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Maurer-Morelli CV, de Vasconcellos JF, Bruxel EM, Rocha CS, do Canto AM, Tedeschi H, Yasuda CL, Cendes F, Lopes-Cendes I. Gene expression profile suggests different mechanisms underlying sporadic and familial mesial temporal lobe epilepsy. Exp Biol Med (Maywood) 2022; 247:2233-2250. [PMID: 36259630 PMCID: PMC9899983 DOI: 10.1177/15353702221126666] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Most patients with pharmacoresistant mesial temporal lobe epilepsy (MTLE) have hippocampal sclerosis on the postoperative histopathological examination. Although most patients with MTLE do not refer to a family history of the disease, familial forms of MTLE have been reported. We studied surgical specimens from patients with MTLE who had epilepsy surgery for medically intractable seizures. We assessed and compared gene expression profiles of the tissue lesion found in patients with familial MTLE (n = 3) and sporadic MTLE (n = 5). In addition, we used data from control hippocampi obtained from a public database (n = 7). We obtained expression profiles using the Human Genome U133 Plus 2.0 (Affymetrix) microarray platform. Overall, the molecular profile identified in familial MTLE differed from that in sporadic MTLE. In the tissue of patients with familial MTLE, we found an over-representation of the biological pathways related to protein response, mRNA processing, and synaptic plasticity and function. In sporadic MTLE, the gene expression profile suggests that the inflammatory response is highly activated. In addition, we found enrichment of gene sets involved in inflammatory cytokines and mediators and chemokine receptor pathways in both groups. However, in sporadic MTLE, we also found enrichment of epidermal growth factor signaling, prostaglandin synthesis and regulation, and microglia pathogen phagocytosis pathways. Furthermore, based on the gene expression signatures, we identified different potential compounds to treat patients with familial and sporadic MTLE. To our knowledge, this is the first study assessing the mRNA profile in surgical tissue obtained from patients with familial MTLE and comparing it with sporadic MTLE. Our results clearly show that, despite phenotypic similarities, both forms of MTLE present distinct molecular signatures, thus suggesting different underlying molecular mechanisms that may require distinct therapeutic approaches.
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Affiliation(s)
- Claudia V Maurer-Morelli
- Department of Translational Medicine,
School of Medical Sciences, University of Campinas (UNICAMP), Campinas 13083-888,
Brazil,Brazilian Institute of Neuroscience and
Neurotechnology (BRAINN), Campinas 13083-888, Brazil
| | - Jaira F de Vasconcellos
- Department of Translational Medicine,
School of Medical Sciences, University of Campinas (UNICAMP), Campinas 13083-888,
Brazil,Department of Biology, James Madison
University, Harrisonburg, VA 22807, USA
| | - Estela M Bruxel
- Department of Translational Medicine,
School of Medical Sciences, University of Campinas (UNICAMP), Campinas 13083-888,
Brazil,Brazilian Institute of Neuroscience and
Neurotechnology (BRAINN), Campinas 13083-888, Brazil
| | - Cristiane S Rocha
- Department of Translational Medicine,
School of Medical Sciences, University of Campinas (UNICAMP), Campinas 13083-888,
Brazil,Brazilian Institute of Neuroscience and
Neurotechnology (BRAINN), Campinas 13083-888, Brazil
| | - Amanda M do Canto
- Department of Translational Medicine,
School of Medical Sciences, University of Campinas (UNICAMP), Campinas 13083-888,
Brazil,Brazilian Institute of Neuroscience and
Neurotechnology (BRAINN), Campinas 13083-888, Brazil
| | - Helder Tedeschi
- Department of Neurology, School of
Medical Sciences, University of Campinas (UNICAMP), Campinas 13083-887, Brazil
| | - Clarissa L Yasuda
- Brazilian Institute of Neuroscience and
Neurotechnology (BRAINN), Campinas 13083-888, Brazil,Department of Neurology, School of
Medical Sciences, University of Campinas (UNICAMP), Campinas 13083-887, Brazil
| | - Fernando Cendes
- Brazilian Institute of Neuroscience and
Neurotechnology (BRAINN), Campinas 13083-888, Brazil,Department of Neurology, School of
Medical Sciences, University of Campinas (UNICAMP), Campinas 13083-887, Brazil
| | - Iscia Lopes-Cendes
- Department of Translational Medicine,
School of Medical Sciences, University of Campinas (UNICAMP), Campinas 13083-888,
Brazil,Brazilian Institute of Neuroscience and
Neurotechnology (BRAINN), Campinas 13083-888, Brazil,Iscia Lopes-Cendes.
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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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Liu C, Qiao XZ, Wei ZH, Cao M, Wu ZY, Deng YC. Molecular typing of familial temporal lobe epilepsy. World J Psychiatry 2022; 12:98-107. [PMID: 35111581 PMCID: PMC8783165 DOI: 10.5498/wjp.v12.i1.98] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 09/25/2021] [Accepted: 12/02/2021] [Indexed: 02/06/2023] Open
Abstract
The pathogenesis of temporal lobe epilepsy (TLE) was originally considered to be acquired. However, some reports showed that TLE was clustered in some families, indicating a genetic etiology. With the popularity of genetic testing technology, eleven different types of familial TLE (FTLE), including ETL1-ETL11, have been reported, of which ETL9-ETL11 had not yet been included in the OMIM database. These types of FTLE were caused by different genes/Loci and had distinct characteristics. ETL1, ETL7 and ETL10 were characterized by auditory, visual and aphasia seizures, leading to the diagnosis of familial lateral TLE. ETL2, ETL3 and ETL6 showed prominent autonomic symptom and automatism with or without hippocampal abnormalities, indicating a mesial temporal origin. Febrile seizures were common in FTLEs such as ETL2, ETL5, ETL6 and ETL11. ETL4 was diagnosed as occipitotemporal lobe epilepsy with a high incidence of migraine and visual aura. Considering the diversity and complexity of the symptoms of TLE, neurologists enquiring about the family history of epilepsy should ask whether the relatives of the proband had experienced unnoticeable seizures and whether there is a family history of other neurological diseases carefully. Most FTLE patients had a good prognosis with or without anti-seizure medication treatment, with the exception of patients with heterozygous mutations of the CPA6 gene. The pathogenic mechanism was diverse among these genes and spans disturbances of neuron development, differentiation and synaptic signaling. In this article, we describe the research progress on eleven different types of FTLE. The precise molecular typing of FTLE would facilitate the diagnosis and treatment of FTLE and genetic counseling for this disorder.
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Affiliation(s)
- Chao Liu
- Department of Neurology, The First Affiliated Hospital of Air Force Medical University, Xi'an 710032, Shaanxi Province, China
| | - Xiao-Zhi Qiao
- Department of Neurology, The First Affiliated Hospital of Air Force Medical University, Xi'an 710032, Shaanxi Province, China
| | - Zi-Han Wei
- Department of Neurology, The First Affiliated Hospital of Air Force Medical University, Xi'an 710032, Shaanxi Province, China
| | - Mi Cao
- Department of Neurology, The First Affiliated Hospital of Air Force Medical University, Xi'an 710032, Shaanxi Province, China
| | - Zhen-Yu Wu
- Department of Anatomy, Histology and Embryology and K.K. Leung Brain Research Centre, School of Basic Medicine, Air Force Medical University, Xi'an 710032, Shaanxi Province, China
| | - Yan-Chun Deng
- Department of Neurology, The First Affiliated Hospital of Air Force Medical University, Xi'an 710032, Shaanxi Province, China
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Shallie PD, Sulaiman AI, Oladejo MK, Shallie OF, Naicker T. Early glutathione intervention educed positive correlation between VGLUT1 expression and spatial memory in the Nω-nitro-L-arginine methyl rat model of IUGR. IBRO Neurosci Rep 2021; 10:136-141. [PMID: 34179867 PMCID: PMC8211915 DOI: 10.1016/j.ibneur.2021.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Accepted: 02/03/2021] [Indexed: 12/02/2022] Open
Abstract
INTRODUCTION One of the most compelling causes of perinatal mortality and morbidity is intrauterine growth restriction (IUGR). IUGR is linked with numerous health challenges that last lifelong, including neurodevelopmental impairment and a high incidence of brain dysfunction. There is mounting evidence that places the glutamatergic system at the center of the neurobiology and treatment of neurological diseases. Therefore, this study investigated the effects of postnatal glutathione intervention on the spatial memory and the expressions of vesicular glutamate transporter 1 (VGLUT1) in the hippocampus and the cerebellar cortex of Nω-nitro-L-arginine methyl (L-NAME)-induced rat model of IUGR. MATERIALS AND METHOD Twelve adult female rats were divided into Control and L-NAME groups; each containing 6 female rats. The control group received a single daily dose of normal saline while the L-NAME group was administered 50 mg/kg L-NAME daily from gestational day 9 until parturition. Offspring of the control rats were given free access to feeds while offspring from the L-NAME group were assigned into 3 groups: G1: given free access to feeds; G2 and G3 were administered 1.5 mg/kg body weight of glutathione from postnatal day (PND) 4-9 and PND 25-31 respectively. At the end of the intervention, Y-maze was conducted, and the rats euthanized on PND 35. The brain sections were processed, and immunofluorescence staining was performed using the Vectafluor Excel R.T.U Antibody kit. RESULTS IUGR caused a significant 31.1% decrease in spontaneous alternation percentage (SAP), while early treatment with glutathione at PND 4-9 significantly (p < 0.01) increased SAP, while late treatment at PND 25-9 significantly decreased SAP compared to IUGR group. Furthermore, IUGR caused significant (p < 0.001) downregulation in corrected total cell fluorescence (CTCF) of VGLUT1 in both the hippocampus and cerebellar cortex. While treatment with glutathione caused upregulation in CTCF of VGLUT1 in the hippocampus and the cerebellar cortex. CONCLUSION Our results showed that early intervention with glutathione has significant therapeutic potential via upregulation of VGLUT1 expression in both hippocampus and cerebellar cortex, which positively correlated with enhanced spatial memory in IUGR rat model.
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Affiliation(s)
| | | | | | | | - Thajasvarie Naicker
- Optics and Imaging Centre, University of KwaZulu-Natal., Durban, South Africa
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Guzmán-Jiménez DE, Campos JB, Venegas-Vega CA, Sánchez MA, Velasco AL. Familial mesial temporal lobe epilepsy in Mexico: Inheritance pattern and clinical features. Epilepsy Res 2020; 167:106450. [PMID: 32949980 DOI: 10.1016/j.eplepsyres.2020.106450] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 08/11/2020] [Accepted: 08/21/2020] [Indexed: 11/19/2022]
Abstract
PURPOSE The objectives of this study were to determine the inheritance pattern by which familial mesial temporal lobe epilepsy (FMTLE) is segregated in Mexican families, and to identify if there was an association between the clinical characteristics and the inheritance pattern. METHOD We included a total of 25 families with two or more members affected with MTLE during two years and elaborated a family pedigree for each family. The inheritance pattern was classified as autosomal dominant (AD) or autosomal recessive (AR), considering the affected members. We used statistical analysis association and differences between clinical characteristics and inheritance patterns. RESULTS The affected families with the AD pattern were 15.7 fold times more likely to start seizures at 5 years of age or earlier than families with AR pattern, OR = 15.7 (IC 95% = 1.9-128.9). We observed a predominance and greater déjà vu association (64.4% vs 31.3%; p = 0.021), OR = 3.9 (CI 95% = 1.1-13.5) in patients with AD versus AR pattern. Finally, we identified that patients with AD pattern had a likelihood of presenting emotional alterations 5.6 times higher than AR (OR = 5.6, IC = 1.1-27.5). CONCLUSION FMTLE is a heterogeneous syndrome, both phenotypically and genotypically; thus, our findings may be helpful for clinical use to perform an early diagnosis, to provide timely treatment, and to prevent comorbidities associated to this disease. However, in order to identify the possible genetic causes underlying these inheritance patterns, the use of molecular studies is necessary.
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Affiliation(s)
- Diana Elena Guzmán-Jiménez
- Epilepsy Clinic, General Hospital of México "Dr. Eduardo Liceaga", Dr. Balmis 148, 06720, Doctores, Mexico City, Mexico; Programa de Doctorado en Ciencias Biomédicas, División de Estudios de Posgrado, Universidad Nacional Autónoma de México (UNAM), Universidad 3000, 04510, Mexico City, Mexico.
| | - Jaime Berumen Campos
- Medical School, Universidad Nacional Autónoma de México, Mexico City, Mexico; Experimental Medicine Unit, Universidad Nacional Autónoma de México, in the General Hospital of México "Dr. Eduardo Liceaga", Dr. Balmis 148, 06720, Doctores, Mexico City, Mexico.
| | - Carlos Alberto Venegas-Vega
- Medical School, Universidad Nacional Autónoma de México, Mexico City, Mexico; Genetic Unit, General Hospital of México "Dr. Eduardo Liceaga", Dr. Balmis 148, 06720, Doctores, Mexico City, Mexico.
| | - Mariana Alejandre Sánchez
- Epilepsy Clinic, General Hospital of México "Dr. Eduardo Liceaga", Dr. Balmis 148, 06720, Doctores, Mexico City, Mexico.
| | - Ana Luisa Velasco
- Epilepsy Clinic, General Hospital of México "Dr. Eduardo Liceaga", Dr. Balmis 148, 06720, Doctores, Mexico City, Mexico.
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Alese OO, Rakgantsho C, Mkhize NV, Zulu S, Mabandla MV. Prolonged febrile seizure history exacerbates seizure severity in a pentylenetetrazole rat model of epilepsy. Brain Res Bull 2019; 155:137-144. [PMID: 31837458 DOI: 10.1016/j.brainresbull.2019.11.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 11/07/2019] [Accepted: 11/30/2019] [Indexed: 12/29/2022]
Abstract
Epilepsy is a debilitating neurological illness that affects all aspect of an individual life. Despite advancement in research there is little reduction in the incidence of this disease. Prolonged febrile seizure (PFS) has been linked to epilepsy however, the pathophysiology of this is still not clear. We therefore looked at the effect of PFS on the development of epilepsy in a pentylenetetrazole (PTZ) rat model of epilepsy. A total of 42 male Sprague-Dawley rats were used for the experiment. On post-natal day (PND) 14, PFS was induced in 14 rats. This was followed by the induction of epilepsy in the 14 PFS animal and 14 animals from the remaining 28 rats by an initial injection of PTZ at a dose of 60 mg/kg on day one followed by 35 mg/kg on alternate day until kindle. We looked at the effect of PFS on the onset and the stage of convulsion at kindle. We also observed it effect on the hippocampal glial fibrillary acidic protein (GFAP), synaptophysin and metabotropic glutamate receptor 3 (mGluR3) expression measured with immunofluorescence, LI Cor Tissue florescence and immunohistochemistry respectively. Our study showed that PFS reduced seizure threshold by decreasing the time it took animals to kindle and also increased the stage of convulsion. The hippocampal GFAP, synaptophysin and mGluR3 expressions where upregulated in PTZ rats with PFS history when compared to PTZ rats alone.These findings indicated that PFS may increase the severity of epilepsy and alter brain expression of GFAP, synaptophysin and mGluR3 proteins.
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Affiliation(s)
- Oluwole Ojo Alese
- Department of Human Physiology, College of Health Sciences, University of Kwazulu-Natal, South Africa.
| | - Cleopatra Rakgantsho
- Department of Human Physiology, College of Health Sciences, University of Kwazulu-Natal, South Africa
| | - Nombuso V Mkhize
- Department of Human Physiology, College of Health Sciences, University of Kwazulu-Natal, South Africa
| | - Simo Zulu
- Department of Human Physiology, College of Health Sciences, University of Kwazulu-Natal, South Africa
| | - Musa V Mabandla
- Department of Human Physiology, College of Health Sciences, University of Kwazulu-Natal, South Africa
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Upregulation of hippocampal synaptophysin, GFAP and mGluR3 in a pilocarpine rat model of epilepsy with history of prolonged febrile seizure. J Chem Neuroanat 2019; 100:101659. [DOI: 10.1016/j.jchemneu.2019.101659] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Revised: 05/20/2019] [Accepted: 06/22/2019] [Indexed: 12/12/2022]
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Song M, Tian F, Xia H, Xie Y. Repulsive guidance molecule a suppresses seizures and mossy fiber sprouting via the FAK‑p120RasGAP‑Ras signaling pathway. Mol Med Rep 2019; 19:3255-3262. [PMID: 30816469 DOI: 10.3892/mmr.2019.9951] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Accepted: 01/21/2019] [Indexed: 11/05/2022] Open
Abstract
Repulsive guidance molecule a (RGMa) is a membrane‑associated glycoprotein that regulates axonal guidance and inhibits axon outgrowth. In our previous study, we hypothesized that RGMa may be involved in temporal lobe epilepsy (TLE) via the repulsive guidance molecule a (RGMa)‑focal adhesion kinase (FAK)‑Ras signaling pathway. To investigate the role of RGMa in epilepsy, recombinant RGMa protein and FAK inhibitor 14 was intracerebroventricularly injected into a pentylenetetrazol (PTZ) kindling model and Timm staining, co‑immunoprecipitation and western blotting analyses were subsequently performed. The results of the present study revealed that intracerebroventricular injection of recombinant RGMa protein reduced the phosphorylation of FAK (Tyr397) and intracerebroventricular injection of FAK inhibitor 14 reduced the interaction between FAK and p120GAP, as wells as Ras expression. Recombinant RGMa protein and FAK inhibitor 14 exerted seizure‑suppressant effects; however, recombinant RGMa protein but not FAK inhibitor 14 suppressed mossy fiber sprouting in the PTZ kindling model. Collectively, these results demonstrated that RGMa may be considered as a potential therapeutic agent for epilepsy, and that RGMa may exert the aforementioned biological effects partly via the FAK‑p120GAP‑Ras signaling pathway.
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Affiliation(s)
- Mingyu Song
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan 410008, P.R. China
| | - Fafa Tian
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan 410008, P.R. China
| | - Huang Xia
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan 410008, P.R. China
| | - Yuanyuan Xie
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan 410008, P.R. China
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Yu Y, Hasegawa D, Hamamoto Y, Mizoguchi S, Kuwabara T, Fujiwara-Igarashi A, Tsuboi M, Chambers JK, Fujita M, Uchida K. Neuropathologic features of the hippocampus and amygdala in cats with familial spontaneous epilepsy. Am J Vet Res 2018; 79:324-332. [PMID: 29466043 DOI: 10.2460/ajvr.79.3.324] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To investigate epilepsy-related neuropathologic changes in cats of a familial spontaneous epileptic strain (ie, familial spontaneous epileptic cats [FSECs]). ANIMALS 6 FSECs, 9 age-matched unrelated healthy control cats, and 2 nonaffected (without clinical seizures)dams and 1 nonaffected sire of FSECs. PROCEDURES Immunohistochemical analyses were used to evaluate hippocampal sclerosis, amygdaloid sclerosis, mossy fiber sprouting, and granule cell pathological changes. Values were compared between FSECs and control cats. RESULTS Significantly fewer neurons without gliosis were detected in the third subregion of the cornu ammonis (CA) of the dorsal and ventral aspects of the hippocampus as well as the central nucleus of the amygdala in FSECs versus control cats. Gliosis without neuronal loss was also observed in the CA4 subregion of the ventral aspect of the hippocampus. No changes in mossy fiber sprouting and granule cell pathological changes were detected. Moreover, similar changes were observed in the dams and sire without clinical seizures, although to a lesser extent. CONCLUSIONS AND CLINICAL RELEVANCE Findings suggested that the lower numbers of neurons in the CA3 subregion of the hippocampus and the central nucleus of the amygdala were endophenotypes of familial spontaneous epilepsy in cats. In contrast to results of other veterinary medicine reports, severe epilepsy-related neuropathologic changes (eg, hippocampal sclerosis, amygdaloid sclerosis, mossy fiber sprouting, and granule cell pathological changes) were not detected in FSECs. Despite the use of a small number of cats with infrequent seizures, these findings contributed new insights on the pathophysiologic mechanisms of genetic-related epilepsy in cats.
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Regner GG, Pereira P, Leffa DT, de Oliveira C, Vercelino R, Fregni F, Torres ILS. Preclinical to Clinical Translation of Studies of Transcranial Direct-Current Stimulation in the Treatment of Epilepsy: A Systematic Review. Front Neurosci 2018; 12:189. [PMID: 29623027 PMCID: PMC5874505 DOI: 10.3389/fnins.2018.00189] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Accepted: 03/08/2018] [Indexed: 12/09/2022] Open
Abstract
Epilepsy is a chronic brain syndrome characterized by recurrent seizures resulting from excessive neuronal discharges. Despite the development of various new antiepileptic drugs, many patients are refractory to treatment and report side effects. Non-invasive methods of brain stimulation, such as transcranial direct current stimulation (tDCS), have been tested as alternative approaches to directly modulate the excitability of epileptogenic neural circuits. Although some pilot and initial clinical studies have shown positive results, there is still uncertainty regarding the next steps of investigation in this field. Therefore, we reviewed preclinical and clinical studies using the following framework: (1) preclinical studies that have been successfully translated to clinical studies, (2) preclinical studies that have failed to be translated to clinical studies, and (3) clinical findings that were not previously tested in preclinical studies. We searched PubMed, Web of Science, Embase, and SciELO (2002–2017) using the keywords “tDCS,” “epilepsy,” “clinical trials,” and “animal models.” Our initial search resulted in 64 articles. After applying inclusion and exclusion criteria, we screened 17 full-text articles to extract findings about the efficacy of tDCS, with respect to the therapeutic framework used and the resulting reduction in seizures and epileptiform patterns. We found that few preclinical findings have been translated into clinical research (number of sessions and effects on seizure frequency) and that most findings have not been tested clinically (effects of tDCS on status epilepticus and absence epilepsy, neuroprotective effects in the hippocampus, and combined use with specific medications). Finally, considering that clinical studies on tDCS have been conducted for several epileptic syndromes, most were not previously tested in preclinical studies (Rasmussen's encephalitis, drug resistant epilepsy, and hippocampal sclerosis-induced epilepsy). Overall, most studies report positive findings. However, it is important to underscore that a successful preclinical study may not indicate success in a clinical study, considering the differences highlighted herein. Although most studies report significant findings, there are still important insights from preclinical work that must be tested clinically. Understanding these factors may improve the evidence for the potential use of this technique as a clinical tool in the treatment of epilepsy.
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Affiliation(s)
- Gabriela G Regner
- Laboratory of Neuropharmacology and Preclinical Toxicology, Institute of Basic Health Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Laboratory of Pain Pharmacology and Neuromodulation, Preclinical Studies - Pharmacology Department, Institute of Basic Health Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Postgraduate Program in Biological Sciences, Pharmacology and Therapeutics, Institute of Basic Health Sciences, Universidade Federal Rio Grande do Sul, Porto Alegre, Brazil
| | - Patrícia Pereira
- Laboratory of Neuropharmacology and Preclinical Toxicology, Institute of Basic Health Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Postgraduate Program in Biological Sciences, Pharmacology and Therapeutics, Institute of Basic Health Sciences, Universidade Federal Rio Grande do Sul, Porto Alegre, Brazil
| | - Douglas T Leffa
- Laboratory of Pain Pharmacology and Neuromodulation, Preclinical Studies - Pharmacology Department, Institute of Basic Health Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Postgraduate Program in Medical Sciences, School of Medicine Universidade Federal Rio Grande do Sul, Porto Alegre, Brazil
| | - Carla de Oliveira
- Laboratory of Pain Pharmacology and Neuromodulation, Preclinical Studies - Pharmacology Department, Institute of Basic Health Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Postgraduate Program in Medical Sciences, School of Medicine Universidade Federal Rio Grande do Sul, Porto Alegre, Brazil
| | - Rafael Vercelino
- Laboratory of Pain Pharmacology and Neuromodulation, Preclinical Studies - Pharmacology Department, Institute of Basic Health Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Centro Universitário FADERGS, Health and Wellness School Laureate International Universities, Porto Alegre, Brazil
| | - Felipe Fregni
- Laboratory of Neuromodulation, Department of Physical Medicine & Rehabilitation, Spaulding Rehabilitation Hospital and Massachusetts General Hospital, Harvard University, Boston, MA, United States
| | - Iraci L S Torres
- Laboratory of Pain Pharmacology and Neuromodulation, Preclinical Studies - Pharmacology Department, Institute of Basic Health Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Postgraduate Program in Biological Sciences, Pharmacology and Therapeutics, Institute of Basic Health Sciences, Universidade Federal Rio Grande do Sul, Porto Alegre, Brazil.,Postgraduate Program in Medical Sciences, School of Medicine Universidade Federal Rio Grande do Sul, Porto Alegre, Brazil
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11
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Esteves I, Lopes-Aguiar C, Rossignoli M, Ruggiero R, Broggini A, Bueno-Junior L, Kandratavicius L, Monteiro M, Romcy-Pereira R, Leite J. Chronic nicotine attenuates behavioral and synaptic plasticity impairments in a streptozotocin model of Alzheimer’s disease. Neuroscience 2017; 353:87-97. [DOI: 10.1016/j.neuroscience.2017.04.011] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Revised: 04/04/2017] [Accepted: 04/10/2017] [Indexed: 01/23/2023]
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12
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Tezer FI, Xasiyev F, Soylemezoglu F, Bilginer B, Oguz KK, Saygi S. Clinical and electrophysiological findings in mesial temporal lobe epilepsy with hippocampal sclerosis, based on the recent histopathological classifications. Epilepsy Res 2016; 127:50-54. [DOI: 10.1016/j.eplepsyres.2016.08.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Revised: 07/04/2016] [Accepted: 08/14/2016] [Indexed: 11/25/2022]
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Choe M, Cortés E, Vonsattel JPG, Kuo SH, Faust PL, Louis ED. Purkinje cell loss in essential tremor: Random sampling quantification and nearest neighbor analysis. Mov Disord 2016; 31:393-401. [PMID: 26861543 DOI: 10.1002/mds.26490] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Revised: 10/20/2015] [Accepted: 10/26/2015] [Indexed: 12/24/2022] Open
Abstract
INTRODUCTION Purkinje cell loss has been documented in some, although not all, postmortem studies of essential tremor. Hence, there is considerable controversy concerning the presence of Purkinje cell loss in this disease. To date, few studies have been performed. METHODS Over the past 8 years, we have assembled 50 prospectively studied cases and 25 age-matched controls; none were reported in our previous large series of 33 essential tremor and 21 controls. In addition to methods used in previous studies, the current study used a random sampling approach to quantify Purkinje cells along the Purkinje cell layer with a mean of 217 sites examined in each specimen, allowing for extensive sampling of the Purkinje cell layer within the section. For the first time, we also quantified the distance between Purkinje cell bodies-a nearest neighbor analysis. RESULTS In the Purkinje cell count data collected from fifteen 100 × fields, cases had lower counts than controls in all three counting criteria (cell bodies, nuclei, and nucleoli; all P < 0.001). Purkinje cell linear density was also lower in cases than controls (all P < 0.001). Purkinje cell linear density obtained by random sampling was similarly lower in cases than controls in all three counting criteria (cell bodies, nuclei, and nucleoli, all P ≤ 0.005). In agreement with the quantitative Purkinje cell counts, the mean distance from one Purkinje cell body to another Purkinje cell body along the Purkinje cell layer was greater in cases than controls (P = 0.002). CONCLUSIONS These data provide support for the neurodegeneration of cerebellar Purkinje cells in essential tremor.
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Affiliation(s)
- Matthew Choe
- Department of Pathology and Cell Biology, Columbia University Medical Center and the New York Presbyterian Hospital, New York, New York, USA
| | - Etty Cortés
- Department of Pathology and Cell Biology, Columbia University Medical Center and the New York Presbyterian Hospital, New York, New York, USA.,Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, New York, USA
| | - Jean-Paul G Vonsattel
- Department of Pathology and Cell Biology, Columbia University Medical Center and the New York Presbyterian Hospital, New York, New York, USA.,Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, New York, USA
| | - Sheng-Han Kuo
- Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, New York, USA
| | - Phyllis L Faust
- Department of Pathology and Cell Biology, Columbia University Medical Center and the New York Presbyterian Hospital, New York, New York, USA
| | - Elan D Louis
- Department of Neurology, Yale School of Medicine, Yale University, New Haven, Connecticut, USA.,Department of Chronic Disease Epidemiology, Yale School of Medicine, Yale University, New Haven, Connecticut, USA.,Center for Neuroepidemiology and Clinical Neurological Research, Yale School of Medicine, Yale University, New Haven, Connecticut, USA
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Song MY, Tian FF, Dang J, Huang WJ, Guo JL. Possible Role of Protein CPG15 in Hippocampal Mossy Fiber Sprouting Under Conditions of Pentylenetetrazole Kindling. NEUROPHYSIOLOGY+ 2015. [DOI: 10.1007/s11062-015-9533-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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15
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Kubota BY, Coan AC, Yasuda CL, Cendes F. T2 hyperintense signal in patients with temporal lobe epilepsy with MRI signs of hippocampal sclerosis and in patients with temporal lobe epilepsy with normal MRI. Epilepsy Behav 2015; 46:103-8. [PMID: 25936278 DOI: 10.1016/j.yebeh.2015.04.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2014] [Revised: 03/17/2015] [Accepted: 04/01/2015] [Indexed: 12/27/2022]
Abstract
BACKGROUND Increased MRI T2 signal is commonly present not only in the hippocampus but also in other temporal structures of patients with temporal lobe epilepsy (TLE), and it is associated with histological abnormalities related to the epileptogenic lesion. OBJECTIVE This study aimed to verify the distribution of T2 increased signal in temporal lobe structures and its correlations with clinical characteristics of TLE patients with (TLE-HS) or without (TLE-NL) MRI signs of hippocampal sclerosis. METHODS We selected 203 consecutive patients: 124 with TLE-HS and 79 with TLE-NL. Healthy controls (N=59) were used as a comparison group/comparative group. T2 multiecho images obtained via a 3-T MRI were evaluated with in-house software. T2 signal decays were computed from five original echoes in regions of interest in the hippocampus, amygdala, and white matter of the anterior temporal lobe. Values higher than 2 standard deviations from the mean of controls were considered as abnormal. RESULTS T2 signal increase was observed in the hippocampus in 78% of patients with TLE-HS and in 17% of patients with TLE-NL; in the amygdala in 13% of patients with TLE-HS and in 14% of patients with TLE-NL; and in the temporal lobe white matter in 22% of patients with TLE-HS and in 8% of patients with TLE-NL. Group analysis demonstrated a significant difference in the distribution of the T2 relaxation times of the hippocampus (ANOVA, p<0.0001), amygdala (p=0.003), and temporal lobe white matter (p<0.0001) ipsilateral to the epileptogenic zone for patients with TLE-HS compared with controls but only for the amygdala (p=0.029) and temporal lobe white matter (ANOVA, p=0.025) for patients with TLE-NL compared with controls. The average signal from the hippocampus ipsilateral to the epileptogenic zone was significantly higher in patients with no family history of epilepsy (two-sample T-test, p=0.005). CONCLUSION Increased T2 signal occurs in different temporal structures of patients with TLE-HS and in patients with TLE-NL. The hippocampal hyperintense signal is more pronounced in patients without family history of epilepsy and is influenced by earlier seizure onset. These changes in T2 signal may be associated with structural abnormalities related to the epileptogenic zone or to the nature of the initial precipitating injury in patients with TLE.
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Affiliation(s)
- Bruno Yukio Kubota
- Neuroimaging Laboratory, Department of Neurology, University of Campinas, Campinas, SP, Brazil.
| | - Ana Carolina Coan
- Neuroimaging Laboratory, Department of Neurology, University of Campinas, Campinas, SP, Brazil.
| | - Clarissa Lin Yasuda
- Neuroimaging Laboratory, Department of Neurology, University of Campinas, Campinas, SP, Brazil.
| | - Fernando Cendes
- Neuroimaging Laboratory, Department of Neurology, University of Campinas, Campinas, SP, Brazil.
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Song MY, Tian FF, Wang YZ, Huang X, Guo JL, Ding DX. Potential roles of the RGMa-FAK-Ras pathway in hippocampal mossy fiber sprouting in the pentylenetetrazole kindling model. Mol Med Rep 2014; 11:1738-44. [PMID: 25420768 PMCID: PMC4270322 DOI: 10.3892/mmr.2014.2993] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2014] [Accepted: 08/01/2014] [Indexed: 11/23/2022] Open
Abstract
Mossy fiber sprouting (MFS) is a unique feature of chronic epilepsy. However, the molecular signals underlying MFS are still unclear. The repulsive guidance molecule A (RGMa) appears to contribute to axon growth and axonal guidance, and may exert its biological effects by dephosphorylating focal adhesion kinase (FAK) at Tyr397, then regulating the activation of Ras. The objective of this study was to explore the expression patterns of RGMa, FAK (Tyr397) and Ras in epileptogenesis, and their correlation with MFS. The epileptic models were established by intraperitoneal pentylenetetrazole (PTZ) injection of Sprague-Dawley rats. At 3 days and at 1, 2, 4 and 6 weeks after the first PTZ injection, Timm staining was scored at different time points in the CA3 region of the hippocampus and dentate gyrus. The protein levels of RGMa, FAK (Tyr397) and Ras were analyzed at different time points in the CA3 region of the hippocampus using immunofluorescence, immunohistochemistry and western blot analysis. Compared with the control (saline-injected) group, the expression of RGMa in the CA3 area was significantly downregulated (P<0.05) from 3 days and still maintained the low expression at 6 weeks in the PTZ group. The expression of FAK (Tyr397) and Ras was upregulated (P<0.05) in the PTZ groups. The Timm score in the CA3 region was significantly higher than that in the control group at different time points and reached a peak at 4 weeks. In the CA3 region, no obvious distinction was observed at the different time points in the control group. To the best of our knowledge, these are the first results to indicate that the RGMa-FAK-Ras pathway may be involved in MFS and the development of temporal lobe epilepsy.
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Affiliation(s)
- Ming-Yu Song
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan 410008, P.R. China
| | - Fa-Fa Tian
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan 410008, P.R. China
| | - Yu-Zhong Wang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan 410008, P.R. China
| | - Xia Huang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan 410008, P.R. China
| | - Jia-Ling Guo
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan 410008, P.R. China
| | - Dong-Xue Ding
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan 410008, P.R. China
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17
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Quantification of subfield pathology in hippocampal sclerosis: A systematic review and meta-analysis. Epilepsy Res 2014; 108:1279-85. [DOI: 10.1016/j.eplepsyres.2014.07.003] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2014] [Accepted: 07/15/2014] [Indexed: 10/25/2022]
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18
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Cendes F, Sakamoto AC, Spreafico R, Bingaman W, Becker AJ. Epilepsies associated with hippocampal sclerosis. Acta Neuropathol 2014; 128:21-37. [PMID: 24823761 DOI: 10.1007/s00401-014-1292-0] [Citation(s) in RCA: 93] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2014] [Revised: 05/05/2014] [Accepted: 05/06/2014] [Indexed: 01/22/2023]
Abstract
Hippocampal sclerosis (HS) is considered the most frequent neuropathological finding in patients with mesial temporal lobe epilepsy (MTLE). Hippocampal specimens of pharmacoresistant MTLE patients that underwent epilepsy surgery for seizure control reveal the characteristic pattern of segmental neuronal cell loss and concomitant astrogliosis. However, classification issues of hippocampal lesion patterns have been a matter of intense debate. International consensus classification has only recently provided significant progress for comparisons of neurosurgical and clinic-pathological series between different centers. The respective four-tiered classification system of the International League Against Epilepsy subdivides HS into three types and includes a term of "gliosis only, no-HS". Future studies will be necessary to investigate whether each of these subtypes of HS may be related to different etiological factors or with postoperative memory and seizure outcome. Molecular studies have provided potential deeper insights into the pathogenesis of HS and MTLE on the basis of epilepsy-surgical hippocampal specimens and corresponding animal models. These include channelopathies, activation of NMDA receptors, and other conditions related to Ca(2+) influx into neurons, the imbalance of Ca(2+)-binding proteins, acquired channelopathies that increase neuronal excitability, paraneoplastic and non-paraneoplastic inflammatory events, and epigenetic regulation promoting or facilitating hippocampal epileptogenesis. Genetic predisposition for HS is clearly suggested by the high incidence of family history in patients with HS, and by familial MTLE with HS. So far, it is clear that HS is multifactorial and there is no individual pathogenic factor either necessary or sufficient to generate this intriguing histopathological condition. The obvious variety of pathogenetic combinations underlying HS may explain the multitude of clinical presentations, different responses to clinical and surgical treatment. We believe that the stratification of neuropathological patterns can help to characterize specific clinic-pathological entities and predict the postsurgical seizure control in an improved fashion.
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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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20
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HUANG WENJIAO, TIAN FAFA, CHEN JINMEI, GUO TINGHUI, MA YUNFENG, FANG JIA, DANG JING, SONG MINGYU. GSK-3β may be involved in hippocampal mossy fiber sprouting in the pentylenetetrazole-kindling model. Mol Med Rep 2013; 8:1337-42. [DOI: 10.3892/mmr.2013.1660] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2013] [Accepted: 08/16/2013] [Indexed: 11/06/2022] Open
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Chen N, Liu C, Yan N, Hu W, Zhang JG, Ge Y, Meng FG. A macaque model of mesial temporal lobe epilepsy induced by unilateral intrahippocampal injection of kainic Acid. PLoS One 2013; 8:e72336. [PMID: 23991095 PMCID: PMC3753347 DOI: 10.1371/journal.pone.0072336] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2013] [Accepted: 07/08/2013] [Indexed: 11/18/2022] Open
Abstract
Objective In order to better investigate the cause/effect relationships of human mesial temporal lobe epilepsy (mTLE), we hereby describe a new non-human primate model of mTLE. Methods Ten macaques were studied and divided into 2 groups: saline control group (n = 4) and kainic acid (KA) injection group (n = 6). All macaques were implanted bilaterally with subdural electrodes over temporal cortex and depth electrodes in CA3 hippocampal region. KA was stereotaxically injected into the right hippocampus of macaques. All animals were monitored by video and electrocorticography (ECoG) to assess status epilepticus (SE) and subsequent spontaneous recurrent seizures (SRS). Additionally, in order to evaluate brain injury produced by SE or SRS, we used both neuroimaging, including magnetic resonance image (MRI) & magnetic resonance spectroscopy (MRS), and histological pathology, including Nissl stainning and glial fibrillary acid protein (GFAP) immunostaining. Results The typical seizures were observed in the KA-injected animal model. Hippocampal sclerosis could be found by MRI & MRS. Hematoxylin and eosin (H&E) staining and GFAP immunostaining showed neuronal loss, proliferation of glial cells, formation of glial scars, and hippocampal atrophy. Electron microscopic analysis of hippocampal tissues revealed neuronal pyknosis, partial ribosome depolymerization, an abnormal reduction in rough endoplasmic reticulum size, expansion of Golgi vesicles and swollen star-shaped cells. Furthermore, we reported that KA was able to induce SE followed by SRS after a variable period of time. Similar to human mTLE, brain damage is confined to the hippocampus. Accordingly, hippocampal volume is in positive correlations with the neuronal cells count in the CA3, especially the ratio of neuron/glial cell. Conclusions The results suggest that a model of mTLE can be developed in macaques by intra-hippocampal injection of KA. Brain damage is confined to the hippocampus which is similar to the human mTLE. The hippocampal volume correlates with the extension of the hippocampal damage.
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Affiliation(s)
- Ning Chen
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Chong Liu
- Beijing Neurosurgical Institute, Capital Medical University, Beijing, China
| | - Na Yan
- School of Public Health and Family Medicine, Capital Medical University, Beijing, China
| | - Wei Hu
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, United States of America
| | - Jian-guo Zhang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yan Ge
- Beijing Neurosurgical Institute, Capital Medical University, Beijing, China
| | - Fan-gang Meng
- Beijing Neurosurgical Institute, Capital Medical University, Beijing, China
- * E-mail:
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Xia Y, Luo C, Dai S, Yao D. Increased EphA/ephrinA expression in hippocampus of pilocarpine treated mouse. Epilepsy Res 2013; 105:20-9. [PMID: 23352741 DOI: 10.1016/j.eplepsyres.2013.01.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2011] [Revised: 12/17/2012] [Accepted: 01/03/2013] [Indexed: 01/21/2023]
Abstract
PURPOSE EphA family receptor tyrosine kinases and their ephrinA ligands are involved in patterning axonal connections during brain development. Although it has been evidenced that these molecules continue to play a key role in synaptic reorganization and plasticity in normal and injured adult brains, their effect still remains unclear during epileptogenesis. Temporal lobe epilepsy (TLE) is the most common form of adult focal epilepsy and often associates with sclerosis of the hippocampus and mossy fiber sprouting (MFS). The purpose of this study is to evaluate the relationship between EphA/ephrinA molecules and epileptogenesis after status epilepticus (SE). METHOD A mouse model of chronic temporal lobe epilepsy was prepared by intraperitoneal administration of pilocarpine. EphAs/ephrinAs expression levels of the mouse hippocampus areas were detected at different time points after SE by PCR, in situ hybridization and immunohistochemistry. Mossy fiber sprouting was estimated by Neo-Timm staining. RESULT EphAs/ephrinAs were widely distributed in the hippocampus area. EphA10 and ephrinA4 were increased significantly following epileptogenesis, and mossy fiber sprouting appeared after SE. CONCLUSION The up-regulation of EphA/ephrinA expression after SE suggests that they are involved in the pilocarpine-induced epileptogenesis.
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Affiliation(s)
- Yang Xia
- Key Laboratory for NeuroInformation of Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 610054, China.
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Blair RDG. Temporal lobe epilepsy semiology. EPILEPSY RESEARCH AND TREATMENT 2012; 2012:751510. [PMID: 22957241 PMCID: PMC3420439 DOI: 10.1155/2012/751510] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/22/2011] [Accepted: 12/26/2011] [Indexed: 11/17/2022]
Abstract
Epilepsy represents a multifaceted group of disorders divided into two broad categories, partial and generalized, based on the seizure onset zone. The identification of the neuroanatomic site of seizure onset depends on delineation of seizure semiology by a careful history together with video-EEG, and a variety of neuroimaging technologies such as MRI, fMRI, FDG-PET, MEG, or invasive intracranial EEG recording. Temporal lobe epilepsy (TLE) is the commonest form of focal epilepsy and represents almost 2/3 of cases of intractable epilepsy managed surgically. A history of febrile seizures (especially complex febrile seizures) is common in TLE and is frequently associated with mesial temporal sclerosis (the commonest form of TLE). Seizure auras occur in many TLE patients and often exhibit features that are relatively specific for TLE but few are of lateralizing value. Automatisms, however, often have lateralizing significance. Careful study of seizure semiology remains invaluable in addressing the search for the seizure onset zone.
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Affiliation(s)
- Robert D. G. Blair
- Division of Neurology, Department of Medicine, Credit Valley Hospital, University of Toronto, Mississauga, ON, Canada L5M 2N1
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Affiliation(s)
- Ciğdem Ozkara
- Department of Neurology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey.
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Das SR, Mechanic-Hamilton D, Pluta J, Korczykowski M, Detre JA, Yushkevich PA. Heterogeneity of functional activation during memory encoding across hippocampal subfields in temporal lobe epilepsy. Neuroimage 2011; 58:1121-30. [PMID: 21763431 DOI: 10.1016/j.neuroimage.2011.06.085] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2011] [Accepted: 06/28/2011] [Indexed: 11/27/2022] Open
Abstract
Pathology studies have shown that the anatomical subregions of the hippocampal formation are differentially affected in various neurological disorders, including temporal lobe epilepsy (TLE). Analysis of structure and function within these subregions using magnetic resonance imaging (MRI) has the potential to generate insights on disease associations as well as normative brain function. In this study, an atlas-based normalization method (Yushkevich, P.A., Avants, B.B., Pluta, J., Das, S., Minkoff, D., Mechanic-Hamilton, D., Glynn, S., Pickup, S., Liu, W., Gee, J.C., Grossman, M., Detre, J.A., 2009. A high-resolution computational atlas of the human hippocampus from postmortem magnetic resonance imaging at 9.4 T. NeuroImage 44 (2), 385-398) was used to label hippocampal subregions, making it possible to examine subfield-level functional activation during an episodic memory task in two different cohorts of healthy controls and subjects diagnosed with intractable unilateral TLE. We report, for the first time, functional activation patterns within hippocampal subfields in TLE. We detected group differences in subfield activation between patients and controls as well as inter-hemispheric activation asymmetry within subfields in patients, with dentate gyrus (DG) and the anterior hippocampus region showing the greatest effects. DG was also found to be more active than CA1 in controls, but not in patients' epileptogenic side. These preliminary results will encourage further research on the utility of subfield-based biomarkers in TLE.
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Affiliation(s)
- Sandhitsu R Das
- Penn Image Computing and Science Laboratory (PICSL), Department of Radiology, University of Pennsylvania, PA, USA.
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Pereno GL, Beltramino CA. Timed changes of synaptic zinc, synaptophysin and MAP2 in medial extended amygdala of epileptic animals are suggestive of reactive neuroplasticity. Brain Res 2010; 1328:130-8. [PMID: 20144592 DOI: 10.1016/j.brainres.2010.01.087] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2009] [Revised: 01/28/2010] [Accepted: 01/29/2010] [Indexed: 11/17/2022]
Abstract
Repeated seizures induce permanent alterations of the brain in experimental models and patients with intractable temporal lobe epilepsy (TLE), which is a common form of epilepsy in humans. Together with cell loss and gliosis in many brain regions, synaptic reorganization is observed principally in the hippocampus. However, in the amygdala this synaptic reorganization has been not studied. The changes in Zn density, synaptophysin and MAP(2) as markers of reactive synaptogenesis in medial extended amygdala induced by kainic acid (KA) as a model of TLE was studied. Adult male rats (n=6) were perfused at 10 days, 1, 2, 3 and 4 months after KA i.p. injection (9 mg/kg). Controls were injected with saline. The brains were processed by the Timm's method to reveal synaptic Zn and analyzed by densitometry. Immunohistochemistry was used to reveal synaptophysin and MAP(2) expression. A two-way ANOVA was used for statistics, with a P<0.05 as a significance limit. Normal dark staining was seen in all medial extended amygdala subdivisions of control animals. At 10 days post KA injection a dramatic loss of staining was observed. A slow but steady recovery of Zn density can be followed in the 4 month period studied. Parallel, from 10 days to 2 months stronger synaptophysin expression could be observed, whereas MAP(2) expression increased from 1 month with peak levels at 3-4 months. The results suggest that a process of sprouting exists in surviving neurons of medial extended amygdala after status epilepticus and that these neurons might be an evidence of a reactive synaptogenesis process.
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Affiliation(s)
- Germán L Pereno
- Facultad de Psicología, Universidad Nacional de Córdoba, Córdoba, Argentina
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