade Federal do Rio Grande do Sul (UFRGS), Sarmento Leite, 500, Porto Alegre, RS, 90050-170, Brazil
| | - Amanda Stapenhorst Azambuja
- Laboratory of Neurohumoral Interaction, Department of Physiology, Universidade Federal do Rio Grande do Sul (UFRGS), Sarmento Leite, 500, Porto Alegre, RS, 90050-170, Brazil
- Programa de Pós-Graduação em Ciências Biológicas: Fisiologia, Universidade Federal do Rio Grande do Sul (UFRGS), Sarmento Leite, 500, Porto Alegre, RS, 90050-170, Brazil
| | - Eduardo Farias Sanches
- Laboratory of Cerebral Ischemia, Department of Biochemistry, Universidade Federal do Rio Grande do Sul (UFRGS), Ramiro Barcelos, 2600, Porto Alegre, RS, 90035-000, Brazil
| | - Maria Flavia Marques Ribeiro
- Laboratory of Neurohumoral Interaction, Department of Physiology, Universidade Federal do Rio Grande do Sul (UFRGS), Sarmento Leite, 500, Porto Alegre, RS, 90050-170, Brazil
- Programa de Pós-Graduação em Ciências Biológicas: Fisiologia, Universidade Federal do Rio Grande do Sul (UFRGS), Sarmento Leite, 500, Porto Alegre, RS, 90050-170, Brazil
| | - Luciano Stürmer de Fraga
- Laboratory of Comparative Metabolism and Endocrinology, Department of Physiology, Universidade Federal do Rio Grande do Sul (UFRGS), Sarmento Leite, 500, Porto Alegre, RS, 90050-170, Brazil.
- Programa de Pós-Graduação em Ciências Biológicas: Fisiologia, Universidade Federal do Rio Grande do Sul (UFRGS), Sarmento Leite, 500, Porto Alegre, RS, 90050-170, Brazil.
- Hospital de Clínicas de Porto Alegre (HCPA), Ramiro Barcelos, 2350, Porto Alegre, RS, 90035-903, Brazil.
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Abstract
The goal of any epilepsy surgery is to improve patient's quality of life by achieving seizure freedom or by reducing the frequency of severely debilitating seizures. To achieve this goal, non-invasive and invasive diagnostic methods must precisely delineate the epileptogenic zone (EZ), which is defined as the area that needs to be resected to obtain seizure freedom. At the same time, the correct identification of eloquent brain areas is inevitable to avoid new neurological deficits from surgery. In recent years, the technical advances in diagnostics have enabled us to achieve these goals in an increasing number of cases. As a consequence, and with new surgical treatment options available, the number of patients who might benefit from epilepsy surgery is constantly increasing. Especially in pediatric epilepsy, early surgical intervention is becoming frequently advocated as it has been shown to improve cognitive and behavioral outcome. Specialized epilepsy centers and multidisciplinary teams are required to provide adequate care and treatment. The goal of this review is to describe important diseases that are accessible to epilepsy surgery and to give an overview of current diagnostic methods. The focus lies on established as well as novel techniques in epilepsy surgery. The presurgical work-up and patient selection is outlined.
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Affiliation(s)
- Johannes Herta
- Department of Neurosurgery, Vienna General Hospital, Medical University of Vienna, Vienna, Austria
| | - Christian Dorfer
- Department of Neurosurgery, Vienna General Hospital, Medical University of Vienna, Vienna, Austria -
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Surgical Considerations of Intractable Mesial Temporal Lobe Epilepsy. Brain Sci 2018; 8:brainsci8020035. [PMID: 29461485 PMCID: PMC5836054 DOI: 10.3390/brainsci8020035] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Revised: 02/14/2018] [Accepted: 02/15/2018] [Indexed: 11/30/2022] Open
Abstract
Surgery of temporal lobe epilepsy is the best opportunity for seizure freedom in medically intractable patients. The surgical approach has evolved to recognize the paramount importance of the mesial temporal structures in the majority of patients with temporal lobe epilepsy who have a seizure origin in the mesial temporal structures. For those individuals with medically intractable mesial temporal lobe epilepsy, a selective amygdalohippocampectomy surgery can be done that provides an excellent opportunity for seizure freedom and limits the resection to temporal lobe structures primarily involved in seizure genesis.
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18
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Carvajal-Castrillón J, Aguirre-Acevedo DC, Montoya Arenas DA. DETERMINATES CLÍNICOS EN LA MEMORIA AUTOBIOGRÁFICA DE PACIENTES CON EPILEPSIA DEL LÓBULO TEMPORAL. UNIVERSITAS PSYCHOLOGICA 2017. [DOI: 10.11144/javeriana.upsy15-5.dcma] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Introducción. El paciente con epilepsia del lóbulo temporal presenta generalmente una enfermedad de difícil manejo, y la enfermedad cursa con alteraciones en memoria autobiográfica. Sin embargo, la epilepsia es una enfermedad en la que actúan diversos factores clínicos que contribuyen a determinar la severidad y el pronóstico de la enfermedad. Objetivo. Explorar la posible relación entre el rendimiento de los pacientes con epilepsia del lóbulo temporal con esclerosis hipocampal en memoria autobiográfica y las variables clínicas asociadas. Pacientes y métodos. La muestra estuvo conformada por 25 pacientes con diagnóstico de epilepsia del lóbulo temporal. Se les suministró la Entrevista de Memoria Autobiográfica para valorar el desempeño en memoria personal semántica e incidentes autobiográficos. Se determinó la relación entre el rendimiento en memoria autobiográfica y variables clínicas asociadas como edad de inicio, número de años con epilepsia, lateralización de la zona de inicio ictal, refractariedad al tratamiento, tipo de terapia farmacológica y número de medicamentos. Para determinar las correlaciones se calculó el coeficiente de correlación de Spearman, mientras que para la comparación entre grupos se utilizó la prueba U de Mann-Whitney. Resultados. Variables clínicas como el tiempo de la evolución de la enfermedad, refractariedad al tratamiento, empleo de politerapia y número de medicamentos, afectan el desempeño en memoria autobiográfica en pacientes con epilepsia del lóbulo temporal. Conclusiones. Si bien, la epilepsia del lóbulo temporal general alteraciones en la memoria autobiográfica, diversas variables clínicas asociadas a la enfermedad, afectan aún más la capacidad mnésica de los pacientes.
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Sendrowski K, Sobaniec P, Poskrobko E, Rusak M, Sobaniec W. Unfavorable effect of levetiracetam on cultured hippocampal neurons after hyperthermic injury. Pharmacol Rep 2017; 69:462-468. [PMID: 31994103 DOI: 10.1016/j.pharep.2017.01.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Revised: 01/19/2017] [Accepted: 01/23/2017] [Indexed: 11/25/2022]
Abstract
BACKGROUND The aim of this study was to examine the viability of neurons and the putative neuroprotective effects of second-generation antiepileptic drug, levetiracetam (LEV), on cultured hippocampal neurons injured by hyperthermia. METHODS Primary cultures of rat's hippocampal neurons at 7 day in vitro (DIV) were incubated in the presence or absence of LEV in varied concentrations under hyperthermic conditions. Cultures were heated in a temperature of 40 °C for 24 h or in a temperature of 41 °C for 6 h. Flow cytometry with Annexin V/PI staining as well as fluorescent microscopy assay were used for counting and establishing neurons as viable, necrotic or apoptotic. Additionally, the release of lactate dehydrogenase (LDH) to the culture medium, as a marker of cell death, was evaluated. Assessment was performed after 9DIV and 10 DIV. RESULTS Incubation of hippocampal cultures in hyperthermic conditions resulted in statistically significant increase in the number of injured neurons when compared with non-heated control cultures. Intensity of neuronal destruction was dependent on temperature-value. When incubation temperature 40 °C was used, over 80% of the population of neurons remained viable after 10 DIV. Under higher temperature 41 °C, only less than 60% of neurons were viable after 10 DIV. Both apoptotic and necrotic pathways of neuronal death induced by hyperthermia were confirmed by Annexin V/PI staining. CONCLUSIONS LEV showed no neuroprotective effects in the current model of hyperthermia in vitro. Moreover, drug, especially when used in higher concentrations, exerted unfavorable intensification of aponecrosis of cultured hippocampal neurons.
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Affiliation(s)
- Krzysztof Sendrowski
- Department of Pediatric Neurology and Rehabilitation, Medical University of Bialystok, Białystok, Poland.
| | - Piotr Sobaniec
- Department of Pediatric Neurology and Rehabilitation, Medical University of Bialystok, Białystok, Poland
| | - Elżbieta Poskrobko
- Department of Pediatric Laboratory Diagnostic, Medical University of Bialystok, Białystok, Poland
| | - Małgorzata Rusak
- Department of Hematological Diagnostics, Medical University of Bialystok, Białystok, Poland
| | - Wojciech Sobaniec
- Department of Pediatric Neurology and Rehabilitation, Medical University of Bialystok, Białystok, Poland
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Kariuki SM, Abubakar A, Stein A, Marsh K, Newton CRJC. Prevalence, causes, and behavioral and emotional comorbidities of acute symptomatic seizures in Africa: A critical review. Epilepsia Open 2017; 2:8-19. [PMID: 29750209 PMCID: PMC5939456 DOI: 10.1002/epi4.12035] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/20/2016] [Indexed: 12/19/2022] Open
Abstract
Seizures with fever includes both febrile seizures (due to nonneurological febrile infections) and acute symptomatic seizures (due to neurological febrile infections). The cumulative incidence (lifetime prevalence) of febrile seizures in children aged ≤6 years is 2-5% in American and European studies, but there are no community-based data on acute symptomatic seizures in Africa. The incidence of acute symptomatic seizures in sub-Saharan Africa is more than twice that in high-income countries. However, most studies of acute symptomatic seizures from Africa are based on hospital samples or do not conduct surveys in demographic surveillance systems, which underestimates the burden. It is difficult to differentiate between febrile seizures and acute symptomatic seizures in Africa, especially in malaria-endemic areas where malaria parasites can sequester in the brain microvasculature; but this challenge can be addressed by robust identification of underlying causes. The proportion of complex acute symptomatic seizures (i.e., seizures that are focal, repetitive, or prolonged) in Africa are twice that reported in other parts of the world (>60% vs. ∼30%), which is often attributed to falciparum malaria. These complex phenotypes of acute symptomatic seizures can be associated with behavioral and emotional problems in high-income countries, and outcomes may be even worse in Africa. One Kenyan study reported behavioral and emotional problems in approximately 10% of children admitted with acute symptomatic seizures, but it is not clear whether the behavioral and emotional problems were due to the seizures, shared genetic susceptibility, etiology, or underlying neurological damage. The underlying neurological damage in acute symptomatic seizures can lead not only to behavioral and emotional problems but also to neurocognitive impairment and epilepsy. Electroencephalography may have a prognostic role in African children with acute symptomatic seizures. There are significant knowledge gaps regarding acute symptomatic seizures in Africa, which results in lack of reliable estimates for planning interventions. Future epidemiological studies of acute symptomatic seizures should be set up in Africa.
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Affiliation(s)
| | - Amina Abubakar
- KEMRI‐Wellcome Trust Research ProgrammeKilifiKenya
- Department of Public HealthPwani UniversityKilifiKenya
- Department of PsychiatryUniversity of OxfordOxfordUnited Kingdom
| | - Alan Stein
- Department of PsychiatryUniversity of OxfordOxfordUnited Kingdom
| | - Kevin Marsh
- KEMRI‐Wellcome Trust Research ProgrammeKilifiKenya
- Nuffield Department of MedicineUniversity of OxfordOxfordUnited Kingdom
- Alliance for Accelerating Excellence in Science in AfricaAfrican Academy of SciencesNairobiKenya
| | - Charles R. J. C. Newton
- KEMRI‐Wellcome Trust Research ProgrammeKilifiKenya
- Department of PsychiatryUniversity of OxfordOxfordUnited Kingdom
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Fujisao EK, Cristaldo NR, da Silva Braga AM, Cunha PR, Yamashita S, Betting LE. Hippocampal Damage and Atrophy Secondary to Status Epilepticus in a Patient with Schizophrenia. Front Neurol 2017; 8:24. [PMID: 28220103 PMCID: PMC5292431 DOI: 10.3389/fneur.2017.00024] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2016] [Accepted: 01/17/2017] [Indexed: 11/15/2022] Open
Abstract
A 59-year-old man was admitted with respiratory tract infection, compromised conscience and generalized tonic–clonic seizures. His medical history included schizophrenia diagnosis, for which he had been being treated since he was 27 years old. EEG disclosed non-convulsive status epilepticus. A magnetic resonance image (MRI) acquired 3 days later showed increased left hippocampal volume with hyperintensity on T2-weighted and FLAIR sequences. After being treated with antibiotics and antiepileptic medications, the patient’s condition improved. A follow-up MRI showed reduction of the left hippocampus. The relationship between epilepsy and schizophrenia is not yet clear. This case illustrates this interaction. Hippocampal atrophy may have been caused by environmental aggression in the present patient with schizophrenia, perhaps in association with a predisposing genotype.
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Affiliation(s)
- Elaine Keiko Fujisao
- Departamento de Neurologia, Psicologia e Psiquiatria, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista (UNESP) , Botucatu , Brazil
| | - Nathalia Raquel Cristaldo
- Departamento de Neurologia, Psicologia e Psiquiatria, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista (UNESP) , Botucatu , Brazil
| | - Aline Marques da Silva Braga
- Departamento de Neurologia, Psicologia e Psiquiatria, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista (UNESP) , Botucatu , Brazil
| | - Paulina Rodrigues Cunha
- Departamento de Neurologia, Psicologia e Psiquiatria, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista (UNESP) , Botucatu , Brazil
| | - Seizo Yamashita
- Departamento de Doenças Tropicais e Diagnósticos por Imagem, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista (UNESP) , Botucatu , Brazil
| | - Luiz Eduardo Betting
- Departamento de Neurologia, Psicologia e Psiquiatria, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista (UNESP) , Botucatu , Brazil
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Dekeyzer S, De Kock I, Nikoubashman O, Vanden Bossche S, Van Eetvelde R, De Groote J, Acou M, Wiesmann M, Deblaere K, Achten E. "Unforgettable" - a pictorial essay on anatomy and pathology of the hippocampus. Insights Imaging 2017; 8:199-212. [PMID: 28108955 PMCID: PMC5359145 DOI: 10.1007/s13244-016-0541-2] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Revised: 12/18/2016] [Accepted: 12/20/2016] [Indexed: 11/24/2022] Open
Abstract
Abstract The hippocampus is a small but complex anatomical structure that plays an important role in spatial and episodic memory. The hippocampus can be affected by a wide range of congenital variants and degenerative, inflammatory, vascular, tumoral and toxic-metabolic pathologies. Magnetic resonance imaging is the preferred imaging technique for evaluating the hippocampus. The main indications requiring tailored imaging sequences of the hippocampus are medically refractory epilepsy and dementia. The purpose of this pictorial review is threefold: (1) to review the normal anatomy of the hippocampus on MRI; (2) to discuss the optimal imaging strategy for the evaluation of the hippocampus; and (3) to present a pictorial overview of the most common anatomic variants and pathologic conditions affecting the hippocampus. Teaching points • Knowledge of normal hippocampal anatomy helps recognize anatomic variants and hippocampal pathology. • Refractory epilepsy and dementia are the main indications requiring dedicated hippocampal imaging. • Pathologic conditions centered in and around the hippocampus often have similar imaging features. • Clinical information is often necessary to come to a correct diagnosis or an apt differential.
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Affiliation(s)
- Sven Dekeyzer
- Department of Diagnostic and Interventional Neuroradiology, University Hospital, RWTH Aachen University, Pauwelsstr. 30, 52074, Aachen, Germany. .,Department of Radiology, University Hospital (UZ) Ghent, De Pintelaan 185, 9000, Ghent, Belgium. .,Department of Medical Imaging, Onze-Lieve-Vrouw Hospital (OLV) Aalst, Moorselbaan 164, 9300, Aalst, Belgium.
| | - Isabelle De Kock
- Department of Radiology, University Hospital (UZ) Ghent, De Pintelaan 185, 9000, Ghent, Belgium
| | - Omid Nikoubashman
- Department of Diagnostic and Interventional Neuroradiology, University Hospital, RWTH Aachen University, Pauwelsstr. 30, 52074, Aachen, Germany
| | | | - Ruth Van Eetvelde
- Department of Radiology, University Hospital (UZ) Ghent, De Pintelaan 185, 9000, Ghent, Belgium.,Department of Medical Imaging, Onze-Lieve-Vrouw Hospital (OLV) Aalst, Moorselbaan 164, 9300, Aalst, Belgium
| | - Jeroen De Groote
- Department of Radiology, University Hospital (UZ) Ghent, De Pintelaan 185, 9000, Ghent, Belgium
| | - Marjan Acou
- Department of Radiology, University Hospital (UZ) Ghent, De Pintelaan 185, 9000, Ghent, Belgium
| | - Martin Wiesmann
- Department of Diagnostic and Interventional Neuroradiology, University Hospital, RWTH Aachen University, Pauwelsstr. 30, 52074, Aachen, Germany
| | - Karel Deblaere
- Department of Radiology, University Hospital (UZ) Ghent, De Pintelaan 185, 9000, Ghent, Belgium
| | - Eric Achten
- Department of Radiology, University Hospital (UZ) Ghent, De Pintelaan 185, 9000, Ghent, Belgium
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Asadi-Pooya AA, Nei M, Rostami C, Sperling MR. Mesial temporal lobe epilepsy with childhood febrile seizure. Acta Neurol Scand 2017; 135:88-91. [PMID: 26861129 DOI: 10.1111/ane.12566] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/11/2016] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To evaluate the demographic and clinical manifestations of patients with mesial temporal sclerosis and temporal lobe epilepsy (MTS-TLE) with childhood febrile seizure (FS) and establishing the potential differences as compared to those without FS. We also investigated the surgery outcome in these two groups of patients. MATERIALS AND METHODS In this retrospective study, all patients with a clinical diagnosis of drug-resistant TLE due to mesial temporal sclerosis, who underwent epilepsy surgery at Jefferson Comprehensive Epilepsy Center, were recruited. Patients were prospectively registered in a database from 1986 through 2014. Postsurgical outcome was classified into two groups; seizure-free or relapsed. Clinical manifestations and outcome were compared between patients with MTS-TLE with FS and those without FS. RESULTS Two hundred and sixty-two patients were eligible for this study. One hundred and seventy patients (64.9%) did not have FS in their childhood, while 92 patients (35.1%) reported experiencing FS in their childhood. Demographic and clinical characteristics of these two groups of patients were not different. Postoperative seizure outcome was not statistically different between these two groups of patients (P = 0.19). CONCLUSIONS When MTS is the pathological substrate of TLE, clinical manifestations and response to surgical treatment of patients are very similar in patients with history of febrile seizure in their childhood compared to those without such an experience. In other words, when the subgroup of patients with MTS-TLE and drug-resistant seizures is examined history of childhood febrile seizure loses its value as a distinguishing factor in characteristics or predictive factor for surgery outcome.
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Affiliation(s)
- A. A. Asadi-Pooya
- Jefferson Comprehensive Epilepsy Center; Department of Neurology; Thomas Jefferson University; Philadelphia PA USA
| | - M. Nei
- Jefferson Comprehensive Epilepsy Center; Department of Neurology; Thomas Jefferson University; Philadelphia PA USA
| | - C. Rostami
- Jefferson Comprehensive Epilepsy Center; Department of Neurology; Thomas Jefferson University; Philadelphia PA USA
| | - M. R. Sperling
- Jefferson Comprehensive Epilepsy Center; Department of Neurology; Thomas Jefferson University; Philadelphia PA USA
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Khan D, Dupper A, Deshpande T, Graan PNED, Steinhäuser C, Bedner P. Experimental febrile seizures impair interastrocytic gap junction coupling in juvenile mice. J Neurosci Res 2016; 94:804-13. [PMID: 26931373 DOI: 10.1002/jnr.23726] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2015] [Revised: 01/25/2016] [Accepted: 02/04/2016] [Indexed: 02/02/2023]
Abstract
Prolonged and focal febrile seizures (FSs) have been associated with the development of temporal lobe epilepsy (TLE), although the underlying mechanism and the contribution of predisposing risk factors are still poorly understood. Using a kainate model of TLE, we previously provided strong evidence that interruption of astrocyte gap junction-mediated intercellular communication represents a crucial event in epileptogenesis. To elucidate this aspect further, we induced seizures in immature mice by hyperthermia (HT) to study the consequences of FSs on the hippocampal astrocytic network. Changes in interastrocytic coupling were assessed by tracer diffusion studies in acute slices from mice 5 days after experimental FS induction. The results reveal that HT-induced FSs cause a pronounced reduction of astrocyte gap junctional coupling in the hippocampus by more than 50%. Western blot analysis indicated that reduced connexin43 protein expression and/or changes in the phosphorylation status account for this astrocyte dysfunction. Remarkably, uncoupling occurred in the absence of neuronal death and reactive gliosis. These data provide a mechanistic link between FSs and the subsequent development of TLE and further strengthen the emerging view that astrocytes have a central role in the pathogenesis of this disorder. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Dilaware Khan
- Institute of Cellular Neurosciences, Medical Faculty, University of Bonn, Bonn, Germany
| | - Alexander Dupper
- Institute of Cellular Neurosciences, Medical Faculty, University of Bonn, Bonn, Germany
| | - Tushar Deshpande
- Institute of Cellular Neurosciences, Medical Faculty, University of Bonn, Bonn, Germany
| | - Pierre N E De Graan
- Department of Translational Neuroscience, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Christian Steinhäuser
- Institute of Cellular Neurosciences, Medical Faculty, University of Bonn, Bonn, Germany
| | - Peter Bedner
- Institute of Cellular Neurosciences, Medical Faculty, University of Bonn, Bonn, Germany
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Shorvon S, Diehl B, Duncan J, Koepp M, Rugg-Gunn F, Sander J, Walker M, Wehner T. Epilepsy and Related Disorders. Neurology 2016. [DOI: 10.1002/9781118486160.ch7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
| | | | | | | | | | | | | | - Tim Wehner
- National Hospital for Neurology & Neurosurgery
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26
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Abstract
Investigators from Virginia Commonwealth University, Norwegian Center for Epilepsy and University of Southern Denmark carried out twin studies to analyse the genetic influence of developing epilepsy after febrile seizures.
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Affiliation(s)
- Dipak Ram
- Department of Paediatric Neurology, Royal Manchester Children's Hospital, Manchester, UK
| | - Richard Newton
- Department of Paediatric Neurology, Royal Manchester Children's Hospital, Manchester, UK
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da Rocha AJ, Nunes RH, Maia ACM, do Amaral LLF. Recognizing Autoimmune-Mediated Encephalitis in the Differential Diagnosis of Limbic Disorders. AJNR Am J Neuroradiol 2015; 36:2196-205. [PMID: 26381566 DOI: 10.3174/ajnr.a4408] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Limbic encephalitis is far more common than previously thought. It is not always associated with cancer, and it is potentially treatable. Autoantibodies against various neuronal cell antigens may arise independently or in association with cancer and cause autoimmune damage to the limbic system. Neuroimaging plays a key role in the management of patients with suspected limbic encephalitis by supporting diagnosis and excluding differential possibilities. This article describes the main types of autoimmune limbic encephalitis and its mimic disorders, and emphasizes their major imaging features.
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Affiliation(s)
- A J da Rocha
- From the Division of Neuroradiology (A.J.d.R., R.H.N., A.C.M.M., L.L.F.d.A.), Santa Casa de São Paulo School of Medical Sciences, São Paulo, Brazil Division of Neuroradiology (A.J.d.R., R.H.N., A.C.M.M.), Fleury Medicina e Saúde, São Paulo, Brazil
| | - R H Nunes
- From the Division of Neuroradiology (A.J.d.R., R.H.N., A.C.M.M., L.L.F.d.A.), Santa Casa de São Paulo School of Medical Sciences, São Paulo, Brazil Division of Neuroradiology (A.J.d.R., R.H.N., A.C.M.M.), Fleury Medicina e Saúde, São Paulo, Brazil Research Fellow, University of North Carolina (R.H.N.), Chapel Hill, North Carolina
| | - A C M Maia
- From the Division of Neuroradiology (A.J.d.R., R.H.N., A.C.M.M., L.L.F.d.A.), Santa Casa de São Paulo School of Medical Sciences, São Paulo, Brazil Division of Neuroradiology (A.J.d.R., R.H.N., A.C.M.M.), Fleury Medicina e Saúde, São Paulo, Brazil
| | - L L F do Amaral
- From the Division of Neuroradiology (A.J.d.R., R.H.N., A.C.M.M., L.L.F.d.A.), Santa Casa de São Paulo School of Medical Sciences, São Paulo, Brazil Division of Neuroradiology (L.L.F.d.A.), Med Imagem, Hospital da Beneficência Portuguesa de São Paulo, São Paulo, Brazil
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Febrile Seizures and Febrile Seizure Syndromes: An Updated Overview of Old and Current Knowledge. Neurol Res Int 2015; 2015:849341. [PMID: 26697219 PMCID: PMC4677235 DOI: 10.1155/2015/849341] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Revised: 10/26/2015] [Accepted: 10/28/2015] [Indexed: 01/04/2023] Open
Abstract
Febrile seizures are the most common paroxysmal episode during childhood, affecting up to one in 10 children. They are a major cause of emergency facility visits and a source of family distress and anxiety. Their etiology and pathophysiological pathways are being understood better over time; however, there is still more to learn. Genetic predisposition is thought to be a major contributor. Febrile seizures have been historically classified as benign; however, many emerging febrile seizure syndromes behave differently. The way in which human knowledge has evolved over the years in regard to febrile seizures has not been dealt with in depth in the current literature, up to our current knowledge. This review serves as a documentary of how scientists have explored febrile seizures, elaborating on the journey of knowledge as far as etiology, clinical features, approach, and treatment strategies are concerned. Although this review cannot cover all clinical aspects related to febrile seizures at the textbook level, we believe it can function as a quick summary of the past and current sources of knowledge for all varieties of febrile seizure types and syndromes.
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Iwase T, Yoshida M, Mizuno T, Sato S, Nokura K. An autopsy case of hemiconvulsion-hemiplegia-epilepsy syndrome manifesting as cerebral hemiatrophy in an elderly man. Neuropathology 2015; 35:592-8. [PMID: 26179932 DOI: 10.1111/neup.12225] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2015] [Revised: 05/05/2015] [Accepted: 05/06/2015] [Indexed: 11/28/2022]
Abstract
We report an autopsy case of hemiconvulsion-hemiplegia-epilepsy (HHE) syndrome in a 79-year-old man. HHE syndrome usually occurs in children younger than 4 years of age. Although most HHE syndrome patients live into adult life, only a few cases of the syndrome have been reported in the elderly. In our case, cerebral hemiatrophy, left mesial temporal sclerosis and crossed cerebellar atrophy were observed. Because this is the oldest case ever reported, we further investigated age-related neuropathological changes and found an interhemispheric difference in amyloid-β-related neuropathologic changes. There were almost no senile plaques or amyloid-laden vessels in the left hemisphere. As far as we know, this is the first report of age-related neuropathology in a brain manifesting HHE syndrome.
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Affiliation(s)
- Tamaki Iwase
- Department of Neurology, Nagoya City Koseiin Medical Welfare Center, Aichi, Japan
| | - Mari Yoshida
- Department of Neuropathology, Institute for Medical Science of Aging, Aichi Medical University, Aichi, Japan
| | - Tomoyuki Mizuno
- Department of Neurology, Nagoya City Koseiin Medical Welfare Center, Aichi, Japan
| | - Shinya Sato
- Department of Experimental Pathology and Tumor Biology, Nagoya City University Graduate School of Medical Sciences, Aichi, Japan
| | - Kazuya Nokura
- Department of Neurology, Ban Buntane Hotokukai Hospital, School of Medicine, Fujita Health University, Aichi, Japan
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Thom M. Review: Hippocampal sclerosis in epilepsy: a neuropathology review. Neuropathol Appl Neurobiol 2015; 40:520-43. [PMID: 24762203 PMCID: PMC4265206 DOI: 10.1111/nan.12150] [Citation(s) in RCA: 341] [Impact Index Per Article: 37.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2013] [Accepted: 04/23/2014] [Indexed: 12/12/2022]
Abstract
Hippocampal sclerosis (HS) is a common pathology encountered in mesial temporal lobe epilepsy (MTLE) as well as other epilepsy syndromes and in both surgical and post-mortem practice. The 2013 International League Against Epilepsy (ILAE) classification segregates HS into typical (type 1) and atypical (type 2 and 3) groups, based on the histological patterns of subfield neuronal loss and gliosis. In addition, granule cell reorganization and alterations of interneuronal populations, neuropeptide fibre networks and mossy fibre sprouting are distinctive features of HS associated with epilepsies; they can be useful diagnostic aids to discriminate from other causes of HS, as well as highlighting potential mechanisms of hippocampal epileptogenesis. The cause of HS remains elusive and may be multifactorial; the contribution of febrile seizures, genetic susceptibility, inflammatory and neurodevelopmental factors are discussed. Post-mortem based research in HS, as an addition to studies on surgical samples, has the added advantage of enabling the study of the wider network changes associated with HS, the long-term effects of epilepsy on the pathology and associated comorbidities. It is likely that HS is heterogeneous in aspects of its cause, epileptogenetic mechanisms, network alterations and response to medical and surgical treatments. Future neuropathological studies will contribute to better recognition and understanding of these clinical and patho-aetiological subtypes of HS.
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Affiliation(s)
- Maria Thom
- Departments of Neuropathology and Clinical and Experimental Epilepsy, Institute of Neurology, University College London, London, UK
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31
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Bernhardt BC, Hong SJ, Bernasconi A, Bernasconi N. Magnetic resonance imaging pattern learning in temporal lobe epilepsy: classification and prognostics. Ann Neurol 2015; 77:436-46. [PMID: 25546153 DOI: 10.1002/ana.24341] [Citation(s) in RCA: 98] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2014] [Revised: 12/08/2014] [Accepted: 12/21/2014] [Indexed: 11/06/2022]
Abstract
OBJECTIVE In temporal lobe epilepsy (TLE), although hippocampal atrophy lateralizes the focus, the value of magnetic resonance imaging (MRI) to predict postsurgical outcome is rather modest. Prediction solely based on the hippocampus may be hampered by widespread mesiotemporal structural damage shown by advanced imaging. Increasingly complex and high-dimensional representation of MRI metrics motivates a shift to machine learning to establish objective, data-driven criteria for pathogenic processes and prognosis. METHODS We applied clustering to 114 consecutive unilateral TLE patients using 1.5T MRI profiles derived from surface morphology of hippocampus, amygdala, and entorhinal cortex. To evaluate the diagnostic validity of the classification, we assessed its yield to predict outcome in 79 surgically treated patients. Reproducibility of outcome prediction was assessed in an independent cohort of 27 patients evaluated on 3.0T MRI. RESULTS Four similarly sized classes partitioned our cohort; in all, alterations spanned over the 3 mesiotemporal structures. Compared to 46 controls, TLE-I showed marked bilateral atrophy; in TLE-II atrophy was ipsilateral; TLE-III showed mild bilateral atrophy; whereas TLE-IV showed hypertrophy. Classes differed with regard to histopathology and freedom from seizures. Classwise surface-based classifiers accurately predicted outcome in 92 ± 1% of patients, outperforming conventional volumetry. Predictors of relapse were distributed bilaterally across structures. Prediction accuracy was similarly high in the independent cohort (96%), supporting generalizability. INTERPRETATION We provide a novel description of individual variability across the TLE spectrum. Class membership was associated with distinct patterns of damage and outcome predictors that did not spatially overlap, emphasizing the ability of machine learning to disentangle the differential contribution of morphology to patient phenotypes, ultimately refining the prognosis of epilepsy surgery.
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Affiliation(s)
- Boris C Bernhardt
- Neuroimaging of Epilepsy Laboratory, Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec, Canada
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Oliveira MCB, Martin MGM, Tsunemi MH, Vieira G, Castro LHM. Small calcified lesions suggestive of neurocysticercosis are associated with mesial temporal sclerosis. ARQUIVOS DE NEURO-PSIQUIATRIA 2014; 72:510-6. [PMID: 25054983 DOI: 10.1590/0004-282x20140080] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/16/2014] [Accepted: 05/13/2014] [Indexed: 11/22/2022]
Abstract
UNLABELLED Recent studies have suggested a possible relationship between temporal lobe epilepsy with mesial temporal sclerosis (MTS) and neurocysticercosis (NC). We performed a case-control study to evaluate the association of NC and MTS. METHOD We randomly selected patients with different epilepsy types, including: MTS, primary generalized epilepsy (PGE) and focal symptomatic epilepsy (FSE). Patients underwent a structured interview, followed by head computed tomography (CT). A neuroradiologist evaluated the scan for presence of calcified lesions suggestive of NC. CT results were matched with patients' data. RESULTS More patients in the MTS group displayed calcified lesions suggestive of NC than patients in the other groups (p=0.002). On multivariate analysis, MTS was found to be an independent predictor of one or more calcified NC lesions (p=0.033). CONCLUSION After controlling for confounding factors, we found an independent association between NC calcified lesions and MTS.
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Affiliation(s)
- Marcos C B Oliveira
- Departamento de Neurologia, Faculdade de Medicina, Universidade de São Paulo, Sao Paulo, SP, Brazil
| | - Maria G M Martin
- Laboratório de Investigações Médicas 44, Instituto de Radiologia, Hospital das Clínicas, Faculdade de Medicina de São Paulo, Sao Paulo, SP, Brazil
| | - Miriam H Tsunemi
- Departamento de Bioestatística, Instituto de Biociências, Campus de Botucatu Distrito de Rubião Júnior, Universidade Estadual Paulista ?Júlio de Mesquita Filho?, Botucatu, SP, Brazil
| | - Gilson Vieira
- Instituto de Radiologia, Hospital das Clínicas, Faculdade de Medicina de São Paulo, Sao Paulo, SP, Brazil
| | - Luiz H M Castro
- Departamento de Neurologia, Faculdade de Medicina, Universidade de São Paulo, Sao Paulo, SP, Brazil
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SCN1A and Febrile Seizures in Mesial Temporal Epilepsy: An Early Signal to Guide Prognosis and Treatment? Epilepsy Curr 2014; 14:189-90. [PMID: 25170313 DOI: 10.5698/1535-7597-14.4.189] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Cohn M, St-Laurent M, Barnett A, McAndrews MP. Social inference deficits in temporal lobe epilepsy and lobectomy: risk factors and neural substrates. Soc Cogn Affect Neurosci 2014; 10:636-44. [PMID: 25062843 DOI: 10.1093/scan/nsu101] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2014] [Accepted: 07/17/2014] [Indexed: 11/12/2022] Open
Abstract
In temporal lobe epilepsy and lobectomy, deficits in emotion identification have been found consistently, but there is limited evidence for complex social inference skills such as theory of mind. Furthermore, risk factors and the specific neural underpinnings of these deficits in this population are unclear. We investigated these issues using a comprehensive range of social inference tasks (emotion identification and comprehension of sincere, deceitful and sarcastic social exchanges) in individuals with temporal lobe epilepsy or lobectomy (n = 87). We observed deficits across patient groups which were partly related to the presence of mesial temporal lobe sclerosis, early age of seizure onset and left lobectomy. A voxel-based morphometry analysis conducted in the pre-operative group confirmed the importance of the temporal lobe by showing a relationship between left hippocampal atrophy and overall social inference abilities, and between left anterior neocortex atrophy and sarcasm comprehension. These findings are in keeping with theoretical proposals that the hippocampus is critical for binding diverse elements in cognitive domains beyond canonical episodic memory operations, and that the anterior temporal cortex is a convergence zone of higher-order perceptual and emotional processes, and of stored representations. As impairments were frequent, we require further investigation of this behavioural domain and its impact on the lives of people with epilepsy.
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Affiliation(s)
- Melanie Cohn
- Krembil Neuroscience Centre at Toronto Western Hospital - UHN, Toronto, ON, Canada, Department of Psychology, University of Toronto, Toronto, ON, Canada, and Rotman Research Institute at Baycrest, Toronto, ON, Canada Krembil Neuroscience Centre at Toronto Western Hospital - UHN, Toronto, ON, Canada, Department of Psychology, University of Toronto, Toronto, ON, Canada, and Rotman Research Institute at Baycrest, Toronto, ON, Canada
| | - Marie St-Laurent
- Krembil Neuroscience Centre at Toronto Western Hospital - UHN, Toronto, ON, Canada, Department of Psychology, University of Toronto, Toronto, ON, Canada, and Rotman Research Institute at Baycrest, Toronto, ON, Canada
| | - Alexander Barnett
- Krembil Neuroscience Centre at Toronto Western Hospital - UHN, Toronto, ON, Canada, Department of Psychology, University of Toronto, Toronto, ON, Canada, and Rotman Research Institute at Baycrest, Toronto, ON, Canada
| | - Mary Pat McAndrews
- Krembil Neuroscience Centre at Toronto Western Hospital - UHN, Toronto, ON, Canada, Department of Psychology, University of Toronto, Toronto, ON, Canada, and Rotman Research Institute at Baycrest, Toronto, ON, Canada Krembil Neuroscience Centre at Toronto Western Hospital - UHN, Toronto, ON, Canada, Department of Psychology, University of Toronto, Toronto, ON, Canada, and Rotman Research Institute at Baycrest, Toronto, ON, Canada
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35
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Clinico-pathological factors influencing surgical outcome in drug resistant epilepsy secondary to mesial temporal sclerosis. J Neurol Sci 2014; 340:183-90. [DOI: 10.1016/j.jns.2014.03.026] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2013] [Revised: 03/11/2014] [Accepted: 03/12/2014] [Indexed: 11/20/2022]
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Avanzini G, Depaulis A, Tassinari A, de Curtis M. Do seizures and epileptic activity worsen epilepsy and deteriorate cognitive function? Epilepsia 2014; 54 Suppl 8:14-21. [PMID: 24571112 DOI: 10.1111/epi.12418] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Relevant to the definition of epileptic encephalopathy (EE) is the concept that the epileptic activity itself may contribute to bad outcomes, both in terms of epilepsy and cognition, above and beyond what might be expected from the underlying pathology alone, and that these can worsen over time. The review of the clinical and experimental evidence that seizures or interictal electroencephalography (EEG) discharges themselves can induce a progression toward more severe epilepsy and a regression of brain function leads to the following conclusions: The possibility of seizure-dependent worsening is by no means a general one but is limited to some types of epilepsy, namely mesial temporal lobe epilepsy (MTLE) and EEs. Clinical and experimental data concur in indicating that prolonged seizures/status epilepticus (SE) are a risky initial event that can set in motion an epileptogenic process leading to persistent, possibly drug-refractory epilepsies. The mechanisms for SE-related epileptogenic process are incompletely known; they seem to involve inflammation and/or glutamatergic transmission. The evidence of the role of recurrent individual seizures in sustaining epilepsy progression is ambiguous. The correlation between high seizure frequency and bad outcome does not necessarily demonstrate a cause-effect relationship, rather high seizure frequency and bad outcome can both depend on a particularly aggressive epileptogenic process. The results of EE studies challenge the idea of a common seizure-dependent mechanism for epilepsy progression/intellectual deterioration.
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Affiliation(s)
- Giuliano Avanzini
- Department of Neurophysiology, IRCCS Foundation Neurological Institute Carlo Besta, Milano, Italy
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Mériaux C, Franck J, Park DB, Quanico J, Kim YH, Chung CK, Park YM, Steinbusch H, Salzet M, Fournier I. Human temporal lobe epilepsy analyses by tissue proteomics. Hippocampus 2014; 24:628-42. [DOI: 10.1002/hipo.22246] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/18/2014] [Indexed: 01/01/2023]
Affiliation(s)
- Céline Mériaux
- Laboratoire de Spectrométrie de Masse Biologique Fondamentale et Appliquée-EA 4550, Bât SN3, 1 étage; Université de Lille 1; Villeneuve d'Ascq France
- EURON-European Graduate School of Neuroscience, Maastricht University; Maastricht The Netherlands
| | - Julien Franck
- Laboratoire de Spectrométrie de Masse Biologique Fondamentale et Appliquée-EA 4550, Bât SN3, 1 étage; Université de Lille 1; Villeneuve d'Ascq France
- EURON-European Graduate School of Neuroscience, Maastricht University; Maastricht The Netherlands
| | - Dan Bi Park
- Division of Mass Spectrometry Research; Korea Basic Science Institute; Ochang Chungbuk Republic of Korea
- Graduate School of Analytical Science and Technology; Chungnam National University; Daejeon Republic of Korea
| | - Jusal Quanico
- Laboratoire de Spectrométrie de Masse Biologique Fondamentale et Appliquée-EA 4550, Bât SN3, 1 étage; Université de Lille 1; Villeneuve d'Ascq France
- EURON-European Graduate School of Neuroscience, Maastricht University; Maastricht The Netherlands
| | - Young Hye Kim
- Division of Mass Spectrometry Research; Korea Basic Science Institute; Ochang Chungbuk Republic of Korea
| | - Chun Kee Chung
- Department of Neurosurgery; College of Medicine, Seoul National University; Seoul Republic of Korea
| | - Young Mok Park
- Division of Mass Spectrometry Research; Korea Basic Science Institute; Ochang Chungbuk Republic of Korea
- Graduate School of Analytical Science and Technology; Chungnam National University; Daejeon Republic of Korea
| | - Harry Steinbusch
- EURON-European Graduate School of Neuroscience, Maastricht University; Maastricht The Netherlands
- Department of Translational Neuroscience; Faculty of Health; Medicine & Life Sciences; Maastricht University; Maastricht The Netherlands
| | - Michel Salzet
- Laboratoire de Spectrométrie de Masse Biologique Fondamentale et Appliquée-EA 4550, Bât SN3, 1 étage; Université de Lille 1; Villeneuve d'Ascq France
- EURON-European Graduate School of Neuroscience, Maastricht University; Maastricht The Netherlands
| | - Isabelle Fournier
- Laboratoire de Spectrométrie de Masse Biologique Fondamentale et Appliquée-EA 4550, Bât SN3, 1 étage; Université de Lille 1; Villeneuve d'Ascq France
- EURON-European Graduate School of Neuroscience, Maastricht University; Maastricht The Netherlands
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Avanzini G, Forcelli PA, Gale K. Are there really "epileptogenic" mechanisms or only corruptions of "normal" plasticity? ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2014; 813:95-107. [PMID: 25012370 DOI: 10.1007/978-94-017-8914-1_8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Plasticity in the nervous system, whether for establishing connections and networks during development, repairing networks after injury, or modifying connections based on experience, relies primarily on highly coordinated patterns of neural activity. Rhythmic, synchronized bursting of neuronal ensembles is a fundamental component of the activity-dependent plasticity responsible for the wiring and rewiring of neural circuits in the CNS. It is therefore not surprising that the architecture of the CNS supports the generation of highly synchronized bursts of neuronal activity in non-pathological conditions, even though the activity resembles the ictal and interictal events that are the hallmark symptoms of epilepsy. To prevent such natural epileptiform events from becoming pathological, multiple layers of homeostatic control operate on cellular and network levels. Many data on plastic changes that occur in different brain structures during the processes by which the epileptogenic aggregate is constituted have been accumulated but their role in counteracting or promoting such processes is still controversial. In this chapter we will review experimental and clinical evidence on the role of neural plasticity in the development of epilepsy. We will address questions such as: is epilepsy a progressive disorder? What do we know about mechanism(s) accounting for progression? Have we reliable biomarkers of epilepsy-related plastic processes? Do seizure-associated plastic changes protect against injury and aid in recovery? As a necessary premise we will consider the value of seizure-like activity in the context of normal neural development.
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Affiliation(s)
- Giuliano Avanzini
- Fondazione I.RC.C.S. Istituto Neurologico Carlo Besta, Via Celoria 11, 20133, Milan, Italy,
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Abstract
Febrile seizures are the most common form of childhood seizures, affecting 2% to 5% of children. They are considered benign and self-limiting; however, a febrile seizure is a terrifying event for most parents, and is one of the most common causes of trips to the emergency room. A febrile seizure is "an event in infancy or childhood, usually occurring between 3 months and 5 years of age, associated with fever but without evidence of intracranial infection or defined cause." This definition excludes seizures with fever in children who have had a prior afebrile seizure. In 2011, The American Academy of Pediatrics (AAP) published a clinical practice guideline defining a febrile seizure as "a seizure accompanied by fever (temperature ≥ 100.4°F or 38°C by any method), without central nervous system infection, that occurs in infants and children 6 through 60 months of age." Febrile seizures are further classified as simple or complex. This article reviews the evaluation, management, and prognosis of simple and complex seizures, including febrile status epilepticus.
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Bando SY, Silva FN, Costa LDF, Silva AV, Pimentel-Silva LR, Castro LHM, Wen HT, Amaro E, Moreira-Filho CA. Complex network analysis of CA3 transcriptome reveals pathogenic and compensatory pathways in refractory temporal lobe epilepsy. PLoS One 2013; 8:e79913. [PMID: 24278214 PMCID: PMC3836787 DOI: 10.1371/journal.pone.0079913] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2013] [Accepted: 09/25/2013] [Indexed: 12/21/2022] Open
Abstract
We previously described - studying transcriptional signatures of hippocampal CA3 explants - that febrile (FS) and afebrile (NFS) forms of refractory mesial temporal lobe epilepsy constitute two distinct genomic phenotypes. That network analysis was based on a limited number (hundreds) of differentially expressed genes (DE networks) among a large set of valid transcripts (close to two tens of thousands). Here we developed a methodology for complex network visualization (3D) and analysis that allows the categorization of network nodes according to distinct hierarchical levels of gene-gene connections (node degree) and of interconnection between node neighbors (concentric node degree). Hubs are highly connected nodes, VIPs have low node degree but connect only with hubs, and high-hubs have VIP status and high overall number of connections. Studying the whole set of CA3 valid transcripts we: i) obtained complete transcriptional networks (CO) for FS and NFS phenotypic groups; ii) examined how CO and DE networks are related; iii) characterized genomic and molecular mechanisms underlying FS and NFS phenotypes, identifying potential novel targets for therapeutic interventions. We found that: i) DE hubs and VIPs are evenly distributed inside the CO networks; ii) most DE hubs and VIPs are related to synaptic transmission and neuronal excitability whereas most CO hubs, VIPs and high hubs are related to neuronal differentiation, homeostasis and neuroprotection, indicating compensatory mechanisms. Complex network visualization and analysis is a useful tool for systems biology approaches to multifactorial diseases. Network centrality observed for hubs, VIPs and high hubs of CO networks, is consistent with the network disease model, where a group of nodes whose perturbation leads to a disease phenotype occupies a central position in the network. Conceivably, the chance for exerting therapeutic effects through the modulation of particular genes will be higher if these genes are highly interconnected in transcriptional networks.
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Affiliation(s)
- Silvia Yumi Bando
- Department of Pediatrics, Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, São Paulo, Brazil
| | | | | | - Alexandre V. Silva
- Department of Biosciences, Universidade Federal de São Paulo, Santos, São Paulo, Brazil
| | | | - Luiz HM. Castro
- Clinical Neurology Division, Hospital das Clínicas da FMUSP, São Paulo, São Paulo, Brazil
| | - Hung-Tzu Wen
- Epilepsy Surgery Group, Hospital das Clínicas da FMUSP, São Paulo, São Paulo, Brazil
| | - Edson Amaro
- Department of Radiology, Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, São Paulo, Brazil
| | - Carlos Alberto Moreira-Filho
- Department of Pediatrics, Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, São Paulo, Brazil
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Glushakov AV, Robbins SW, Bracy CL, Narumiya S, Doré S. Prostaglandin F2α FP receptor antagonist improves outcomes after experimental traumatic brain injury. J Neuroinflammation 2013; 10:132. [PMID: 24172576 DOI: 10.1186/1742-2094-10-132] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2013] [Accepted: 10/04/2013] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Injuries to the brain promote upregulation of prostaglandins, notably the proinflammatory PGF2α, and overactivation of their cognate G-protein-coupled FP receptor, which could exacerbate neuronal damage. Our study is focused on investigation of the FP receptor as a target for novel neuroprotective drugs in a preclinical animal traumatic brain injury (TBI) model. METHODS Accordingly, the effects of acute intraperitoneal post-treatment with selective FP antagonist AL-8810 were studied in wildtype (WT) and FP receptor knockout (FP-/-) mice after controlled cortical impact (CCI). Neurological impairments were evaluated using neurological deficit scores (NDS) and the grip strength test. Cortical lesions and overall brain pathology were assessed using immunohistochemistry. RESULTS Morphological analyses of cerebral vasculature and anastomoses revealed no differences between WT and FP-/- mice. CCI produced cortical lesions characterized by cavitation, neuronal loss, and hematoma with a volume of 20.0 ± 1.0 mm(3) and significant hippocampal swelling (146.5 ± 7.4% of contralateral) compared with sham (P < 0.05). Post-treatment with AL-8810 (1 to 10 mg/kg) had no significant effect on cortical lesions, which suggests the irreversible effect of primary CCI injury, but significantly reduced hippocampal swelling to a size not significantly different from the sham group. Post-treatment with AL-8810 at a dose of 10 mg/kg significantly improved NDS at 24 and 48 hours after CCI (P < 0.001 and P < 0.01, respectively). In the AL-8810 group, CCI-induced decrease in grip strength was three-fold (2.93 ± 1.71) less and significantly different than in the saline-treated group. The FP-/- mice had significantly less hippocampal swelling, but not NDS, compared with WT mice. In addition, immunohistochemistry showed that pharmacologic blockade and genetic deletion of FP receptor led to attenuation of CCI-induced gliosis and microglial activation in selected brain regions. CONCLUSION This study provides, for the first time, demonstration of the unique role of the FP receptor as a potential target for disease-modifying CNS drugs for treatment of acute traumatic injury.
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Affiliation(s)
- Alexander V Glushakov
- Department of Anesthesiology, University of Florida College of Medicine, PO Box 100159, Gainesville, FL 32610, USA.
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Yoong M, Seunarine K, Martinos M, Chin RF, Clark CA, Scott RC. Prolonged febrile seizures cause reversible reductions in white matter integrity. NEUROIMAGE-CLINICAL 2013; 3:515-21. [PMID: 24273734 PMCID: PMC3830064 DOI: 10.1016/j.nicl.2013.10.010] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/03/2013] [Revised: 10/03/2013] [Accepted: 10/17/2013] [Indexed: 11/24/2022]
Abstract
Prolonged febrile seizures (PFS) are the commonest cause of childhood status epilepticus and are believed to carry a risk of neuronal damage, in particular to the mesial temporal lobe. This study was designed to determine: i) the effect of prolonged febrile seizures on white matter and ii) the temporal evolution of any changes seen. 33 children were recruited 1 month following PFS and underwent diffusion tensor imaging (DTI) with repeat imaging at 6 and 12 months after the original episode of PFS. 18 age-matched healthy control subjects underwent similar investigations at a single time point. Tract-based spatial statistics (TBSS) was used to compare fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD) and radial diffusivity (RD) between patients and controls on a voxel-wise basis within the white matter skeleton. Widespread reductions in FA along multiple white matter tracts were found at 1 and 6 months post-PFS, but these had resolved at 12 months. At one month post-PFS the main changes seen were reductions in AD but at 6 months these had predominantly changed to increases in RD. These widespread white matter changes have not previously been noted following PFS. There are many possible explanations, but one plausible hypothesis is that this represents a temporary halting of normal white matter development caused by the seizure, that then resumes and normalises in the majority of children. Widespread reductions in FA occur in children after prolonged febrile seizures. These reductions persist up to 6 months post-PFS but resolve by 1 year. This may represent a seizure-related disruption of white matter development.
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Affiliation(s)
- M Yoong
- Neurosciences Unit, UCL Institute of Child Health, 4/5 Long Yard, London WC1N 3LU, UK ; Imaging and Biophysics Unit, UCL Institute of Child Health, 30 Guilford Street, London WC1N 2AP, UK ; Young Epilepsy, Lingfield, Surrey, UK ; Edinburgh Neurosciences, The University of Edinburgh, Muir Maxwell Epilepsy Centre, Edinburgh, UK
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Kasperavičiūtė D, Catarino CB, Matarin M, Leu C, Novy J, Tostevin A, Leal B, Hessel EVS, Hallmann K, Hildebrand MS, Dahl HHM, Ryten M, Trabzuni D, Ramasamy A, Alhusaini S, Doherty CP, Dorn T, Hansen J, Krämer G, Steinhoff BJ, Zumsteg D, Duncan S, Kälviäinen RK, Eriksson KJ, Kantanen AM, Pandolfo M, Gruber-Sedlmayr U, Schlachter K, Reinthaler EM, Stogmann E, Zimprich F, Théâtre E, Smith C, O’Brien TJ, Meng Tan K, Petrovski S, Robbiano A, Paravidino R, Zara F, Striano P, Sperling MR, Buono RJ, Hakonarson H, Chaves J, Costa PP, Silva BM, da Silva AM, de Graan PNE, Koeleman BPC, Becker A, Schoch S, von Lehe M, Reif PS, Rosenow F, Becker F, Weber Y, Lerche H, Rössler K, Buchfelder M, Hamer HM, Kobow K, Coras R, Blumcke I, Scheffer IE, Berkovic SF, Weale ME, Delanty N, Depondt C, Cavalleri GL, Kunz WS, Sisodiya SM. Epilepsy, hippocampal sclerosis and febrile seizures linked by common genetic variation around SCN1A. Brain 2013; 136:3140-50. [PMID: 24014518 PMCID: PMC3784283 DOI: 10.1093/brain/awt233] [Citation(s) in RCA: 120] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2013] [Revised: 06/28/2013] [Accepted: 07/02/2013] [Indexed: 01/01/2023] Open
Abstract
Epilepsy comprises several syndromes, amongst the most common being mesial temporal lobe epilepsy with hippocampal sclerosis. Seizures in mesial temporal lobe epilepsy with hippocampal sclerosis are typically drug-resistant, and mesial temporal lobe epilepsy with hippocampal sclerosis is frequently associated with important co-morbidities, mandating the search for better understanding and treatment. The cause of mesial temporal lobe epilepsy with hippocampal sclerosis is unknown, but there is an association with childhood febrile seizures. Several rarer epilepsies featuring febrile seizures are caused by mutations in SCN1A, which encodes a brain-expressed sodium channel subunit targeted by many anti-epileptic drugs. We undertook a genome-wide association study in 1018 people with mesial temporal lobe epilepsy with hippocampal sclerosis and 7552 control subjects, with validation in an independent sample set comprising 959 people with mesial temporal lobe epilepsy with hippocampal sclerosis and 3591 control subjects. To dissect out variants related to a history of febrile seizures, we tested cases with mesial temporal lobe epilepsy with hippocampal sclerosis with (overall n = 757) and without (overall n = 803) a history of febrile seizures. Meta-analysis revealed a genome-wide significant association for mesial temporal lobe epilepsy with hippocampal sclerosis with febrile seizures at the sodium channel gene cluster on chromosome 2q24.3 [rs7587026, within an intron of the SCN1A gene, P = 3.36 × 10(-9), odds ratio (A) = 1.42, 95% confidence interval: 1.26-1.59]. In a cohort of 172 individuals with febrile seizures, who did not develop epilepsy during prospective follow-up to age 13 years, and 6456 controls, no association was found for rs7587026 and febrile seizures. These findings suggest SCN1A involvement in a common epilepsy syndrome, give new direction to biological understanding of mesial temporal lobe epilepsy with hippocampal sclerosis with febrile seizures, and open avenues for investigation of prognostic factors and possible prevention of epilepsy in some children with febrile seizures.
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Affiliation(s)
- Dalia Kasperavičiūtė
- 1 NIHR University College London Hospitals Biomedical Research Centre, Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, Queen Square, London, WC1N 3BG, UK
| | - Claudia B. Catarino
- 1 NIHR University College London Hospitals Biomedical Research Centre, Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, Queen Square, London, WC1N 3BG, UK
- 2 Epilepsy Society, Chalfont-St-Peter, SL9 0RJ, UK
| | - Mar Matarin
- 1 NIHR University College London Hospitals Biomedical Research Centre, Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, Queen Square, London, WC1N 3BG, UK
| | - Costin Leu
- 1 NIHR University College London Hospitals Biomedical Research Centre, Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, Queen Square, London, WC1N 3BG, UK
| | - Jan Novy
- 1 NIHR University College London Hospitals Biomedical Research Centre, Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, Queen Square, London, WC1N 3BG, UK
- 2 Epilepsy Society, Chalfont-St-Peter, SL9 0RJ, UK
| | - Anna Tostevin
- 1 NIHR University College London Hospitals Biomedical Research Centre, Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, Queen Square, London, WC1N 3BG, UK
- 2 Epilepsy Society, Chalfont-St-Peter, SL9 0RJ, UK
| | - Bárbara Leal
- 3 Immunogenetics Laboratory, University of Porto, 4050-313 Porto, Portugal
- 4 UMIB - Instituto Ciências Biomédicas Abel Salazar, University of Porto, 4099-003 Porto, Portugal
| | - Ellen V. S. Hessel
- 5 Rudolf Magnus Institute of Neuroscience, Department of Neuroscience and Pharmacology, University Medical Centre Utrecht, 3584 CG Utrecht, The Netherlands
| | - Kerstin Hallmann
- 6 Department of Epileptology, University of Bonn, 53105 Bonn, Germany
- 7 Life & Brain Centre, University of Bonn, 53105 Bonn, Germany
| | - Michael S. Hildebrand
- 8 Epilepsy Research Centre, Austin Health, University of Melbourne, Melbourne VIC 3084, Australia
| | - Hans-Henrik M. Dahl
- 8 Epilepsy Research Centre, Austin Health, University of Melbourne, Melbourne VIC 3084, Australia
| | - Mina Ryten
- 9 Department of Molecular Neuroscience, UCL Institute of Neurology, London, WC1N 3BG, UK
- 10 Reta Lila Weston Institute, UCL Institute of Neurology, London, WC1N 3BG, UK
| | - Daniah Trabzuni
- 9 Department of Molecular Neuroscience, UCL Institute of Neurology, London, WC1N 3BG, UK
- 10 Reta Lila Weston Institute, UCL Institute of Neurology, London, WC1N 3BG, UK
- 11 Department of Genetics, King Faisal Specialist Hospital and Research Centre, Riyadh, 11211, Saudi Arabia
| | - Adaikalavan Ramasamy
- 9 Department of Molecular Neuroscience, UCL Institute of Neurology, London, WC1N 3BG, UK
- 10 Reta Lila Weston Institute, UCL Institute of Neurology, London, WC1N 3BG, UK
- 12 Department of Medical and Molecular Genetics, King’s College London, Guy's Hospital, London, SE1 9RT, UK
| | - Saud Alhusaini
- 13 Molecular and Cellular Therapeutics Department, Royal College of Surgeons in Ireland, Dublin 2, Ireland
- 14 Brain Morphometry Laboratory, Neurophysics Department, Beaumont Hospital, Dublin 9, Ireland
| | - Colin P. Doherty
- 15 Department of Neurology, St James’ Hospital, Dublin 8, Ireland
| | - Thomas Dorn
- 16 Swiss Epilepsy Centre, 8008 Zurich, Switzerland
| | - Jörg Hansen
- 16 Swiss Epilepsy Centre, 8008 Zurich, Switzerland
| | | | | | - Dominik Zumsteg
- 18 Department of Neurology, University Hospital Zurich, 8091 Zurich, Switzerland
| | - Susan Duncan
- 19 Edinburgh and South East Scotland Epilepsy Service, Western General Hospital Edinburgh, EH4 2XU, Scotland, UK
| | - Reetta K. Kälviäinen
- 20 Kuopio Epilepsy Centre, Kuopio University Hospital, 70211 Kuopio, Finland
- 21 Department of Neurology, Institute of Clinical Medicine, University of Eastern Finland, 70211 Kuopio, Finland
| | - Kai J. Eriksson
- 22 Paediatric Neurology Unit, Tampere University Hospital and Paediatric Research Centre, University of Tampere, 33521 Tampere, Finland
| | - Anne-Mari Kantanen
- 20 Kuopio Epilepsy Centre, Kuopio University Hospital, 70211 Kuopio, Finland
| | - Massimo Pandolfo
- 23 Department of Neurology, Hôpital Erasme, Université Libre de Bruxelles, 1070 Brussels, Belgium
| | | | - Kurt Schlachter
- 25 Department of Paediatrics, LKH Bregenz, 6900 Bregenz, Austria
| | - Eva M. Reinthaler
- 26 Department of Clinical Neurology, Medical University of Vienna, 1090 Vienna, Austria
| | - Elisabeth Stogmann
- 26 Department of Clinical Neurology, Medical University of Vienna, 1090 Vienna, Austria
| | - Fritz Zimprich
- 26 Department of Clinical Neurology, Medical University of Vienna, 1090 Vienna, Austria
| | - Emilie Théâtre
- 27 Groupe Interdisciplinaire de Génoprotéomique Appliquée (GIGA-R) and Faculty of Veterinary Medicine, University of Liège, 4000 Liège, Belgium
- 28 Unit of Gastroenterology, Centre Hospitalier Universitaire, University of Liège, 4000 Liège, Belgium
| | - Colin Smith
- 29 Department of Neuropathology, MRC Sudden Death Brain Bank Project, University of Edinburgh, Wilkie Building, Edinburgh, EH8 9AG, UK
| | - Terence J. O’Brien
- 30 Departments of Medicine and Neurology, Royal Melbourne Hospital, University of Melbourne, Melbourne VIC 3050, Australia
- 31 Melbourne Brain Centre, University of Melbourne, Melbourne VIC 3084, Australia
| | - K. Meng Tan
- 30 Departments of Medicine and Neurology, Royal Melbourne Hospital, University of Melbourne, Melbourne VIC 3050, Australia
- 31 Melbourne Brain Centre, University of Melbourne, Melbourne VIC 3084, Australia
| | - Slave Petrovski
- 30 Departments of Medicine and Neurology, Royal Melbourne Hospital, University of Melbourne, Melbourne VIC 3050, Australia
- 31 Melbourne Brain Centre, University of Melbourne, Melbourne VIC 3084, Australia
- 32 Department of Medicine, Austin Health, University of Melbourne, Melbourne VIC 3084, Australia
| | - Angela Robbiano
- 33 Department of Neurosciences, Laboratory of Neurogenetics, University of Genoa, ‘G. Gaslini’ Institute, 16147 Genova, Italy
| | - Roberta Paravidino
- 33 Department of Neurosciences, Laboratory of Neurogenetics, University of Genoa, ‘G. Gaslini’ Institute, 16147 Genova, Italy
| | - Federico Zara
- 33 Department of Neurosciences, Laboratory of Neurogenetics, University of Genoa, ‘G. Gaslini’ Institute, 16147 Genova, Italy
| | - Pasquale Striano
- 34 Paediatric Neurology and Muscular Diseases Unit, Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, ‘G. Gaslini’ Institute, 16147 Genova, Italy
| | - Michael R. Sperling
- 35 Department of Neurology, Thomas Jefferson University, Philadelphia, PA 19107, USA
| | - Russell J. Buono
- 36 Department of Biomedical Science, Cooper Medical School of Rowan University, Camden, NJ 08103, USA
| | - Hakon Hakonarson
- 37 Centre for Applied Genomics, The Children’s Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104-4318, USA
| | - João Chaves
- 38 Department of Neurological Disorders and Senses, Hospital Santo António / Centro Hospitalar do Porto, 4099-001 Porto, Portugal
| | - Paulo P. Costa
- 3 Immunogenetics Laboratory, University of Porto, 4050-313 Porto, Portugal
- 4 UMIB - Instituto Ciências Biomédicas Abel Salazar, University of Porto, 4099-003 Porto, Portugal
- 39 Instituto Nacional de Saúde Dr. Ricardo Jorge (INSA), 4049-019 Porto, Portugal
| | - Berta M. Silva
- 3 Immunogenetics Laboratory, University of Porto, 4050-313 Porto, Portugal
- 4 UMIB - Instituto Ciências Biomédicas Abel Salazar, University of Porto, 4099-003 Porto, Portugal
| | - António M. da Silva
- 4 UMIB - Instituto Ciências Biomédicas Abel Salazar, University of Porto, 4099-003 Porto, Portugal
- 38 Department of Neurological Disorders and Senses, Hospital Santo António / Centro Hospitalar do Porto, 4099-001 Porto, Portugal
| | - Pierre N. E. de Graan
- 5 Rudolf Magnus Institute of Neuroscience, Department of Neuroscience and Pharmacology, University Medical Centre Utrecht, 3584 CG Utrecht, The Netherlands
| | - Bobby P. C. Koeleman
- 40 Department of Medical Genetics, University Medical Centre Utrecht, 3584 CG Utrecht, The Netherlands
| | - Albert Becker
- 41 Department of Neuropathology, University of Bonn, 53105 Bonn, Germany
| | - Susanne Schoch
- 41 Department of Neuropathology, University of Bonn, 53105 Bonn, Germany
| | - Marec von Lehe
- 42 Department of Neurosurgery, University of Bochum, 44892 Bochum, Germany
| | - Philipp S. Reif
- 43 Epilepsy-Centre Hessen, Department of Neurology, University Hospitals and Philipps-University Marburg, 35043 Marburg, Germany
| | - Felix Rosenow
- 43 Epilepsy-Centre Hessen, Department of Neurology, University Hospitals and Philipps-University Marburg, 35043 Marburg, Germany
| | - Felicitas Becker
- 44 Department of Neurology and Epileptology, Hertie Institute for Clinical Brain Research, University of Tübingen, 72076 Tübingen, Germany
| | - Yvonne Weber
- 44 Department of Neurology and Epileptology, Hertie Institute for Clinical Brain Research, University of Tübingen, 72076 Tübingen, Germany
| | - Holger Lerche
- 44 Department of Neurology and Epileptology, Hertie Institute for Clinical Brain Research, University of Tübingen, 72076 Tübingen, Germany
| | - Karl Rössler
- 45 Department of Neurosurgery, University Hospital Erlangen, 91054 Erlangen, Germany
| | - Michael Buchfelder
- 45 Department of Neurosurgery, University Hospital Erlangen, 91054 Erlangen, Germany
| | - Hajo M. Hamer
- 46 Department of Neurology, Epilepsy Centre, University Hospital Erlangen, 91054 Erlangen, Germany
| | - Katja Kobow
- 47 Department of Neuropathology, University Hospital Erlangen, 91054 Erlangen, Germany
| | - Roland Coras
- 47 Department of Neuropathology, University Hospital Erlangen, 91054 Erlangen, Germany
| | - Ingmar Blumcke
- 47 Department of Neuropathology, University Hospital Erlangen, 91054 Erlangen, Germany
| | - Ingrid E. Scheffer
- 8 Epilepsy Research Centre, Austin Health, University of Melbourne, Melbourne VIC 3084, Australia
- 48 Florey Institute of Neuroscience and Mental Health, Melbourne VIC 3010, Australia
- 49 Department of Paediatrics, University of Melbourne, Royal Children’s Hospital, Melbourne VIC 3052, Australia
| | - Samuel F. Berkovic
- 8 Epilepsy Research Centre, Austin Health, University of Melbourne, Melbourne VIC 3084, Australia
| | - Michael E. Weale
- 12 Department of Medical and Molecular Genetics, King’s College London, Guy's Hospital, London, SE1 9RT, UK
| | - UK Brain Expression Consortium
- 9 Department of Molecular Neuroscience, UCL Institute of Neurology, London, WC1N 3BG, UK
- 10 Reta Lila Weston Institute, UCL Institute of Neurology, London, WC1N 3BG, UK
| | - Norman Delanty
- 13 Molecular and Cellular Therapeutics Department, Royal College of Surgeons in Ireland, Dublin 2, Ireland
- 50 Department of Neurology, Beaumont Hospital, Dublin 9, Ireland
| | - Chantal Depondt
- 23 Department of Neurology, Hôpital Erasme, Université Libre de Bruxelles, 1070 Brussels, Belgium
| | - Gianpiero L. Cavalleri
- 13 Molecular and Cellular Therapeutics Department, Royal College of Surgeons in Ireland, Dublin 2, Ireland
| | - Wolfram S. Kunz
- 6 Department of Epileptology, University of Bonn, 53105 Bonn, Germany
- 7 Life & Brain Centre, University of Bonn, 53105 Bonn, Germany
| | - Sanjay M. Sisodiya
- 1 NIHR University College London Hospitals Biomedical Research Centre, Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, Queen Square, London, WC1N 3BG, UK
- 2 Epilepsy Society, Chalfont-St-Peter, SL9 0RJ, UK
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Experimental models of status epilepticus and neuronal injury for evaluation of therapeutic interventions. Int J Mol Sci 2013; 14:18284-318. [PMID: 24013377 PMCID: PMC3794781 DOI: 10.3390/ijms140918284] [Citation(s) in RCA: 171] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2013] [Revised: 07/31/2013] [Accepted: 08/09/2013] [Indexed: 01/19/2023] Open
Abstract
This article describes current experimental models of status epilepticus (SE) and neuronal injury for use in the screening of new therapeutic agents. Epilepsy is a common neurological disorder characterized by recurrent unprovoked seizures. SE is an emergency condition associated with continuous seizures lasting more than 30 min. It causes significant mortality and morbidity. SE can cause devastating damage to the brain leading to cognitive impairment and increased risk of epilepsy. Benzodiazepines are the first-line drugs for the treatment of SE, however, many people exhibit partial or complete resistance due to a breakdown of GABA inhibition. Therefore, new drugs with neuroprotective effects against the SE-induced neuronal injury and degeneration are desirable. Animal models are used to study the pathophysiology of SE and for the discovery of newer anticonvulsants. In SE paradigms, seizures are induced in rodents by chemical agents or by electrical stimulation of brain structures. Electrical stimulation includes perforant path and self-sustaining stimulation models. Pharmacological models include kainic acid, pilocarpine, flurothyl, organophosphates and other convulsants that induce SE in rodents. Neuronal injury occurs within the initial SE episode, and animals exhibit cognitive dysfunction and spontaneous seizures several weeks after this precipitating event. Current SE models have potential applications but have some limitations. In general, the experimental SE model should be analogous to the human seizure state and it should share very similar neuropathological mechanisms. The pilocarpine and diisopropylfluorophosphate models are associated with prolonged, diazepam-insensitive seizures and neurodegeneration and therefore represent paradigms of refractory SE. Novel mechanism-based or clinically relevant models are essential to identify new therapies for SE and neuroprotective interventions.
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Abstract
Febrile seizures are the most common type of childhood seizures, affecting 2% to 5% of children. A complex febrile seizure is one with focal onset, one that occurs more than once during a febrile illness, or one that lasts more than 10 to 15 minutes. Confusion still exists on the proper evaluation of a child presenting with a complex febrile seizure. There are ongoing research attempts to determine the link between complex febrile seizures and epilepsy. Further clarification and understanding of this disorder would be of great benefit to primary care providers and child neurologists.
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Affiliation(s)
- Anup D Patel
- Division of Child Neurology, Nationwide Children's Hospital, Columbus, OH 43205, USA.
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46
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Anand KS, Dhikav V. Hippocampus in health and disease: An overview. Ann Indian Acad Neurol 2013; 15:239-46. [PMID: 23349586 PMCID: PMC3548359 DOI: 10.4103/0972-2327.104323] [Citation(s) in RCA: 273] [Impact Index Per Article: 24.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2012] [Revised: 04/29/2012] [Accepted: 06/20/2012] [Indexed: 12/20/2022] Open
Abstract
Hippocampus is a complex brain structure embedded deep into temporal lobe. It has a major role in learning and memory. It is a plastic and vulnerable structure that gets damaged by a variety of stimuli. Studies have shown that it also gets affected in a variety of neurological and psychiatric disorders. In last decade or so, lot has been learnt about conditions that affect hippocampus and produce changes ranging from molecules to morphology. Progresses in radiological delineation, electrophysiology, and histochemical characterization have made it possible to study this archicerebral structure in greater detail. Present paper attempts to give an overview of hippocampus, both in health and diseases.
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Affiliation(s)
- Kuljeet Singh Anand
- Department of Neurology, Dr. Ram Manohar Lohia, PGIMER- Guru Gobind Singh Indraprasth University, New Delhi, India
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47
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Pediatric temporal lobe epilepsy surgery: resection based on etiology and anatomical location. Adv Tech Stand Neurosurg 2012. [PMID: 23250838 DOI: 10.1007/978-3-7091-1360-8_4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register]
Abstract
Advances in electrophysiological assessment with improved structural and functional neuroimaging have been very helpful in the use of surgery as a tool for drug-resistant epilepsy. Increasing interest in epilepsy surgery has had a major impact on adult patients; a refined evaluation process and new criteria for drug resistance combined with refined surgical techniques resulted in large surgical series in many centers. Pediatric surgery has lagged behind this evolution, possibly because of the diverse semiology and electrophysiology of pediatric epilepsy obscuring the focal nature of the seizures and frustrating the treatment of catastrophic epileptic syndromes specific to children. Unfortunately, refractory -epilepsy is more -devastating in children than in adults as it interferes with all aspects of neural development. Nevertheless, during the last few decades, the efforts of a small number of centers with encouraging results in pediatric epilepsy surgery have motivated pediatric neurologists to gain interest. Although well behind in the number of patients compared with that of adults, pediatric series are increasing exponentially. While temporal lobe epilepsy is the focus of interest in adults, with almost 70 % of resections in the temporal lobe, the pediatric epilepsy spectrum is different. Resective or functional surgery techniques devoted to resistant extratemporal epilepsy are the major improvements in pediatric epilepsy surgery. Temporal lobe epilepsy in adults has been studied extensively but only recently has begun to receive attention in children. Several aspects of temporal lobe epilepsy in childhood remain unclear or controversial in terms of seizure semiology and its pathology. This is reflected in the surgical treatment. Information on the major contributors to a favorable outcome, such as type or extent of resection, in terms of seizure control and morbidity is not available as in adult temporal lobe epilepsy. This chapter discusses the major discrepancies between adult and pediatric temporal lobe epilepsy and outlines the current concepts in surgical treatment. The resection strategy based on the different substrates at different locations in the temporal lobe causing seizures is emphasized with respect to available literature.
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Swijsen A, Nelissen K, Janssen D, Rigo JM, Hoogland G. Validation of reference genes for quantitative real-time PCR studies in the dentate gyrus after experimental febrile seizures. BMC Res Notes 2012; 5:685. [PMID: 23237195 PMCID: PMC3598510 DOI: 10.1186/1756-0500-5-685] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2012] [Accepted: 09/24/2012] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Quantitative real-time PCR (qPCR) is a commonly used technique to quantify gene expression levels. Validated normalization is essential to obtain reliable qPCR data. In that context, normalizing to multiple reference genes has become the most popular method. However, expression of reference genes may vary per tissue type, developmental stage and in response to experimental treatment. It is therefore imperative to determine stable reference genes for a specific sample set and experimental model. The present study was designed to validate potential reference genes in hippocampal tissue from rats that had experienced early-life febrile seizures (FS). To this end, we applied an established model in which FS were evoked by exposing 10-day old rat pups to heated air. One week later, we determined the expression stability of seven frequently used reference genes in the hippocampal dentate gyrus. RESULTS Gene expression stability of 18S rRNA, ActB, GusB, Arbp, Tbp, CycA and Rpl13A was tested using geNorm and Normfinder software. The ranking order of reference genes proposed by geNorm was not identical to that suggested by Normfinder. However, both algorithms indicated CycA, Rpl13A and Tbp as the most stable genes, whereas 18S rRNA and ActB were found to be the least stably expressed genes. CONCLUSIONS Our data demonstrate that the geometric averaging of at least CycA, Rpl13A and Tbp allows reliable interpretation of gene expression data in this experimental set-up. The results also show that ActB and 18S rRNA are not suited as reference genes in this model.
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Affiliation(s)
- Ann Swijsen
- BIOMED Research Institute, Hasselt University and transnational University Limburg, Agoralaan Bld C, 3590, Diepenbeek, Belgium
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Swijsen A, Avila A, Brône B, Janssen D, Hoogland G, Rigo JM. Experimental early-life febrile seizures induce changes in GABA(A) R-mediated neurotransmission in the dentate gyrus. Epilepsia 2012; 53:1968-77. [PMID: 23030508 DOI: 10.1111/j.1528-1167.2012.03694.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
PURPOSE Febrile seizures (FS), the most frequent seizure type during childhood, have been linked to temporal lobe epilepsy (TLE) in adulthood. Yet, underlying mechanisms are still largely unknown. Altered γ-aminobutyric acid (GABA)ergic neurotransmission in the dentate gyrus (DG) circuit has been hypothesized to be involved. This study aims at analyzing whether experimental FS change inhibitory synaptic input and postsynaptic GABA(A) R function in dentate granule cells. METHODS We applied an immature rat model of hyperthermia (HT)-induced FS. GABA(A) R-mediated neurotransmission was studied using whole-cell patch-clamp recordings from dentate granule neurons in hippocampal slices within 6-9 days post-HT. KEY FINDINGS Frequencies of spontaneous inhibitory postsynaptic currents (sIPSCs) were reduced in HT rats that had experienced seizures, whereas sIPSC amplitudes were enhanced. Whole-cell GABA responses revealed a doubled GABA(A) R sensitivity in dentate granule cells from HT animals, compared to that of normothermic (NT) controls. Analysis of sIPSCs and whole-cell GABA responses showed similar kinetics in postsynaptic GABA(A) Rs of HT and NT rats. quantitative real-time polymerase chain reaction (qPCR) experiments indicated changes in DG GABA(A) R subunit expression, which was most pronounced for the α3 subunit. SIGNIFICANCE The data support the hypothesis that FS persistently alter neuronal excitability.
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Affiliation(s)
- Ann Swijsen
- BIOMED Research Institute, Hasselt University/Transnational University Limburg, Diepenbeek, Belgium
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Swijsen A, Brône B, Rigo JM, Hoogland G. Long-lasting enhancement of GABA(A) receptor expression in newborn dentate granule cells after early-life febrile seizures. Dev Neurobiol 2012; 72:1516-27. [PMID: 22378685 DOI: 10.1002/dneu.22016] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2011] [Revised: 02/06/2012] [Accepted: 02/23/2012] [Indexed: 02/05/2023]
Abstract
Febrile seizures (FS) are the most common type of seizures in childhood and are suggested to play a role in the development of temporal lobe epilepsy (TLE). Animal studies demonstrated that experimental FS induce a long-lasting change in hippocampal excitability, resulting in enhanced seizure susceptibility. Hippocampal neurogenesis and altered ion channel expression have both been proposed as mechanisms underlying this decreased seizure threshold. The present study aimed to analyze whether dentate gyrus (DG) cells that were born after FS and matured for 8 weeks display an altered repertoire of ligand-gated ion channels. To this end, we applied an established model, in which FS are elicited in 10-day-old rat pups by hyperthermia (HT). Normothermia littermates served as controls. From postnatal day 11 (P11) to P16, rats were injected with bromodeoxyuridine (BrdU) to label dividing cells immediately following FS. At P66, we evaluated BrdU-labeled DG cells for coexpression with γ-aminobutyric acid-type A receptors (GABA(A)Rs) and N-methyl-D-aspartate receptors (NMDARs). In control animals, 40% of BrdU-labeled cells coexpressed GABA(A)R β2/3, whereas in rats that had experienced FS, 60% of BrdU-labeled cells also expressed GABA(A)R β2/3. The number of BrdU-NMDAR NR2A/B coexpressing cells was in both groups about 80% of BrdU-labeled cells. The results demonstrate that developmental seizures cause a long-term increase in GABA(A)R β2/3 expression in newborn DG cells. This may affect hippocampal physiology.
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Affiliation(s)
- Ann Swijsen
- Research Group Cell Physiology, BIOMED Research Institute, Hasselt University, Diepenbeek, Belgium
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