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Peter‐Derex L, Klimes P, Latreille V, Bouhadoun S, Dubeau F, Frauscher B. Sleep Disruption in Epilepsy: Ictal and Interictal Epileptic Activity Matter. Ann Neurol 2020; 88:907-920. [DOI: 10.1002/ana.25884] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 07/27/2020] [Accepted: 08/16/2020] [Indexed: 12/29/2022]
Affiliation(s)
- Laure Peter‐Derex
- Analytical Neurophysiology Lab Montreal Neurological Institute and Hospital, McGill University Montreal QC Canada
- Center for Sleep Medicine and Respiratory Diseases Lyon University Hospital, Lyon 1 University Lyon France
- Lyon Neuroscience Research Center, CNRS UMR5292 / INSERM, U1028 Lyon France
| | - Petr Klimes
- Analytical Neurophysiology Lab Montreal Neurological Institute and Hospital, McGill University Montreal QC Canada
- Institute of Scientific Instruments, The Czech Academy of Sciences Brno Czech Republic
| | - Véronique Latreille
- Analytical Neurophysiology Lab Montreal Neurological Institute and Hospital, McGill University Montreal QC Canada
| | - Sarah Bouhadoun
- Analytical Neurophysiology Lab Montreal Neurological Institute and Hospital, McGill University Montreal QC Canada
| | - François Dubeau
- Montreal Neurological Institute and Hospital, McGill University Montreal QC Canada
| | - Birgit Frauscher
- Analytical Neurophysiology Lab Montreal Neurological Institute and Hospital, McGill University Montreal QC Canada
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Sullivan BJ, Ammanuel S, Kipnis PA, Araki Y, Huganir RL, Kadam SD. Low-Dose Perampanel Rescues Cortical Gamma Dysregulation Associated With Parvalbumin Interneuron GluA2 Upregulation in Epileptic Syngap1 +/- Mice. Biol Psychiatry 2020; 87:829-842. [PMID: 32107006 PMCID: PMC7166168 DOI: 10.1016/j.biopsych.2019.12.025] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 12/19/2019] [Accepted: 12/19/2019] [Indexed: 12/22/2022]
Abstract
BACKGROUND Loss-of-function SYNGAP1 mutations cause a neurodevelopmental disorder characterized by intellectual disability and epilepsy. SYNGAP1 is a Ras GTPase-activating protein that underlies the formation and experience-dependent regulation of postsynaptic densities. The mechanisms that contribute to this proposed monogenic cause of intellectual disability and epilepsy remain unresolved. METHODS We established the phenotype of the epileptogenesis in a Syngap1+/- mouse model using 24-hour video electroencephalography (vEEG)/electromyography recordings at advancing ages. We administered an acute low dose of perampanel, a Food and Drug Administration-approved AMPA receptor (AMPAR) antagonist, during a follow-on 24-hour vEEG to investigate the role of AMPARs in Syngap1 haploinsufficiency. Immunohistochemistry was performed to determine the region- and location-specific differences in the expression of the GluA2 AMPAR subunit. RESULTS A progressive worsening of the epilepsy with emergence of multiple seizure phenotypes, interictal spike frequency, sleep dysfunction, and hyperactivity was identified in Syngap1+/- mice. Interictal spikes emerged predominantly during non-rapid eye movement sleep in 24-hour vEEG of Syngap1+/- mice. Myoclonic seizures occurred at behavioral-state transitions both in Syngap1+/- mice and during an overnight EEG from a child with SYNGAP1 haploinsufficiency. In Syngap1+/- mice, EEG spectral power analyses identified a significant loss of gamma power modulation during behavioral-state transitions. A significant region-specific increase of GluA2 AMPAR subunit expression in the somas of parvalbumin-positive interneurons was identified. CONCLUSIONS Acute dosing with perampanel significantly rescued behavioral state-dependent cortical gamma homeostasis, identifying a novel mechanism implicating Ca2+-impermeable AMPARs on parvalbumin-positive interneurons underlying circuit dysfunction in SYNGAP1 haploinsufficiency.
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Affiliation(s)
- Brennan J Sullivan
- Neuroscience Laboratory, Hugo Moser Research Institute, Kennedy Krieger Institute, Baltimore, Maryland
| | - Simon Ammanuel
- Department of Neurological Surgery, University of California San Francisco, San Francisco, California
| | - Pavel A Kipnis
- Neuroscience Laboratory, Hugo Moser Research Institute, Kennedy Krieger Institute, Baltimore, Maryland
| | - Yoichi Araki
- Department of Neuroscience, Kavli Neuroscience Discovery Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Richard L Huganir
- Department of Neuroscience, Kavli Neuroscience Discovery Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Shilpa D Kadam
- Neuroscience Laboratory, Hugo Moser Research Institute, Kennedy Krieger Institute, Baltimore, Maryland; Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland.
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Halász P, Bódizs R, Ujma PP, Fabó D, Szűcs A. Strong relationship between NREM sleep, epilepsy and plastic functions - A conceptual review on the neurophysiology background. Epilepsy Res 2019; 150:95-105. [PMID: 30712997 DOI: 10.1016/j.eplepsyres.2018.11.008] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2018] [Revised: 10/08/2018] [Accepted: 11/15/2018] [Indexed: 12/15/2022]
Abstract
The aim of this review is to summarize and discuss the strong bond between NREM sleep and epilepsy underlain by the shared link and effect on brain plasticity. Beyond the seizure occurrence rate, sleep relatedness may manifest in the enhancement of interictal epileptic discharges (spikes and pathological ripples). The number of the discharges as well as their propagation increase during NREM sleep, unmasking the epileptic network that is hidden during wakefulness. The interictal epileptic discharges associate with different sleep constituents (sleep slow waves, spindling and high frequency oscillations); known to play essential role in memory and learning. We highlight three major groups of epilepsies, in which sleep-related plastic functions suffer an epileptic derailment. In absence epilepsy mainly involving the thalamo-cortical system, sleep spindles transform to generalized spike-wave activity. In mesio-temporal epilepsy affecting the hippocampal declarative memory system, the sharp wave ripples derail to dysfunctional epileptic oscillations (spikes and pathological ripples). Idiopathic childhood epilepsies affecting the perisylvian network may progress to catastrophic status electricus during NREM sleep. In these major epilepsies, NREM sleep has a pivotal role in the development and course of the disorder. Epilepsy is born in-, and exhibits its pathological properties during NREM sleep. Interictal discharges are important causative agents in this process.
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Affiliation(s)
- Péter Halász
- National Institute of Clinical Neuroscience, Amerikai út 57. Budapest, H-1145, Hungary.
| | - Róbert Bódizs
- Semmelweis University, Institute of Behavioral Sciences, Nagyvárad tér 4, Budapest, H-1089, Hungary
| | - Péter Przemyslaw Ujma
- Semmelweis University, Institute of Behavioral Sciences, Nagyvárad tér 4, Budapest, H-1089, Hungary
| | - Dániel Fabó
- National Institute of Clinical Neuroscience, Amerikai út 57. Budapest, H-1145, Hungary
| | - Anna Szűcs
- National Institute of Clinical Neuroscience, Amerikai út 57. Budapest, H-1145, Hungary
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Ujma PP, Halász P, Simor P, Fabó D, Ferri R. Increased cortical involvement and synchronization during CAP A1 slow waves. Brain Struct Funct 2018; 223:3531-3542. [PMID: 29951916 DOI: 10.1007/s00429-018-1703-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2016] [Accepted: 06/20/2018] [Indexed: 12/25/2022]
Abstract
Slow waves recorded with EEG in NREM sleep are indicative of the strength and spatial extent of synchronized firing in neuronal assemblies of the cerebral cortex. Slow waves often appear in the A1 part of the cyclic alternating patterns (CAP), which correlate with a number of behavioral and biological parameters, but their physiological significance is not adequately known. We automatically detected slow waves from the scalp recordings of 37 healthy patients, visually identified CAP A1 events and compared slow waves during CAP A1 with those during NCAP. For each slow wave, we computed the amplitude, slopes, frequency, synchronization (synchronization likelihood) between specific cortical areas, as well as the location of origin and scalp propagation of individual waves. CAP A1 slow waves were characterized by greater spatial extent and amplitude, steeper slopes and greater cortical synchronization, but a similar prominence in frontal areas and similar propagation patterns to other areas on the scalp. Our results indicate that CAP A1 represents a period of highly synchronous neuronal firing over large areas of the cortical mantle. This feature may contribute to the role CAP A1 plays in both normal synaptic homeostasis and in the generation of epileptiform phenomena in epileptic patients.
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Affiliation(s)
- Péter Przemyslaw Ujma
- Institute of Clinical Neuroscience, "Juhász Pál" Epilepsy Centrum, Amerikai út 57, Budapest, 1145, Hungary.
- Institute of Behavioural Sciences, Semmelweis University, Nagyvárad tér 4, Budapest, 1089, Hungary.
| | - Péter Halász
- Institute of Clinical Neuroscience, "Juhász Pál" Epilepsy Centrum, Amerikai út 57, Budapest, 1145, Hungary
| | - Péter Simor
- Institute of Psychology, ELTE, Eötvos Loránd University, Kazinczy utca 23-27, Budapest, 1075, Hungary
| | - Dániel Fabó
- Institute of Clinical Neuroscience, "Juhász Pál" Epilepsy Centrum, Amerikai út 57, Budapest, 1145, Hungary
| | - Raffaele Ferri
- Oasi Research Institute-IRCCS, Via Conte Ruggero 73, 91018, Troina, Italy
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Epileptic interictal discharges are more frequent during NREM slow wave downstates. Neurosci Lett 2017; 658:37-42. [PMID: 28811195 DOI: 10.1016/j.neulet.2017.08.020] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Revised: 07/26/2017] [Accepted: 08/08/2017] [Indexed: 11/22/2022]
Abstract
Epileptiform activity in various but not all epilepsy and recording types and cerebral areas is more frequent in NREM sleep, and especially during sleep periods with high-amplitude EEG slow waves. Slow waves synchronize high-frequency oscillations: physiological activity from the theta through the gamma band usually appears during scalp-positive upstates while epileptiform activity occurs at transitory phases and the scalp-negative downstate. It has been proposed that interictal discharges (IIDs) are facilitated by the high degree of neuronal firing synchrony during slow wave transitory and downstates. This would suggest that their occurrence increases as a function of slow wave synchronization, indicated by greater amplitude, steeper slopes and higher EEG signal synchronization. We investigated the occurrence of IIDs during NREM sleep slow waves in epileptic patients undergoing presurgical electrophysiological monitoring. Intracranially registered IIDs preferentially occurred during the scalp-negative downstates of frontal scalp slow waves in all subjects. IID occurrence was more frequent during larger slow waves in the pooled sample and a subset of subjects. However, slow wave slope steepness and EEG signal synchronization between two frontal scalp channels was not significantly associated with IID occurrence. Our results indicate that IIDs indeed do not occur at the same slow wave phase as physiological rhythms, but contrary to previous hypotheses their occurrence is not strongly affected by EEG synchronization.
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Zubler F, Rubino A, Lo Russo G, Schindler K, Nobili L. Correlating Interictal Spikes with Sigma and Delta Dynamics during Non-Rapid-Eye-Movement-Sleep. Front Neurol 2017; 8:288. [PMID: 28690583 PMCID: PMC5479894 DOI: 10.3389/fneur.2017.00288] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Accepted: 06/02/2017] [Indexed: 01/21/2023] Open
Abstract
Interictal spikes (IS) are one of the major hallmarks of epilepsy. Understanding the factors promoting or suppressing IS would increase our comprehension of epilepsy and possibly open new avenues for therapy. Sleep strongly influences epileptic activity, and the modulatory effects of the different sleep stages on IS have been studied for decades. However, several aspects are still disputed, in particular the role of sleep spindles and slow waves in the activation of IS during Non-REM sleep. Here, we correlate the rate of IS with quantitative measures derived from stereo-EEG during one Non-REM cycle in 10 patients suffering from drug-resistant epilepsy due to type 2 focal cortical dysplasia. We show that the IS rate (ISR) is positively correlated with sigma power (a surrogate for sleep-spindle density) but negatively correlated with delta power (surrogate for slow wave activity). In addition, we present two new indices for quantifying the spatial and temporal instability of sleep. We found that both instability indices are correlated with a high ISR. The main contribution of this study is to confirm the suppressive effect of stable deep sleep on IS. This result might influence future guidelines for therapy of patients suffering from epilepsy and sleep disorders.
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Affiliation(s)
- Frédéric Zubler
- "C. Munari" Center for Epilepsy Surgery, Department of Neuroscience, Niguarda Hospital, Milan, Italy
| | - Annalisa Rubino
- "C. Munari" Center for Epilepsy Surgery, Department of Neuroscience, Niguarda Hospital, Milan, Italy
| | - Giorgio Lo Russo
- "C. Munari" Center for Epilepsy Surgery, Department of Neuroscience, Niguarda Hospital, Milan, Italy
| | - Kaspar Schindler
- Department of Neurology, Inselspital-Bern University Hospital, University of Bern, Bern, Switzerland
| | - Lino Nobili
- "C. Munari" Center for Epilepsy Surgery, Department of Neuroscience, Niguarda Hospital, Milan, Italy
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