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Leung WL, Dill LK, Perucca P, O'Brien TJ, Casillas-Espinosa PM, Semple BD. Inherent Susceptibility to Acquired Epilepsy in Selectively Bred Rats Influences the Acute Response to Traumatic Brain Injury. J Neurotrauma 2023; 40:2174-2192. [PMID: 37221897 DOI: 10.1089/neu.2022.0463] [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] [Indexed: 05/25/2023] Open
Abstract
Traumatic brain injury (TBI) often causes seizures associated with a neuroinflammatory response and neurodegeneration. TBI responses may be influenced by differences between individuals at a genetic level, yet this concept remains understudied. Here, we asked whether inherent differences in one's vulnerability to acquired epilepsy would determine acute physiological and neuroinflammatory responses acutely after experimental TBI, by comparing selectively bred "seizure-prone" (FAST) rats with "seizure-resistant" (SLOW) rats, as well as control parental strains (Long Evans and Wistar rats). Eleven-week-old male rats received a moderate-to-severe lateral fluid percussion injury (LFPI) or sham surgery. Rats were assessed for acute injury indicators and neuromotor performance, and blood was serially collected. At 7 days post-injury, brains were collected for quantification of tissue atrophy by cresyl violet (CV) histology, and immunofluorescent staining of activated inflammatory cells. FAST rats showed an exacerbated physiological response acutely post-injury, with a 100% seizure rate and mortality within 24 h. Conversely, SLOW rats showed no acute seizures and a more rapid neuromotor recovery compared with controls. Brains from SLOW rats also showed only modest immunoreactivity for microglia/macrophages and astrocytes in the injured hemisphere compared with controls. Further, group differences were apparent between the control strains, with greater neuromotor deficits observed in Long Evans rats compared with Wistars post-TBI. Brain-injured Long Evans rats also showed the most pronounced inflammatory response to TBI across multiple brain regions, whereas Wistar rats showed the greatest extent of regional brain atrophy. These findings indicate that differential genetic predisposition to develop acquired epilepsy (i.e., FAST vs. SLOW rat strains) determines acute responses after experimental TBI. Differences in the neuropathological response to TBI between commonly used control rat strains is also a novel finding, and an important consideration for future study design. Our results support further investigation into whether genetic predisposition to acute seizures predicts the chronic outcomes after TBI, including the development of post-traumatic epilepsy.
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Affiliation(s)
- Wai Lam Leung
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Larissa K Dill
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Victoria, Australia
- Department of Neurology, Alfred Health, Melbourne, Victoria, Australia
- The Perron Institute for Neurological and Translational Science, Nedlands, Western Australia, Australia
| | - Piero Perucca
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Victoria, Australia
- Department of Neurology, Alfred Health, Melbourne, Victoria, Australia
- Epilepsy Research Centre, Department of Medicine (Austin Health), The University of Melbourne, Heidelberg, Victoria, Australia
- Bladin-Berkovic Comprehensive Epilepsy Program, Department of Neurology, Austin Health, Heidelberg, Victoria, Australia
- Department of Neurology, The Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Terence J O'Brien
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Victoria, Australia
- Department of Neurology, Alfred Health, Melbourne, Victoria, Australia
- Department of Neurology, The Royal Melbourne Hospital, Parkville, Victoria, Australia
- Department of Medicine (Royal Melbourne Hospital), The University of Melbourne, Parkville, Victoria, Australia
| | - Pablo M Casillas-Espinosa
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Victoria, Australia
- Department of Neurology, Alfred Health, Melbourne, Victoria, Australia
- Department of Medicine (Royal Melbourne Hospital), The University of Melbourne, Parkville, Victoria, Australia
| | - Bridgette D Semple
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Victoria, Australia
- Department of Neurology, Alfred Health, Melbourne, Victoria, Australia
- Department of Medicine (Royal Melbourne Hospital), The University of Melbourne, Parkville, Victoria, Australia
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Ahmed S, Pande AH, Sharma SS. Therapeutic potential of ApoE-mimetic peptides in CNS disorders: Current perspective. Exp Neurol 2022; 353:114051. [DOI: 10.1016/j.expneurol.2022.114051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 02/23/2022] [Accepted: 03/14/2022] [Indexed: 02/07/2023]
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Tarcin G, Aksu Uzunhan T, Kacar A, Kucur M, Saltik S. The relationship between epileptic seizure and melatonin in children. Epilepsy Behav 2020; 112:107345. [PMID: 32861898 DOI: 10.1016/j.yebeh.2020.107345] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 07/08/2020] [Accepted: 07/14/2020] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Studies about the relationship between epileptic seizures (ESs) and melatonin are limited in children and have been performed in heterogeneous patient groups and with different methods. In this study, it was planned to investigate this relationship according to seizure and epilepsy characteristics. MATERIAL AND METHODS In 91 children with ES, serum melatonin levels were measured within half an hour following the seizure and on a seizure-free day. Seizures were categorized according to the diagnosis, semiology, etiology, duration, electroencephalography (EEG) findings, and response to treatment. Melatonin levels were compared between each group and control group. In addition, basal melatonin levels of 21 patients with electrical status epilepticus in sleep (ESES) were compared with a control group. RESULTS Basal melatonin levels were found to be lower in children with ESs and ESES group compared with the control group (p < 0.001, p < 0.001). Likewise, similar results were obtained in subgroups except for remote symptomatic etiology, severe EEG findings, and refractory epilepsy. No significant difference was observed between basal and postseizure levels of melatonin. CONCLUSION This is the first study to reveal the relationship between ESs and basal melatonin levels according to all the characteristics of seizure and epilepsy in the largest patient group. It also demonstrates the need for more detailed studies on the role of melatonin in the pathogenesis of both ESs and ESES, which may provide a basis for a future treatment.
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Affiliation(s)
- Gurkan Tarcin
- Istanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, Department of Pediatrics, Istanbul, Turkey.
| | - Tugce Aksu Uzunhan
- Okmeydanı Training and Research Hospital, Department of Pediatric Neurology, Istanbul, Turkey
| | - Alper Kacar
- Okmeydanı Training and Research Hospital, Department of Pediatric Emergency, Istanbul, Turkey
| | - Mine Kucur
- Istanbul University-Cerrahpasa Cerrahpasa Faculty of Medicine, Department of Medical Biochemistry, Istanbul, Turkey
| | - Sema Saltik
- Istanbul University-Cerrahpasa Cerrahpasa Faculty of Medicine, Department of Pediatric Neurology, Istanbul, Turkey
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Liang Y, Zhou Z, Wang H, Cheng X, Zhong S, Zhao C. Association of apolipoprotein E genotypes with epilepsy risk: A systematic review and meta-analysis. Epilepsy Behav 2019; 98:27-35. [PMID: 31299529 DOI: 10.1016/j.yebeh.2019.06.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 06/12/2019] [Accepted: 06/12/2019] [Indexed: 01/16/2023]
Abstract
OBJECTIVE The objective of this study was to identify the association between certain genotypes or alleles of the APOE (Apolipoprotein E) gene and the epilepsy risk. METHODS All studies on human APOE genotypes associated with epilepsy were included. Separate meta-analyses were conducted between the patients with epilepsy and the control group from the following three aspects: ε4 carriers or ε2 carriers vs ε3/ε3 (the ε2/ε4 genotype was excluded), ε4 carriers vs ε2 carriers, and five genotypes vs ε3/ε3. The subgroup analysis was conducted on the ethnicity, the control group was healthy or not, and type of epilepsy. RESULTS Nine studies with 2210 individuals were included. Compared with ε3/ε3 genotype, ε4 carriers increased the epilepsy risk (odds ratios [ORs]: 1.27; 95% confidence intervals [CI]: 1.01 to 1.59; P = 0.042), while ε2 carriers had no association with epilepsy risk (OR: 0.88; 95% CI: 0.66 to 1.18; P = 0.184). The risk of epilepsy was 1.45 times greater in ε4 carriers compared with ε2 carriers (OR: 1.45; 95% CI: 1.02 to 2.04; P = 0.037). When the number of APOE ε4 allele increased, the ORs increased progressively (no ε4 alleles, OR: 0.88, 95% CI: 0.66 to 1.18; one ε4 allele, OR: 1.25, 95% CI: 0.99 to 1.57; two ε4 alleles, OR: 1.84, 95% CI: 0.83 to 4.10). Apolipoprotein E ε4 carriers had a higher epilepsy risk in the population without primary diseases (OR: 1.43; 95% CI: 1.09 to 1.88), and a higher risk in Asian populations (OR: 1.67; 95% CI: 1.12 to 2.49). CONCLUSIONS Apolipoprotein E ε4 allele genotype was associated with an increased epilepsy risk, which was more prominent in the Asian and the population without primary diseases. These findings may be used to guide the directions of prevention and treatment on epilepsy. Larger clinical studies are needed.
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Affiliation(s)
- Yifan Liang
- Department of Neurology, The First Hospital of China Medical University, Shenyang, China
| | - Zhike Zhou
- Department of Geriatrics, The First Hospital of China Medical University, Shenyang, China
| | - Huibin Wang
- Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xi Cheng
- Department of Neurology, The First Hospital of China Medical University, Shenyang, China
| | - Shanshan Zhong
- Department of Neurology, The First Hospital of China Medical University, Shenyang, China
| | - Chuansheng Zhao
- Department of Neurology, The First Hospital of China Medical University, Shenyang, China.
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Leung WL, Casillas-Espinosa P, Sharma P, Perucca P, Powell K, O'Brien TJ, Semple BD. An animal model of genetic predisposition to develop acquired epileptogenesis: The FAST and SLOW rats. Epilepsia 2019; 60:2023-2036. [PMID: 31468516 DOI: 10.1111/epi.16329] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 08/06/2019] [Accepted: 08/06/2019] [Indexed: 12/12/2022]
Abstract
Epidemiological data and gene association studies suggest a genetic predisposition to developing epilepsy after an acquired brain insult, such as traumatic brain injury. An improved understanding of genetic determinants of vulnerability is imperative for early disease diagnosis and prognosis prediction, with flow-on benefits for the development of targeted antiepileptogenic treatments as well as optimal clinical trial design. In the laboratory, one approach to investigate why some individuals are more vulnerable to acquired epilepsy than others is to examine unique rodent models exhibiting either vulnerability or resistance to epileptogenesis. This review focuses on the most well-characterized of these models, the FAST (seizure-prone) and SLOW (seizure-resistant) rat strains, which were derived by selective breeding for differential amygdala electrical kindling rates. We describe how these strains differ in their seizure profiles, neuroanatomy, and neurobehavioral phenotypes, both at baseline and after a brain insult, with this knowledge proving fruitful to identify common pathological abnormalities associated with seizure susceptibility and psychiatric comorbidities. It is important to note that accruing data on strain differences in multiple biological processes provides insight into why some individuals may be more vulnerable to epileptogenesis, although future studies are evidently needed to identify the precise molecular and genetic risk factors. Together, the FAST and SLOW rat strains, and other similar experimental models, are invaluable neurobiological tools to investigate the effect of genetic background on acquired epilepsy risk, as well as the poorly understood relationship between epilepsy development and associated comorbidities.
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Affiliation(s)
- Wai Lam Leung
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Vic., Australia
| | - Pablo Casillas-Espinosa
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Vic., Australia.,Department of Medicine (Royal Melbourne Hospital), The University of Melbourne, Parkville, Vic., Australia
| | - Pragati Sharma
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Vic., Australia.,Department of Medicine (Royal Melbourne Hospital), The University of Melbourne, Parkville, Vic., Australia.,Department of Neurology, Alfred Health, Melbourne, Vic., Australia
| | - Piero Perucca
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Vic., Australia.,Department of Medicine (Royal Melbourne Hospital), The University of Melbourne, Parkville, Vic., Australia.,Department of Neurology, Alfred Health, Melbourne, Vic., Australia.,Department of Neurology, Royal Melbourne Hospital, Parkville, Vic., Australia
| | - Kim Powell
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Vic., Australia.,Department of Medicine (Royal Melbourne Hospital), The University of Melbourne, Parkville, Vic., Australia
| | - Terence J O'Brien
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Vic., Australia.,Department of Medicine (Royal Melbourne Hospital), The University of Melbourne, Parkville, Vic., Australia.,Department of Neurology, Alfred Health, Melbourne, Vic., Australia.,Department of Neurology, Royal Melbourne Hospital, Parkville, Vic., Australia
| | - Bridgette D Semple
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Vic., Australia.,Department of Medicine (Royal Melbourne Hospital), The University of Melbourne, Parkville, Vic., Australia
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Sharma P, Wright DK, Johnston LA, Powell KL, Wlodek ME, Shultz SR, O'Brien TJ, Gilby KL. Differences in white matter structure between seizure prone (FAST) and seizure resistant (SLOW) rat strains. Neurobiol Dis 2017; 104:33-40. [DOI: 10.1016/j.nbd.2017.04.022] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Revised: 03/20/2017] [Accepted: 04/27/2017] [Indexed: 02/09/2023] Open
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Sharma P, Dedeurwaerdere S, Vandenberg MAD, Fang K, Johnston LA, Shultz SR, O'Brien TJ, Gilby KL. Neuroanatomical differences in FAST and SLOW rat strains with differential vulnerability to kindling and behavioral comorbidities. Epilepsy Behav 2016; 65:42-48. [PMID: 27866083 DOI: 10.1016/j.yebeh.2016.08.022] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Revised: 08/21/2016] [Accepted: 08/22/2016] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The neurobiological factors underlying a predisposition towards developing epilepsy and its common behavioral comorbidities are poorly understood. FAST rats are a strain that has been selectively bred for enhanced vulnerability to kindling, while the SLOW strain has been bred to be resistant to kindling. FAST rats also exhibit behavioral traits reminiscent of those observed in neurodevelopmental disorders (autism spectrum disorder (ASD)/attention-deficit/hyperactivity disorder (ADHD)) commonly comorbid with epilepsy. In this study, we aimed to investigate neuroanatomical differences between these strains that may be associated with a differential vulnerability towards these interrelated disorders. METHODS Ex vivo high-resolution magnetic resonance imaging on adult male FAST and SLOW rat brains was performed to identify morphological differences in regions of interest between the two strains. Behavioral examination using open-field, water consumption, and restraint tests was also conducted on a subgroup of these rats to document their differential ASD/ADHD-like behavior phenotype. Using optical stereological methods, the volume of cerebellar granule, white matter, and molecular layer and number of Purkinje cells were compared in a separate cohort of adult FAST and SLOW rats. RESULTS Behavioral testing demonstrated hyperactivity, impulsivity, and polydipsia in FAST versus SLOW rats, consistent with an ASD/ADHD-like phenotype. Magnetic resonance imaging analysis identified brain structural differences in FAST compared with SLOW rats, including increased volume of the cerebrum, corpus callosum, third ventricle, and posterior inferior cerebellum, while decreased volume of the anterior cerebellar vermis. Stereological measurements on histological slices indicated significantly larger white matter layer volume, reduced number of Purkinje cells, and smaller molecular layer volume in the cerebellum in FAST versus SLOW rats. SIGNIFICANCE These findings provide evidence of structural differences between the brains of FAST and SLOW rats that may be mechanistically related to their differential vulnerability to kindling and associated comorbid ASD/ADHD-like behaviors.
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Affiliation(s)
- Pragati Sharma
- Department of Medicine, Royal Melbourne Hospital, The Melbourne Brain Centre, University of Melbourne, Melbourne, Australia.
| | - Stefanie Dedeurwaerdere
- Department of Medicine, Royal Melbourne Hospital, The Melbourne Brain Centre, University of Melbourne, Melbourne, Australia; Department of Translational Neurosciences, University of Antwerp, Antwerp, Belgium
| | | | - Ke Fang
- Florey Institute of Neuroscience and Mental Health, Melbourne, Australia
| | - Leigh A Johnston
- Department of Electrical and Electronic Engineering, University of Melbourne, Melbourne, Australia; Florey Institute of Neuroscience and Mental Health, Melbourne, Australia
| | - Sandy R Shultz
- Department of Medicine, Royal Melbourne Hospital, The Melbourne Brain Centre, University of Melbourne, Melbourne, Australia
| | - Terence J O'Brien
- Department of Medicine, Royal Melbourne Hospital, The Melbourne Brain Centre, University of Melbourne, Melbourne, Australia
| | - Krista L Gilby
- Department of Medicine, Royal Melbourne Hospital, The Melbourne Brain Centre, University of Melbourne, Melbourne, Australia
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Natsume J, Ogawa C, Fukasawa T, Yamamoto H, Ishihara N, Sakaguchi Y, Ito Y, Takeuchi T, Azuma Y, Ando N, Kubota T, Tsuji T, Kawai H, Naganawa S, Kidokoro H. White Matter Abnormality Correlates with Developmental and Seizure Outcomes in West Syndrome of Unknown Etiology. AJNR Am J Neuroradiol 2015; 37:698-705. [PMID: 26585267 DOI: 10.3174/ajnr.a4589] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Accepted: 08/26/2015] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE West syndrome is an epileptic encephalopathy characterized by epileptic spasms, a specific pattern on electroencephalography of hypsarrhythmia, and developmental regression. Our aim was to assess white matter abnormalities in West syndrome of unknown etiology. We hypothesized that diffusion tensor imaging reveals white matter abnormalities, especially in patients with poor seizure and developmental outcomes. MATERIALS AND METHODS We enrolled 23 patients with new-onset West syndrome of unknown etiology. DTI was performed at 12 and 24 months of age. Fractional anisotropy images were compared with those of controls by using tract-based spatial statistics. We compared axial, radial, and mean diffusivity between patients and controls in the fractional anisotropy skeleton. We determined correlations of these parameters with developmental quotient, electroencephalography, and seizure outcomes. We also compared DTI with hypometabolism on fluorodeoxyglucose positron-emission tomography. RESULTS At 12 months of age, patients showed widespread fractional anisotropy reductions and higher radial diffusivity in the fractional anisotropy skeleton with a significant difference on tract-based spatial statistics. The developmental quotient at 12 months of age correlated positively with fractional anisotropy and negatively with radial and mean diffusivity. Patients with seizure and abnormal findings on electroencephalography after initial treatments had lower fractional anisotropy and higher radial diffusivity. At 24 months, although tract-based spatial statistics did not show significant differences between patients and controls, tract-based spatial statistics in the 10 patients with a developmental quotient of <70 had significant fractional anisotropy reduction. In patients with unilateral temporal lobe hypometabolism on PET, tract-based spatial statistics showed greater fractional anisotropy reduction in the temporal lobe ipsilateral to the side of PET hypometabolism. CONCLUSIONS Diffuse abnormal findings on DTI at 12 months of age suggest delayed myelination as a key factor underlying abnormal findings on DTI. Conversely, asymmetric abnormal findings on DTI at 24 months may reflect underlying focal pathologies.
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Affiliation(s)
- J Natsume
- From the Departments of Pediatrics (J.N., C.O., H.Y., N.I., Y.S., Y.I., T. Takeuchi, Y.A., H. Kidokoro) Developmental Disability Medicine (J.N.) Brain and Mind Research Center (J.N., H. Kidokoro), Nagoya University, Nagoya, Japan
| | - C Ogawa
- From the Departments of Pediatrics (J.N., C.O., H.Y., N.I., Y.S., Y.I., T. Takeuchi, Y.A., H. Kidokoro)
| | - T Fukasawa
- Department of Pediatrics (T.F., T.K.), Anjo Kosei Hospital, Anjo, Japan
| | - H Yamamoto
- From the Departments of Pediatrics (J.N., C.O., H.Y., N.I., Y.S., Y.I., T. Takeuchi, Y.A., H. Kidokoro)
| | - N Ishihara
- From the Departments of Pediatrics (J.N., C.O., H.Y., N.I., Y.S., Y.I., T. Takeuchi, Y.A., H. Kidokoro)
| | - Y Sakaguchi
- From the Departments of Pediatrics (J.N., C.O., H.Y., N.I., Y.S., Y.I., T. Takeuchi, Y.A., H. Kidokoro)
| | - Y Ito
- From the Departments of Pediatrics (J.N., C.O., H.Y., N.I., Y.S., Y.I., T. Takeuchi, Y.A., H. Kidokoro)
| | - T Takeuchi
- From the Departments of Pediatrics (J.N., C.O., H.Y., N.I., Y.S., Y.I., T. Takeuchi, Y.A., H. Kidokoro)
| | - Y Azuma
- From the Departments of Pediatrics (J.N., C.O., H.Y., N.I., Y.S., Y.I., T. Takeuchi, Y.A., H. Kidokoro)
| | - N Ando
- Department of Pediatrics and Neonatology (N.A.), Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - T Kubota
- Department of Pediatrics (T.F., T.K.), Anjo Kosei Hospital, Anjo, Japan
| | - T Tsuji
- Department of Pediatrics (T. Tsuji), Okazaki City Hospital, Okazaki, Japan
| | - H Kawai
- Radiology (H. Kawai, S.N.), Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - S Naganawa
- Radiology (H. Kawai, S.N.), Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - H Kidokoro
- From the Departments of Pediatrics (J.N., C.O., H.Y., N.I., Y.S., Y.I., T. Takeuchi, Y.A., H. Kidokoro) Brain and Mind Research Center (J.N., H. Kidokoro), Nagoya University, Nagoya, Japan
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Natsume J, Maeda N, Itomi K, Kidokoro H, Ishihara N, Takada H, Okumura A, Kubota T, Miura K, Aso K, Morikawa T, Kato K, Negoro T, Watanabe K. PET in infancy predicts long-term outcome during adolescence in cryptogenic West syndrome. AJNR Am J Neuroradiol 2014; 35:1580-5. [PMID: 24676006 DOI: 10.3174/ajnr.a3899] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Developmental and seizure outcomes in patients with cryptogenic West syndrome are variable. Our aim was to clarify the relationship between FDG-PET findings in infancy and long-term seizure and developmental outcome in cryptogenic West syndrome. MATERIALS AND METHODS From 1991 to 1999, we prospectively performed FDG-PET from the onset of cryptogenic West syndrome in 27 patients. PET was performed at onset and at 10 months of age. In 2012, we evaluated the educational status, psychomotor development, and seizure outcome in 23 of the 27 patients (13-22 years of age). The correlation between PET findings and outcome was evaluated. RESULTS At onset, PET showed hypometabolism in 13 patients (57%). The second PET after the initial treatment revealed cortical hypometabolism in 7 patients (30%). While hypometabolism at onset disappeared on the second PET in 9 patients, it was newly revealed in 3 patients on the second PET. In 2012, seven patients had persistent or recurrent seizures. Eight patients had intellectual impairment. The first PET did not correlate with seizure or developmental outcome. Five of 7 patients (71%) with hypometabolism seen on the second PET had persistent or recurrent seizures, while 14 of 16 (88%) patients with normal findings on the second PET were free of seizures. Five of 7 patients (71%) showing hypometabolism on the second PET had intellectual impairment. Thirteen of 16 (81%) patients with normal findings on the second PET showed normal intelligence. A significant correlation was found between the second PET and long-term seizure (P = .01) or developmental outcome (P = .03). CONCLUSIONS Cortical hypometabolism is not permanent; it changes with clinical symptoms. Hypometabolism after initial treatment predicts long-term seizures and poor developmental outcome.
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Affiliation(s)
- J Natsume
- From the Departments of Pediatrics (J.N., N.M., H.K., N.I., H.T., K.M., T.N.)
| | - N Maeda
- From the Departments of Pediatrics (J.N., N.M., H.K., N.I., H.T., K.M., T.N.)
| | - K Itomi
- Department of Neurology (K.I.), Aichi Children's Health and Medical Center, Obu, Japan
| | - H Kidokoro
- From the Departments of Pediatrics (J.N., N.M., H.K., N.I., H.T., K.M., T.N.)
| | - N Ishihara
- From the Departments of Pediatrics (J.N., N.M., H.K., N.I., H.T., K.M., T.N.)
| | - H Takada
- From the Departments of Pediatrics (J.N., N.M., H.K., N.I., H.T., K.M., T.N.)
| | - A Okumura
- Department of Pediatrics (A.O.), Juntendo University Faculty of Medicine, Tokyo, Japan
| | - T Kubota
- Department of Pediatrics (T.K.), Anjo Kosei Hospital, Anjo, Japan
| | - K Miura
- From the Departments of Pediatrics (J.N., N.M., H.K., N.I., H.T., K.M., T.N.)
| | - K Aso
- Department of Pediatrics (K.A.), Aichi Prefecture Medical Welfare Center of Aoitori, Nagoya, Japan
| | | | - K Kato
- Radiological and Medical Laboratory Sciences (K.K.), Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - T Negoro
- From the Departments of Pediatrics (J.N., N.M., H.K., N.I., H.T., K.M., T.N.)
| | - K Watanabe
- Faculty of Health and Medical Sciences (K.W.), Aichi Shukutoku University, Nagakute, Japan
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Gilby KL, O'Brien TJ. Epilepsy, autism, and neurodevelopment: kindling a shared vulnerability? Epilepsy Behav 2013; 26:370-4. [PMID: 23415480 DOI: 10.1016/j.yebeh.2012.11.002] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2012] [Accepted: 11/05/2012] [Indexed: 10/27/2022]
Abstract
Epilepsy and autism spectrum disorder (ASD) share many primary and comorbid symptoms. The degree of clinical overlap is believed to signify a 'spectrum of vulnerability' that arises out of an early common dysfunction in central nervous system development. However, research into the underlying, and potentially shared, etiopathological mechanisms is challenging given the extensive comorbidity profiles. Adding to the degree of difficulty is the frequently evolving recompartmentalization of diagnostic criteria within each disorder. This review discusses potential preclinical strategies that, through the use of animal models, are designed to gain insight into the biological basis of the overlap between epilepsy and autism and to foster a rapid clinical translation of the insights gained.
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Affiliation(s)
- Krista L Gilby
- Department of Medicine (Royal Melbourne Hospital), University of Melbourne, Parkville, VIC, Australia.
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Hunter JM, Cirrito JR, Restivo JL, Kinley RD, Sullivan PM, Holtzman DM, Koger D, Delong C, Lin S, Zhao L, Liu F, Bales K, Paul SM. Emergence of a seizure phenotype in aged apolipoprotein epsilon 4 targeted replacement mice. Brain Res 2012; 1467:120-32. [PMID: 22682924 DOI: 10.1016/j.brainres.2012.05.048] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2012] [Revised: 05/22/2012] [Accepted: 05/23/2012] [Indexed: 01/29/2023]
Abstract
The apolipoprotein ε4 allele is the strongest genetic risk factor for late-onset Alzheimer's disease (AD) and is associated with earlier age of onset. The incidence of spontaneous seizures has been reported to be increased in sporadic AD as well as in the early onset autosomal dominant forms of AD. We now report the emergence of a seizure phenotype in aged apolipoprotein E4 (apoE4) targeted replacement (TR) mice but not in age-matched apoE2 TR or apoE3 TR mice. Tonic-clonic seizures developed spontaneously after 5 months of age in apoE4 TR mice and are triggered by mild stress. Female mice had increased seizure penetrance compared to male mice, but had slightly reduced overall seizure severity. The majority of seizures were characterized by head and neck jerks, but 25% of aged apoE4 TR mice had more severe tonic-clonic seizures which occasionally progressed to tonic extension and death. Aged apoE4 TR mice progressed through pentylenetetrazol-induced seizure stages more rapidly than did apoE3 TR and apoE2 TR mice. Electroencephalographic (EEG) recordings revealed more frequent bursts of synchronous theta activity in the hippocampus of apoE4 TR mice than in apoE2 TR or apoE3 TR mice. Cortical EEG recordings also revealed sharp spikes and other abnormalities in apoE4 TR mice. Taken together, these findings demonstrate the emergence of an age-dependent seizure phenotype in old apoE4 TR mice in the absence of human amyloid-β peptide (Aβ) overexpression, suggesting increased central nervous system neural network excitability.
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Affiliation(s)
- Jesse M Hunter
- Neuroscience Discovery, Eli Lilly and Co., Indianapolis, IN 46285, USA.
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McIntyre DC, Gilby KL. Genetically seizure-prone or seizure-resistant phenotypes and their associated behavioral comorbidities. Epilepsia 2007; 48 Suppl 9:30-2. [DOI: 10.1111/j.1528-1167.2007.01398.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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