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Gong R, Roth RW, Chang AJ, Sinha N, Parashos A, Davis KA, Kuzniecky R, Bonilha L, Gleichgerrcht E. EEG Ictal Power Dynamics, Function-Structure Associations, and Epilepsy Surgical Outcomes. Neurology 2024; 102:e209451. [PMID: 38820468 DOI: 10.1212/wnl.0000000000209451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Postoperative seizure control in drug-resistant temporal lobe epilepsy (TLE) remains variable, and the causes for this variability are not well understood. One contributing factor could be the extensive spread of synchronized ictal activity across networks. Our study used novel quantifiable assessments from intracranial EEG (iEEG) to test this hypothesis and investigated how the spread of seizures is determined by underlying structural network topological properties. METHODS We evaluated iEEG data from 157 seizures in 27 patients with TLE: 100 seizures from 17 patients with postoperative seizure control (Engel score I) vs 57 seizures from 10 patients with unfavorable surgical outcomes (Engel score II-IV). We introduced a quantifiable method to measure seizure power dynamics within anatomical regions, refining existing seizure imaging frameworks and minimizing reliance on subjective human decision-making. Time-frequency power representations were obtained in 6 frequency bands ranging from theta to gamma. Ictal power spectrums were normalized against a baseline clip taken at least 6 hours away from ictal events. Electrodes' time-frequency power spectrums were then mapped onto individual T1-weighted MRIs and grouped based on a standard brain atlas. We compared spatiotemporal dynamics for seizures between groups with favorable and unfavorable surgical outcomes. This comparison included examining the range of activated brain regions and the spreading rate of ictal activities. We then evaluated whether regional iEEG power values were a function of fractional anisotropy (FA) from diffusion tensor imaging across regions over time. RESULTS Seizures from patients with unfavorable outcomes exhibited significantly higher maximum activation sizes in various frequency bands. Notably, we provided quantifiable evidence that in seizures associated with unfavorable surgical outcomes, the spread of beta-band power across brain regions is significantly faster, detectable as early as the first second after seizure onset. There was a significant correlation between beta power during seizures and FA in the corresponding areas, particularly in the unfavorable outcome group. Our findings further suggest that integrating structural and functional features could improve the prediction of epilepsy surgical outcomes. DISCUSSION Our findings suggest that ictal iEEG power dynamics and the structural-functional relationship are mechanistic factors associated with surgical outcomes in TLE.
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Affiliation(s)
- Ruxue Gong
- From the Department of Neurology (R.G., R.W.R., E.G.), School of Medicine, Emory University, Atlanta, GA; Department of Neurology (A.J.C., A.P.), Medical University of South Carolina, Charleston; Department of Neurology (N.S., K.A.D.), University of Pennsylvania, Philadelphia; Department of Neurology (R.K.), Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY; and Department of Neurology (L.B.), School of Medicine, University of South Carolina, Columbia
| | - Rebecca W Roth
- From the Department of Neurology (R.G., R.W.R., E.G.), School of Medicine, Emory University, Atlanta, GA; Department of Neurology (A.J.C., A.P.), Medical University of South Carolina, Charleston; Department of Neurology (N.S., K.A.D.), University of Pennsylvania, Philadelphia; Department of Neurology (R.K.), Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY; and Department of Neurology (L.B.), School of Medicine, University of South Carolina, Columbia
| | - Allen J Chang
- From the Department of Neurology (R.G., R.W.R., E.G.), School of Medicine, Emory University, Atlanta, GA; Department of Neurology (A.J.C., A.P.), Medical University of South Carolina, Charleston; Department of Neurology (N.S., K.A.D.), University of Pennsylvania, Philadelphia; Department of Neurology (R.K.), Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY; and Department of Neurology (L.B.), School of Medicine, University of South Carolina, Columbia
| | - Nishant Sinha
- From the Department of Neurology (R.G., R.W.R., E.G.), School of Medicine, Emory University, Atlanta, GA; Department of Neurology (A.J.C., A.P.), Medical University of South Carolina, Charleston; Department of Neurology (N.S., K.A.D.), University of Pennsylvania, Philadelphia; Department of Neurology (R.K.), Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY; and Department of Neurology (L.B.), School of Medicine, University of South Carolina, Columbia
| | - Alexandra Parashos
- From the Department of Neurology (R.G., R.W.R., E.G.), School of Medicine, Emory University, Atlanta, GA; Department of Neurology (A.J.C., A.P.), Medical University of South Carolina, Charleston; Department of Neurology (N.S., K.A.D.), University of Pennsylvania, Philadelphia; Department of Neurology (R.K.), Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY; and Department of Neurology (L.B.), School of Medicine, University of South Carolina, Columbia
| | - Kathryn A Davis
- From the Department of Neurology (R.G., R.W.R., E.G.), School of Medicine, Emory University, Atlanta, GA; Department of Neurology (A.J.C., A.P.), Medical University of South Carolina, Charleston; Department of Neurology (N.S., K.A.D.), University of Pennsylvania, Philadelphia; Department of Neurology (R.K.), Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY; and Department of Neurology (L.B.), School of Medicine, University of South Carolina, Columbia
| | - Ruben Kuzniecky
- From the Department of Neurology (R.G., R.W.R., E.G.), School of Medicine, Emory University, Atlanta, GA; Department of Neurology (A.J.C., A.P.), Medical University of South Carolina, Charleston; Department of Neurology (N.S., K.A.D.), University of Pennsylvania, Philadelphia; Department of Neurology (R.K.), Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY; and Department of Neurology (L.B.), School of Medicine, University of South Carolina, Columbia
| | - Leonardo Bonilha
- From the Department of Neurology (R.G., R.W.R., E.G.), School of Medicine, Emory University, Atlanta, GA; Department of Neurology (A.J.C., A.P.), Medical University of South Carolina, Charleston; Department of Neurology (N.S., K.A.D.), University of Pennsylvania, Philadelphia; Department of Neurology (R.K.), Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY; and Department of Neurology (L.B.), School of Medicine, University of South Carolina, Columbia
| | - Ezequiel Gleichgerrcht
- From the Department of Neurology (R.G., R.W.R., E.G.), School of Medicine, Emory University, Atlanta, GA; Department of Neurology (A.J.C., A.P.), Medical University of South Carolina, Charleston; Department of Neurology (N.S., K.A.D.), University of Pennsylvania, Philadelphia; Department of Neurology (R.K.), Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY; and Department of Neurology (L.B.), School of Medicine, University of South Carolina, Columbia
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Capitano F, Kuchenbuch M, Lavigne J, Chaptoukaev H, Zuluaga MA, Lorenzi M, Nabbout R, Mantegazza M. Preictal dysfunctions of inhibitory interneurons paradoxically lead to their rebound hyperactivity and to low-voltage-fast onset seizures in Dravet syndrome. Proc Natl Acad Sci U S A 2024; 121:e2316364121. [PMID: 38809712 PMCID: PMC11161744 DOI: 10.1073/pnas.2316364121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 05/01/2024] [Indexed: 05/31/2024] Open
Abstract
Epilepsies have numerous specific mechanisms. The understanding of neural dynamics leading to seizures is important for disclosing pathological mechanisms and developing therapeutic approaches. We investigated electrographic activities and neural dynamics leading to convulsive seizures in patients and mouse models of Dravet syndrome (DS), a developmental and epileptic encephalopathy in which hypoexcitability of GABAergic neurons is considered to be the main dysfunction. We analyzed EEGs from DS patients carrying a SCN1A pathogenic variant, as well as epidural electrocorticograms, hippocampal local field potentials, and hippocampal single-unit neuronal activities in Scn1a+/- and Scn1aRH/+ DS mice. Strikingly, most seizures had low-voltage-fast onset in both patients and mice, which is thought to be generated by hyperactivity of GABAergic interneurons, the opposite of the main pathological mechanism of DS. Analyzing single-unit recordings, we observed that temporal disorganization of the firing of putative interneurons in the period immediately before the seizure (preictal) precedes the increase of their activity at seizure onset, together with the entire neuronal network. Moreover, we found early signatures of the preictal period in the spectral features of hippocampal and cortical field potential of Scn1a mice and of patients' EEG, which are consistent with the dysfunctions that we observed in single neurons and that allowed seizure prediction. Therefore, the perturbed preictal activity of interneurons leads to their hyperactivity at the onset of generalized seizures, which have low-voltage-fast features that are similar to those observed in other epilepsies and are triggered by hyperactivity of GABAergic neurons. Preictal spectral features may be used as predictive seizure biomarkers.
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Affiliation(s)
- Fabrizio Capitano
- University Cote d’Azur, Institute of Molecular and Cellular Pharmacology, Valbonne-Sophia Antipolis06560, France
- CNRS UMR 7275, Valbonne-Sophia Antipolis06560, France
- Inserm U1323, Valbonne-Sophia Antipolis06650, France
| | - Mathieu Kuchenbuch
- Reference Centre for Rare Epilepsies, Member of European Reference Network EpiCARE, Department of Pediatric Neurology, Hôpital Necker-Enfants Malades, Assistance Publique Hôpitaux de Paris, Paris75015, France
- Laboratory of Translational Research for Neurological Disorders, Inserm UMR 1163, Imagine Institute, Université Paris Cité, Paris75015, France
| | - Jennifer Lavigne
- University Cote d’Azur, Institute of Molecular and Cellular Pharmacology, Valbonne-Sophia Antipolis06560, France
- CNRS UMR 7275, Valbonne-Sophia Antipolis06560, France
- Inserm U1323, Valbonne-Sophia Antipolis06650, France
| | | | | | - Marco Lorenzi
- University Cote d’Azur, Institute of Molecular and Cellular Pharmacology, Valbonne-Sophia Antipolis06560, France
- Epione Research team, Inria Center of Université Côte d’Azur, Biot-Sophia Antipolis06410, France
| | - Rima Nabbout
- Reference Centre for Rare Epilepsies, Member of European Reference Network EpiCARE, Department of Pediatric Neurology, Hôpital Necker-Enfants Malades, Assistance Publique Hôpitaux de Paris, Paris75015, France
- Laboratory of Translational Research for Neurological Disorders, Inserm UMR 1163, Imagine Institute, Université Paris Cité, Paris75015, France
| | - Massimo Mantegazza
- University Cote d’Azur, Institute of Molecular and Cellular Pharmacology, Valbonne-Sophia Antipolis06560, France
- CNRS UMR 7275, Valbonne-Sophia Antipolis06560, France
- Inserm U1323, Valbonne-Sophia Antipolis06650, France
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Goodman JH. It Matters Who Starts the Fire in Mesial Temporal Lobe Epilepsy. Epilepsy Curr 2024; 24:197-199. [PMID: 38898905 PMCID: PMC11185215 DOI: 10.1177/15357597241238901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/21/2024] Open
Abstract
CA3 Principal Cell Activation Triggers Hypersynchronous-Onset Seizures in a Mouse Model of Mesial Temporal Lobe Epilepsy Wang S, Lévesque M, Fisher TAJ, Kennedy TE, Avoli M. J Neurophysiol . 2023;130(4):1041-1052. doi:10.1152/jn.00244.2023 Mesial temporal lobe epilepsy (MTLE) is the most common form of focal epilepsy, and it is characterized by seizures that are often refractory to medications. Seizures in MTLE have two main patterns of onset that have been termed hypersynchronous (HYP) and low-voltage fast (LVF) and are believed to mainly depend on the activity of excitatory principal cells and inhibitory interneurons, respectively. In this study, we investigated whether unilateral open-loop optogenetic activation of CaMKII-positive principal cells in the hippocampus CA3 region favors the generation of spontaneous HYP seizures in kainic acid-treated (KA) CaMKII-ChR2 mice. Optogenetic activation of CA3 principal cells (1 Hz, 180 s ON, 220 s OFF) was implemented for 15 days after KA-induced status epilepticus. We found that both LVF and HYP seizures occurred in nonstimulated CaMKII-ChR2 (n = 6) and stimulated CaMKII-Cre (n = 5) mice. In contrast, optogenetic activation of principal cells in CaMKII-ChR2 mice (n = 5) triggered only HYP seizures that were characterized by high fast ripple (250–500 Hz) rates during the pre-ictal and ictal periods. These results provide firm evidence that in MTLE spontaneous seizures with different onset patterns depend on distinct neuronal network mechanisms of generation. They also demonstrate that HYP seizures occurring in vivo along with their associated fast ripples depend on the activity of principal cells in the CA3 region. NEW & NOTEWORTHY Previous evidence suggested that different seizure onset patterns rely on the activity of distinct neuronal populations. In this study, we show for the first time that in vivo optogenetic stimulation of CaMKII principal cells in kainic acid-treated mice triggers hypersynchronous-onset seizures that are associated with fast ripples. Our findings indicate that in patients with predominant HYP-onset seizures, anticonvulsant treatments should be aimed at limiting the firing of principal neurons in the seizure onset zone.
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Affiliation(s)
- Jeffrey H Goodman
- Department of Developmental Neurobiology, NYS Institute for Basic Research in Developmental Disabilities
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4
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Ma Z, Xu Y, Baier G, Liu Y, Li B, Zhang L. Dynamical modulation of hypersynchronous seizure onset with transcranial magneto-acoustic stimulation in a hippocampal computational model. CHAOS (WOODBURY, N.Y.) 2024; 34:043107. [PMID: 38558041 DOI: 10.1063/5.0181510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 03/09/2024] [Indexed: 04/04/2024]
Abstract
Hypersynchronous (HYP) seizure onset is one of the frequently observed seizure-onset patterns in temporal lobe epileptic animals and patients, often accompanied by hippocampal sclerosis. However, the exact mechanisms and ion dynamics of the transition to HYP seizures remain unclear. Transcranial magneto-acoustic stimulation (TMAS) has recently been proposed as a novel non-invasive brain therapy method to modulate neurological disorders. Therefore, we propose a biophysical computational hippocampal network model to explore the evolution of HYP seizure caused by changes in crucial physiological parameters and design an effective TMAS strategy to modulate HYP seizure onset. We find that the cooperative effects of abnormal glial uptake strength of potassium and excessive bath potassium concentration could produce multiple discharge patterns and result in transitions from the normal state to the HYP seizure state and ultimately to the depolarization block state. Moreover, we find that the pyramidal neuron and the PV+ interneuron in HYP seizure-onset state exhibit saddle-node-on-invariant-circle/saddle homoclinic (SH) and saddle-node/SH at onset/offset bifurcation pairs, respectively. Furthermore, the response of neuronal activities to TMAS of different ultrasonic waveforms revealed that lower sine wave stimulation can increase the latency of HYP seizures and even completely suppress seizures. More importantly, we propose an ultrasonic parameter area that not only effectively regulates epileptic rhythms but also is within the safety limits of ultrasound neuromodulation therapy. Our results may offer a more comprehensive understanding of the mechanisms of HYP seizure and provide a theoretical basis for the application of TMAS in treating specific types of seizures.
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Affiliation(s)
- Zhiyuan Ma
- Department of Biomedical Engineering, College of Chemistry and Life Science, Beijing University of Technology, Beijing 100124, China
| | - Yuejuan Xu
- Department of Biomedical Engineering, College of Chemistry and Life Science, Beijing University of Technology, Beijing 100124, China
| | - Gerold Baier
- Cell and Developmental Biology, Faculty of Life Sciences, University College London, London WC1E 6BT, United Kingdom
| | - Youjun Liu
- Department of Biomedical Engineering, College of Chemistry and Life Science, Beijing University of Technology, Beijing 100124, China
| | - Bao Li
- Department of Biomedical Engineering, College of Chemistry and Life Science, Beijing University of Technology, Beijing 100124, China
| | - Liyuan Zhang
- Department of Biomedical Engineering, College of Chemistry and Life Science, Beijing University of Technology, Beijing 100124, China
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5
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Guo F, Li A, Liu Q, Guo D, Chen K, Yao D, Cui Y, Xia Y. Disruption of TLE epileptiform activity retarded the seizure and reduced pathological HFOs. Brain Res Bull 2024; 207:110869. [PMID: 38184151 DOI: 10.1016/j.brainresbull.2024.110869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 12/17/2023] [Accepted: 01/01/2024] [Indexed: 01/08/2024]
Abstract
In temporal lobe epilepsy (TLE), the epileptogenic zones, such as the temporal lobe structure, could generate pathological high-frequency oscillations (pHFOs, 250-500 Hz) before the ictal period. These pHFOs have also been observed during the process of seizures in both TLE patients and animals, exhibiting a critical role as promising biomarkers for TLE seizures. TLE seizures could be modulated via regulating the neural excitability in epileptogenic zones, for that TLE is primarily associated with the excitation-inhibition imbalance. However, whether these kinds of modulations could also impact the pHFOs characteristics during TLE seizures is still unclear. For this purpose, we pharmaco-genetically inhibited the principal cells (PCs) in the mouse CA3 region and tracked the difference in the behavioral and electrophysiological features during LiCl-pilocarpine-induced TLE seizure between the hM4Di+CNO (experimental) mice and mCherry+CNO (control) mice. Delayed latency, decreased averaged duration, and reduced counts of the generalized seizure were observed in the experimental mice. Besides, the electrophysiological characteristics, such as the firing rate of PCs and the count of pHFO, exhibited significant decline in the CA3 and CA1 regions. During TLE seizure, there existed strong phase-coupling between pHFO and PCs spike timing in the control mice, while it was abolished in the experimental mice. In addition, we also found that the counts of pHFO were significantly associated with the behavioral features, indicating the close relationships within them. Collectively, our findings suggested that alterations in pHFO and the retardation of seizures may be attributed to disruptions in neuronal excitability, and the variations of electrophysiological features were related to seizure severity during TLE seizures. These results provide valuable insights into the role of pHFOs in TLE and shed light on the underlying mechanisms involved.
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Affiliation(s)
- Fengru Guo
- Department of Neurosurgery, Sichuan Provincial People's Hospital, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu 611731, China
| | - Airui Li
- Department of Neurosurgery, Sichuan Provincial People's Hospital, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu 611731, China
| | - Qinjun Liu
- Department of Neurosurgery, Sichuan Provincial People's Hospital, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu 611731, China
| | - Daqing Guo
- Department of Neurosurgery, Sichuan Provincial People's Hospital, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu 611731, China
| | - Ke Chen
- Department of Neurosurgery, Sichuan Provincial People's Hospital, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu 611731, China
| | - Dezhong Yao
- Department of Neurosurgery, Sichuan Provincial People's Hospital, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu 611731, China
| | - Yan Cui
- Department of Neurosurgery, Sichuan Provincial People's Hospital, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu 611731, China.
| | - Yang Xia
- Department of Neurosurgery, Sichuan Provincial People's Hospital, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu 611731, China.
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Guo F, Cui Y, Li A, Liu M, Jian Z, Chen K, Yao D, Guo D, Xia Y. Differential patterns of very high-frequency oscillations in two seizure types of the pilocarpine-induced TLE model. Brain Res Bull 2023; 204:110805. [PMID: 37925081 DOI: 10.1016/j.brainresbull.2023.110805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Revised: 10/08/2023] [Accepted: 10/30/2023] [Indexed: 11/06/2023]
Abstract
AIMS Very high-frequency oscillations (VHFOs, >500 Hz) are considered a highly sensitive biomarker of seizures. We hypothesized that VHFOs may exhibit specificity towards hypersynchronous (HYP) seizures and low-voltage fast (LVF) seizures in temporal lobe epilepsy (TLE). METHODS Local field potentials were recorded from the hippocampal network in TLE mice induced by pilocarpine. Subsequently, we analyzed the VHFO features, including their temporal-frequency characteristics and VHFO/theta coupling, during three states: baseline, preictal, and postictal for both HYP- and LVF-seizure groups. RESULTS Significant changes in most of the VHFO features were observed during the preictal state in both seizure groups. In the postictal state, VHFO features in the HYP-seizure group exhibited inverse alterations and appeared to align with those observed during baseline conditions. However, such phenomena were not observed after TLE seizures in the LVF-seizure group. CONCLUSION Our findings highlight distinct patterns of VHFO feature changes across different states of HYP seizures and LVF seizures. These results suggest that VHFOs could serve as indicative biomarkers for seizure alterations specifically associated with HYP-seizure states.
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Affiliation(s)
- Fengru Guo
- Department of Neurosurgery, Sichuan Provincial People's Hospital, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu 611731, China
| | - Yan Cui
- Department of Neurosurgery, Sichuan Provincial People's Hospital, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu 611731, China.
| | - Airui Li
- Department of Neurosurgery, Sichuan Provincial People's Hospital, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu 611731, China
| | - Mingqi Liu
- Department of Neurosurgery, Sichuan Provincial People's Hospital, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu 611731, China
| | - Zhaoxin Jian
- Department of Neurosurgery, Sichuan Provincial People's Hospital, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu 611731, China
| | - Ke Chen
- Department of Neurosurgery, Sichuan Provincial People's Hospital, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu 611731, China
| | - Dezhong Yao
- Department of Neurosurgery, Sichuan Provincial People's Hospital, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu 611731, China
| | - Daqing Guo
- Department of Neurosurgery, Sichuan Provincial People's Hospital, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu 611731, China
| | - Yang Xia
- Department of Neurosurgery, Sichuan Provincial People's Hospital, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu 611731, China.
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7
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Wong S, Simmons A, Villicana JR, Barnett S. Estimating Patient-Level Uncertainty in Seizure Detection Using Group-Specific Out-of-Distribution Detection Technique. SENSORS (BASEL, SWITZERLAND) 2023; 23:8375. [PMID: 37896469 PMCID: PMC10611125 DOI: 10.3390/s23208375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 09/29/2023] [Accepted: 10/05/2023] [Indexed: 10/29/2023]
Abstract
Epilepsy is a chronic neurological disorder affecting around 1% of the global population, characterized by recurrent epileptic seizures. Accurate diagnosis and treatment are crucial for reducing mortality rates. Recent advancements in machine learning (ML) algorithms have shown potential in aiding clinicians with seizure detection in electroencephalography (EEG) data. However, these algorithms face significant challenges due to the patient-specific variability in seizure patterns and the limited availability of high-quality EEG data for training, causing erratic predictions. These erratic predictions are harmful, especially for high-stake domains in healthcare, negatively affecting patients. Therefore, ensuring safety in AI is of the utmost importance. In this study, we propose a novel ensemble method for uncertainty quantification to identify patients with low-confidence predictions in ML-based seizure detection algorithms. Our approach aims to mitigate high-risk predictions in previously unseen seizure patients, thereby enhancing the robustness of existing seizure detection algorithms. Additionally, our method can be implemented with most of the deep learning (DL) models. We evaluated the proposed method against established uncertainty detection techniques, demonstrating its effectiveness in identifying patients for whom the model's predictions are less certain. Our proposed method managed to achieve 87%, 89% and 75% in accuracy, specificity and sensitivity, respectively. This study represents a novel attempt to improve the reliability and robustness of DL algorithms in the domain of seizure detection. This study underscores the value of integrating uncertainty quantification into ML algorithms for seizure detection, offering clinicians a practical tool to gauge the applicability of ML models for individual patients.
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Affiliation(s)
- Sheng Wong
- Applied Artificial Intelligence Institute, Deakin University, Burwood, VIC 3125, Australia
| | - Anj Simmons
- Applied Artificial Intelligence Institute, Deakin University, Burwood, VIC 3125, Australia
| | | | - Scott Barnett
- Applied Artificial Intelligence Institute, Deakin University, Burwood, VIC 3125, Australia
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8
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Wang S, Lévesque M, Fisher TAJ, Kennedy TE, Avoli M. CA3 principal cell activation triggers hypersynchronous-onset seizures in a mouse model of mesial temporal lobe epilepsy. J Neurophysiol 2023; 130:1041-1052. [PMID: 37703488 DOI: 10.1152/jn.00244.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 09/13/2023] [Accepted: 09/13/2023] [Indexed: 09/15/2023] Open
Abstract
Mesial temporal lobe epilepsy (MTLE) is the most common form of focal epilepsy and it is characterized by seizures that are often refractory to medications. Seizures in MTLE have two main patterns of onset that have been termed hypersynchronous (HYP) and low-voltage fast (LVF) and are believed to mainly depend on the activity of excitatory principal cells and inhibitory interneurons, respectively. In this study, we investigated whether unilateral open-loop optogenetic activation of CaMKII-positive principal cells in the hippocampus CA3 region favors the generation of spontaneous HYP seizures in kainic acid-treated (KA) CaMKII-ChR2 mice. Optogenetic activation of CA3 principal cells (1 Hz, 180 s ON, 220 s OFF) was implemented for 15 days after KA-induced status epilepticus. We found that both LVF and HYP seizures occurred in nonstimulated CaMKII-ChR2 (n = 6) and stimulated CaMKII-Cre (n = 5) mice. In contrast, optogenetic activation of principal cells in CaMKII-ChR2 mice (n = 5) triggered only HYP seizures that were characterized by high fast ripple (250-500 Hz) rates during the pre-ictal and ictal periods. These results provide firm evidence that in MTLE spontaneous seizures with different onset patterns depend on distinct neuronal network mechanisms of generation. They also demonstrate that HYP seizures occurring in vivo along with their associated fast ripples depend on the activity of principal cells in the CA3 region.NEW & NOTEWORTHY Previous evidence suggested that different seizure onset patterns rely on the activity of distinct neuronal populations. In this study, we show for the first time that in vivo optogenetic stimulation of CaMKII principal cells in kainic acid-treated mice triggers hypersynchronous-onset seizures that are associated with fast ripples. Our findings indicate that in patients with predominant HYP-onset seizures, anticonvulsant treatments should be aimed at limiting the firing of principal neurons in the seizure onset zone.
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Affiliation(s)
- Siyan Wang
- Department of Neurology & Neurosurgery, Montreal Neurological Institute-Hospital, McGill University, Montréal, Quebec, Canada
| | - Maxime Lévesque
- Department of Neurology & Neurosurgery, Montreal Neurological Institute-Hospital, McGill University, Montréal, Quebec, Canada
| | - Teddy A J Fisher
- Department of Neurology & Neurosurgery, Montreal Neurological Institute-Hospital, McGill University, Montréal, Quebec, Canada
| | - Timothy E Kennedy
- Department of Neurology & Neurosurgery, Montreal Neurological Institute-Hospital, McGill University, Montréal, Quebec, Canada
| | - Massimo Avoli
- Department of Neurology & Neurosurgery, Montreal Neurological Institute-Hospital, McGill University, Montréal, Quebec, Canada
- Department of Physiology, McGill University, Montréal, Quebec, Canada
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9
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Avoli M, Chen LY, Di Cristo G, Librizzi L, Scalmani P, Shiri Z, Uva L, de Curtis M, Lévesque M. Ligand-gated mechanisms leading to ictogenesis in focal epileptic disorders. Neurobiol Dis 2023; 180:106097. [PMID: 36967064 DOI: 10.1016/j.nbd.2023.106097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 03/14/2023] [Accepted: 03/22/2023] [Indexed: 04/03/2023] Open
Abstract
We review here the neuronal mechanisms that cause seizures in focal epileptic disorders and, specifically, those involving limbic structures that are known to be implicated in human mesial temporal lobe epilepsy. In both epileptic patients and animal models, the initiation of focal seizures - which are most often characterized by a low-voltage fast onset EEG pattern - is presumably dependent on the synchronous firing of GABA-releasing interneurons that, by activating post-synaptic GABAA receptors, cause large increases in extracellular [K+] through the activation of the co-transporter KCC2. A similar mechanism may contribute to seizure maintenance; accordingly, inhibiting KCC2 activity transforms seizure activity into a continuous pattern of short-lasting epileptiform discharges. It has also been found that interactions between different areas of the limbic system modulate seizure occurrence by controlling extracellular [K+] homeostasis. In line with this view, low-frequency electrical or optogenetic activation of limbic networks restrain seizure generation, an effect that may also involve the activation of GABAB receptors and activity-dependent changes in epileptiform synchronization. Overall, these findings highlight the paradoxical role of GABAA signaling in both focal seizure generation and maintenance, emphasize the efficacy of low-frequency activation in abating seizures, and provide experimental evidence explaining the poor efficacy of antiepileptic drugs designed to augment GABAergic function in controlling seizures in focal epileptic disorders.
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Affiliation(s)
- Massimo Avoli
- Montreal Neurological Institute-Hospital, Departments of Neurology, Canada; Neurology & Neurosurgery and of Physiology, McGill University, Montreal H3A 2B4, Que, Canada.
| | - Li-Yuan Chen
- Montreal Neurological Institute-Hospital, Departments of Neurology, Canada
| | - Graziella Di Cristo
- Neurosciences Department, Université de Montréal, Montréal, Québec H3T 1N8, Canada; CHU Sainte-Justine Research Center, Montréal, Québec H3T 1C5, Canada
| | - Laura Librizzi
- Epilepsy Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy
| | - Paolo Scalmani
- Epilepsy Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy
| | - Zahra Shiri
- Montreal Neurological Institute-Hospital, Departments of Neurology, Canada
| | - Laura Uva
- Epilepsy Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy
| | - Marco de Curtis
- Epilepsy Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy
| | - Maxime Lévesque
- Montreal Neurological Institute-Hospital, Departments of Neurology, Canada
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Scalmani P, Paterra R, Mantegazza M, Avoli M, de Curtis M. Involvement of GABAergic Interneuron Subtypes in 4-Aminopyridine-Induced Seizure-Like Events in Mouse Entorhinal Cortex in Vitro. J Neurosci 2023; 43:1987-2001. [PMID: 36810229 PMCID: PMC10027059 DOI: 10.1523/jneurosci.1190-22.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 12/30/2022] [Accepted: 01/05/2023] [Indexed: 02/23/2023] Open
Abstract
Single-unit recordings performed in temporal lobe epilepsy patients and in models of temporal lobe seizures have shown that interneurons are active at focal seizure onset. We performed simultaneous patch-clamp and field potential recordings in entorhinal cortex slices of GAD65 and GAD67 C57BL/6J male mice that express green fluorescent protein in GABAergic neurons to analyze the activity of specific interneuron (IN) subpopulations during acute seizure-like events (SLEs) induced by 4-aminopyridine (4-AP; 100 μm). IN subtypes were identified as parvalbuminergic (INPV, n = 17), cholecystokinergic (INCCK), n = 13], and somatostatinergic (INSOM, n = 15), according to neurophysiological features and single-cell digital PCR. INPV and INCCK discharged at the start of 4-AP-induced SLEs characterized by either low-voltage fast or hyper-synchronous onset pattern. In both SLE onset types, INSOM fired earliest before SLEs, followed by INPV and INCCK discharges. Pyramidal neurons became active with variable delays after SLE onset. Depolarizing block was observed in ∼50% of cells in each INs subgroup, and it was longer in IN (∼4 s) than in pyramidal neurons (<1 s). As SLE evolved, all IN subtypes generated action potential bursts synchronous with the field potential events leading to SLE termination. High-frequency firing throughout the SLE occurred in one-third of INPV and INSOM We conclude that entorhinal cortex INs are very active at the onset and during the progression of SLEs induced by 4-AP. These results support earlier in vivo and in vivo evidence and suggest that INs have a preferential role in focal seizure initiation and development.SIGNIFICANCE STATEMENT Focal seizures are believed to result from enhanced excitation. Nevertheless, we and others demonstrated that cortical GABAergic networks may initiate focal seizures. Here, we analyzed for the first time the role of different IN subtypes in seizures generated by 4-aminopyridine in the mouse entorhinal cortex slices. We found that in this in vitro focal seizure model, all IN types contribute to seizure initiation and that INs precede firing of principal cells. This evidence is in agreement with the active role of GABAergic networks in seizure generation.
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Affiliation(s)
| | - Rosina Paterra
- Neuro-Oncology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano 20133, Italy
| | - Massimo Mantegazza
- Université Côte d'Azur, 06560 Valbonne-Sophia Antipolis, France
- Institute of Molecular and Cellular Pharmacology, Centre National de la Recherche Scientifique, Unité Mixte de Recherche 7275, Laboratoire d'Excellence/Canaux Ioniques d'Intérêt Thérapeutique, 06650 Valbonne-Sophia Antipolis, France
- Institut National de la Santé et de la Recherche Médicale, 06650 Valbonne-Sophia Antipolis, France
| | - Massimo Avoli
- Montreal Neurological Institute-Hospital, McGill University, Montreal, Quebec H3A 2B4, Canada
- Departments of Neurology and Neurosurgery and Physiology, McGill University, Montreal, Quebec H3A 2B4, Canada
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11
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Hashemi M, Vattikonda AN, Jha J, Sip V, Woodman MM, Bartolomei F, Jirsa VK. Amortized Bayesian inference on generative dynamical network models of epilepsy using deep neural density estimators. Neural Netw 2023; 163:178-194. [PMID: 37060871 DOI: 10.1016/j.neunet.2023.03.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 03/24/2023] [Accepted: 03/30/2023] [Indexed: 04/03/2023]
Abstract
Whole-brain modeling of epilepsy combines personalized anatomical data with dynamical models of abnormal activities to generate spatio-temporal seizure patterns as observed in brain imaging data. Such a parametric simulator is equipped with a stochastic generative process, which itself provides the basis for inference and prediction of the local and global brain dynamics affected by disorders. However, the calculation of likelihood function at whole-brain scale is often intractable. Thus, likelihood-free algorithms are required to efficiently estimate the parameters pertaining to the hypothetical areas, ideally including the uncertainty. In this study, we introduce the simulation-based inference for the virtual epileptic patient model (SBI-VEP), enabling us to amortize the approximate posterior of the generative process from a low-dimensional representation of whole-brain epileptic patterns. The state-of-the-art deep learning algorithms for conditional density estimation are used to readily retrieve the statistical relationships between parameters and observations through a sequence of invertible transformations. We show that the SBI-VEP is able to efficiently estimate the posterior distribution of parameters linked to the extent of the epileptogenic and propagation zones from sparse intracranial electroencephalography recordings. The presented Bayesian methodology can deal with non-linear latent dynamics and parameter degeneracy, paving the way for fast and reliable inference on brain disorders from neuroimaging modalities.
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12
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Chloride ion dysregulation in epileptogenic neuronal networks. Neurobiol Dis 2023; 177:106000. [PMID: 36638891 DOI: 10.1016/j.nbd.2023.106000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 12/25/2022] [Accepted: 01/09/2023] [Indexed: 01/13/2023] Open
Abstract
GABA is the major inhibitory neurotransmitter in the mature CNS. When GABAA receptors are activated the membrane potential is driven towards hyperpolarization due to chloride entry into the neuron. However, chloride ion dysregulation that alters the ionic gradient can result in depolarizing GABAergic post-synaptic potentials instead. In this review, we highlight that GABAergic inhibition prevents and restrains focal seizures but then reexamine this notion in the context of evidence that a static and/or a dynamic chloride ion dysregulation, that increases intracellular chloride ion concentrations, promotes epileptiform activity and seizures. To reconcile these findings, we hypothesize that epileptogenic pathologically interconnected neuron (PIN) microcircuits, representing a small minority of neurons, exhibit static chloride dysregulation and should exhibit depolarizing inhibitory post-synaptic potentials (IPSPs). We speculate that chloride ion dysregulation and PIN cluster activation may generate fast ripples and epileptiform spikes as well as initiate the hypersynchronous seizure onset pattern and microseizures. Also, we discuss the genetic, molecular, and cellular players important in chloride dysregulation which regulate epileptogenesis and initiate the low-voltage fast seizure onset pattern. We conclude that chloride dysregulation in neuronal networks appears to be critical for epileptogenesis and seizure genesis, but feed-back and feed-forward inhibitory GABAergic neurotransmission plays an important role in preventing and restraining seizures as well.
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Shakhatreh L, Janmohamed M, Baker AA, Willard A, Laing J, Rychkova M, Chen Z, Kwan P, O'Brien TJ, Perucca P. Interictal and seizure-onset EEG patterns in malformations of cortical development: A systematic review. Neurobiol Dis 2022; 174:105863. [PMID: 36165814 DOI: 10.1016/j.nbd.2022.105863] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Revised: 09/07/2022] [Accepted: 09/17/2022] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES Malformations of cortical development (MCDs) are common causes of drug-resistant epilepsy. The mechanisms underlying the associated epileptogenesis and ictogenesis remain poorly elucidated. EEG can help in understanding these mechanisms. We systematically reviewed studies reporting scalp or intracranial EEG features of MCDs to characterise interictal and seizure-onset EEG patterns across different MCD types. METHODS We conducted a systematic review in accordance with PRISMA guidelines. MEDLINE, PubMed, and Cochrane databases were searched for studies describing interictal and seizure-onset EEG patterns in MCD patients. A classification framework was implemented to group EEG features into 20 predefined patterns, comprising nine interictal (five, scalp EEG; four, intracranial EEG) and 11 seizure-onset (five, scalp EEG; six, intracranial EEG) patterns. Logistic regression was used to estimate the odds ratios (OR) of each seizure-onset pattern being associated with specific MCD types. RESULTS Our search yielded 1682 studies, of which 27 comprising 936 MCD patients were included. Of the nine interictal EEG patterns, five (three, scalp EEG; two, intracranial EEG) were detected in ≥2 MCD types, while four (rhythmic epileptiform discharges type 1 and type 2 on scalp EEG; repetitive bursting spikes and sporadic spikes on intracranial EEG) were seen only in focal cortical dysplasia (FCD). Of the 11 seizure-onset patterns, eight (three, scalp EEG; five, intracranial EEG) were found in ≥2 MCD types, whereas three were observed only in FCD (suppression on scalp EEG; delta brush on intracranial EEG) or tuberous sclerosis complex (TSC; focal fast wave on scalp EEG). Among scalp EEG seizure-onset patterns, paroxysmal fast activity (OR = 0.13; 95% CI: 0.03-0.53; p = 0.024) and repetitive epileptiform discharges (OR = 0.18; 95% CI: 0.05-0.61; p = 0.036) were less likely to occur in TSC than FCD. Among intracranial EEG seizure-onset patterns, low-voltage fast activity was more likely to be detected in heterotopia (OR = 19.3; 95% CI: 6.22-60.1; p < 0.001), polymicrogyria (OR = 6.70; 95% CI: 2.25-20.0; p = 0.004) and TSC (OR = 4.27; 95% CI: 1.88-9.70; p = 0.005) than FCD. SIGNIFICANCE Different MCD types can share similar interictal or seizure-onset EEG patterns, reflecting common underlying biological mechanisms. However, selected EEG patterns appear to point to distinct MCD types, suggesting certain differences in their neuronal networks.
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Affiliation(s)
- Lubna Shakhatreh
- Department of Neuroscience, The Central Clinical School, Monash University, Melbourne, Australia; Department of Neurology, The Royal Melbourne Hospital, Melbourne, Australia; Department of Neurology, Alfred Health, Melbourne, Australia.
| | - Mubeen Janmohamed
- Department of Neuroscience, The Central Clinical School, Monash University, Melbourne, Australia; Department of Neurology, The Royal Melbourne Hospital, Melbourne, Australia; Department of Neurology, Alfred Health, Melbourne, Australia
| | - Ana Antonic Baker
- Department of Neuroscience, The Central Clinical School, Monash University, Melbourne, Australia
| | - Anna Willard
- Department of Neuroscience, The Central Clinical School, Monash University, Melbourne, Australia; Department of Neurology, The Royal Melbourne Hospital, Melbourne, Australia; Department of Neurology, Alfred Health, Melbourne, Australia
| | - Joshua Laing
- Department of Neuroscience, The Central Clinical School, Monash University, Melbourne, Australia; Department of Neurology, Alfred Health, Melbourne, Australia
| | - Maria Rychkova
- Department of Neuroscience, The Central Clinical School, Monash University, Melbourne, Australia; Department of Neurology, The Royal Melbourne Hospital, Melbourne, Australia
| | - Zhibin Chen
- Department of Neuroscience, The Central Clinical School, Monash University, Melbourne, Australia
| | - Patrick Kwan
- Department of Neuroscience, The Central Clinical School, Monash University, Melbourne, Australia; Department of Neurology, The Royal Melbourne Hospital, Melbourne, Australia; Department of Neurology, Alfred Health, Melbourne, Australia; Department of Medicine (The Royal Melbourne Hospital), The University of Melbourne, Melbourne, Australia
| | - Terence J O'Brien
- Department of Neuroscience, The Central Clinical School, Monash University, Melbourne, Australia; Department of Neurology, The Royal Melbourne Hospital, Melbourne, Australia; Department of Neurology, Alfred Health, Melbourne, Australia; Department of Medicine (The Royal Melbourne Hospital), The University of Melbourne, Melbourne, Australia
| | - Piero Perucca
- Department of Neuroscience, The Central Clinical School, Monash University, Melbourne, Australia; Department of Neurology, The Royal Melbourne Hospital, Melbourne, Australia; Department of Neurology, Alfred Health, Melbourne, Australia; Bladin-Berkovic Comprehensive Epilepsy Program, Department of Neurology, Austin Health, Melbourne, Australia; Epilepsy Research Centre, Department of Medicine (Austin Health), The University of Melbourne, Melbourne, Australia
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14
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Lisgaras CP, Scharfman HE. Robust chronic convulsive seizures, high frequency oscillations, and human seizure onset patterns in an intrahippocampal kainic acid model in mice. Neurobiol Dis 2022; 166:105637. [PMID: 35091040 PMCID: PMC9034729 DOI: 10.1016/j.nbd.2022.105637] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 01/05/2022] [Accepted: 01/22/2022] [Indexed: 01/21/2023] Open
Abstract
Intrahippocampal kainic acid (IHKA) has been widely implemented to simulate temporal lobe epilepsy (TLE), but evidence of robust seizures is usually limited. To resolve this problem, we slightly modified previous methods and show robust seizures are common and frequent in both male and female mice. We employed continuous wideband video-EEG monitoring from 4 recording sites to best demonstrate the seizures. We found many more convulsive seizures than most studies have reported. Mortality was low. Analysis of convulsive seizures at 2-4 and 10-12 wks post-IHKA showed a robust frequency (2-4 per day on average) and duration (typically 20-30 s) at each time. Comparison of the two timepoints showed that seizure burden became more severe in approximately 50% of the animals. We show that almost all convulsive seizures could be characterized as either low-voltage fast or hypersynchronous onset seizures, which has not been reported in a mouse model of epilepsy and is important because these seizure types are found in humans. In addition, we report that high frequency oscillations (>250 Hz) occur, resembling findings from IHKA in rats and TLE patients. Pathology in the hippocampus at the site of IHKA injection was similar to mesial temporal lobe sclerosis and reduced contralaterally. In summary, our methods produce a model of TLE in mice with robust convulsive seizures, and there is variable progression. HFOs are robust also, and seizures have onset patterns and pathology like human TLE. SIGNIFICANCE: Although the IHKA model has been widely used in mice for epilepsy research, there is variation in outcomes, with many studies showing few robust seizures long-term, especially convulsive seizures. We present an implementation of the IHKA model with frequent convulsive seizures that are robust, meaning they are >10 s and associated with complex high frequency rhythmic activity recorded from 2 hippocampal and 2 cortical sites. Seizure onset patterns usually matched the low-voltage fast and hypersynchronous seizures in TLE. Importantly, there is low mortality, and both sexes can be used. We believe our results will advance the ability to use the IHKA model of TLE in mice. The results also have important implications for our understanding of HFOs, progression, and other topics of broad interest to the epilepsy research community. Finally, the results have implications for preclinical drug screening because seizure frequency increased in approximately half of the mice after a 6 wk interval, suggesting that the typical 2 wk period for monitoring seizure frequency is insufficient.
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Affiliation(s)
- Christos Panagiotis Lisgaras
- Departments of Child & Adolescent Psychiatry, Neuroscience & Physiology, and Psychiatry, and the Neuroscience Institute, New York University Langone Health, 550 First Ave., New York, NY 10016, United States of America,Center for Dementia Research, The Nathan Kline Institute for Psychiatric Research, New York State Office of Mental Health, 140 Old Orangeburg Road, Bldg. 35, Orangeburg, NY 10962, United States of America
| | - Helen E. Scharfman
- Departments of Child & Adolescent Psychiatry, Neuroscience & Physiology, and Psychiatry, and the Neuroscience Institute, New York University Langone Health, 550 First Ave., New York, NY 10016, United States of America,Center for Dementia Research, The Nathan Kline Institute for Psychiatric Research, New York State Office of Mental Health, 140 Old Orangeburg Road, Bldg. 35, Orangeburg, NY 10962, United States of America,Corresponding author at: The Nathan Kline Institute, Center for Dementia Research, 140 Old Orangeburg Rd. Bldg. 35, Orangeburg, NY 10962, United States of America. (H.E. Scharfman)
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15
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Pazarlar BA, Madsen CA, Oyar EÖ, Eğilmez CB, Mikkelsen JD. Temporal and Spatial Changes in Synaptic Vesicle Glycoprotein 2 A (SV2A) under Kainic Acid Induced Epileptogenesis: An Autoradiographic Study. Epilepsy Res 2022; 183:106926. [DOI: 10.1016/j.eplepsyres.2022.106926] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 04/10/2022] [Accepted: 04/14/2022] [Indexed: 11/03/2022]
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16
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Xu C, Zhang X, Zhang G, Yan X, Ma K, Qiao L, Wang X, Zhang X, Yu T, Wang Y, Li Y. Altered ripple density inside seizure onset zone in patients with focal cortical dysplasia-associated epilepsy. Brain Behav 2021; 11:e02169. [PMID: 33960712 PMCID: PMC8213653 DOI: 10.1002/brb3.2169] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 03/19/2021] [Accepted: 04/17/2021] [Indexed: 11/07/2022] Open
Abstract
PURPOSE To evaluate the clinical and stereoelectroencephalography (SEEG) features and postsurgical outcome in a uniform series of patients who underwent epilepsy surgery and had pathologically confirmation of focal cortical dysplasia (FCD). METHODS We studied consecutive patients with drug-refractory epilepsy who underwent SEEG recording. The high-frequency oscillations (HFOs) features of SEEG, clinical characteristics, and surgical outcome were evaluated. RESULTS Sixty patients (31 FCD type I, 13 II, and 16 III) were analyzed retrospectively. Patients with type II tended to have their seizures at an earlier age than those with I and III (p < .01). Six different ictal onset patterns (IOPs) were identified. In patients with temporal lobe epilepsy (TLE), the most common patterns were rhythmic spikes or spike waves and LFRS, and in patients with extratemporal epilepsy, the most common patterns were low-voltage fast activity (LVFA) and rhythmic spikes or spike waves. In addition, ripple density was found to increase significantly from the interictal to ictal onset sections and from the ictal onset to ictal evolution sections in patients with FCD I (p < .001). Regarding the distinct IOPs, ripple density continued to increase significantly between the interictal and ictal onset sections in LVFA, rhythmic spikes or spike waves, and burst of high-amplitude polyspikes (p < .05). Ripple density decreased between ictal onset and ictal evolution sections in patterns of LVFA and rhythmic spikes or spike waves (p < .05). The mean follow-up duration was 2.7 years (range 1-4.2), and 66.7% (n = 40) were class I. Patients with subtypes III and II had favorable surgical outcome than those with I. CONCLUSION The clinical expression of seizure may depend on the pathological types with FCD II patients exhibiting their seizures at an earlier age. Distinct IOPs may demonstrate different ripple features and distinguishing the IOPs is very necessary to have an insight into the electrophysiological characteristics.
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Affiliation(s)
- Cuiping Xu
- Beijing Institute of Functional Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Xiaohua Zhang
- Beijing Institute of Functional Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Guojun Zhang
- Beijing Institute of Functional Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Xiaoming Yan
- Beijing Institute of Functional Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Kai Ma
- Beijing Institute of Functional Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Liang Qiao
- Beijing Institute of Functional Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Xueyuan Wang
- Beijing Institute of Functional Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Xi Zhang
- Beijing Institute of Functional Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Tao Yu
- Beijing Institute of Functional Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Yuping Wang
- Department of neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Yongjie Li
- Beijing Institute of Functional Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
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Lim HK, You N, Bae S, Kang BM, Shon YM, Kim SG, Suh M. Differential contribution of excitatory and inhibitory neurons in shaping neurovascular coupling in different epileptic neural states. J Cereb Blood Flow Metab 2021; 41:1145-1161. [PMID: 32669018 PMCID: PMC8054729 DOI: 10.1177/0271678x20934071] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Understanding the neurovascular coupling (NVC) underlying hemodynamic changes in epilepsy is crucial to properly interpreting functional brain imaging signals associated with epileptic events. However, how excitatory and inhibitory neurons affect vascular responses in different epileptic states remains unknown. We conducted real-time in vivo measurements of cerebral blood flow (CBF), vessel diameter, and excitatory and inhibitory neuronal calcium signals during recurrent focal seizures. During preictal states, decreases in CBF and arteriole diameter were closely related to decreased γ-band local field potential (LFP) power, which was linked to relatively elevated excitatory and reduced inhibitory neuronal activity levels. Notably, this preictal condition was followed by a strengthened ictal event. In particular, the preictal inhibitory activity level was positively correlated with coherent oscillating activity specific to inhibitory neurons. In contrast, ictal states were characterized by elevated synchrony in excitatory neurons. Given these findings, we suggest that excitatory and inhibitory neurons differentially contribute to shaping the ictal and preictal neural states, respectively. Moreover, the preictal vascular activity, alongside with the γ-band, may reflect the relative levels of excitatory and inhibitory neuronal activity, and upcoming ictal activity. Our findings provide useful insights into how perfusion signals of different epileptic states are related in terms of NVC.
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Affiliation(s)
- Hyun-Kyoung Lim
- Center for Neuroscience Imaging Research (CNIR), Institute for Basic Science (IBS), Suwon, South Korea.,Department of Biological Sciences, Sungkyunkwan University, Suwon, South Korea
| | - Nayeon You
- Center for Neuroscience Imaging Research (CNIR), Institute for Basic Science (IBS), Suwon, South Korea.,Department of Biomedical Engineering, Sungkyunkwan University, Suwon, South Korea
| | - Sungjun Bae
- Center for Neuroscience Imaging Research (CNIR), Institute for Basic Science (IBS), Suwon, South Korea.,Department of Biomedical Engineering, Sungkyunkwan University, Suwon, South Korea
| | - Bok-Man Kang
- Center for Neuroscience Imaging Research (CNIR), Institute for Basic Science (IBS), Suwon, South Korea.,Department of Biomedical Engineering, Sungkyunkwan University, Suwon, South Korea
| | - Young-Min Shon
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Seong-Gi Kim
- Center for Neuroscience Imaging Research (CNIR), Institute for Basic Science (IBS), Suwon, South Korea.,Department of Biomedical Engineering, Sungkyunkwan University, Suwon, South Korea
| | - Minah Suh
- Center for Neuroscience Imaging Research (CNIR), Institute for Basic Science (IBS), Suwon, South Korea.,Department of Biomedical Engineering, Sungkyunkwan University, Suwon, South Korea.,Biomedical Institute for Convergence at SKKU (BICS), Sungkyunkwan University, Suwon, South Korea.,Samsung Advanced Institute for Health Sciences & Technology (SAIHST), Sungkyunkwan University, Suwon, South Korea
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Uva L, Aracri P, Forcaia G, de Curtis M. Mapping region-specific seizure-like patterns in the in vitro isolated guinea pig brain. Exp Neurol 2021; 342:113727. [PMID: 33930392 DOI: 10.1016/j.expneurol.2021.113727] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 04/09/2021] [Accepted: 04/22/2021] [Indexed: 10/21/2022]
Abstract
Specific neurophysiological seizure patterns in patients with focal epilepsy depend on cerebral location and the underlying neuropathology. Location-specific patterns have been also reported in experimental models. Two focal seizure patterns, named p-type and l-type, typical of neocortical and mesial temporal regions were identified in both patients explored with intracerebral EEG and in animal models. These two patterns were recorded in the olfactory regions and in the entorhinal cortex after either 4AP or BMI administration. Here we mapped epileptiform activities in other cortices to verify the existence of specific epileptiform patterns. Field potentials were simultaneously recorded at multiple locations in olfactory, limbic and neocortical regions of the isolated guinea pig brain after arterial administration of either 4AP or BMI. Most neocortical areas did not generate new distinctive focal seizure-like event (SLE), beside the p-type and l-type patterns. Spiking activity was typically recorded after BMI in all new analyzed regions, whereas SLEs were commonly observed during 4AP perfusion. We confirmed the presence of reproducible region-specific epileptiform patterns in all explored cortical areas and demonstrated that strongly inter-connected areas generate similar SLEs. Our study suggests that p- and l-type SLE represent the most common focal seizure patterns during acute manipulations with pro-epileptic compounds.
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Affiliation(s)
- Laura Uva
- Epilepsy Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, via Amadeo 42, 20133 Milano, Italy.
| | - Patrizia Aracri
- Epilepsy Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, via Amadeo 42, 20133 Milano, Italy
| | - Greta Forcaia
- School of Medicine and Surgery, University of Milano-Bicocca, via Cadore 48, 20900 Monza, MB, Italy.
| | - Marco de Curtis
- Epilepsy Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, via Amadeo 42, 20133 Milano, Italy.
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Salami P, Peled N, Nadalin JK, Martinet LE, Kramer MA, Lee JW, Cash SS. Seizure onset location shapes dynamics of initiation. Clin Neurophysiol 2020; 131:1782-1797. [PMID: 32512346 DOI: 10.1016/j.clinph.2020.04.168] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 03/24/2020] [Accepted: 04/13/2020] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Ictal electrographic patterns are widely thought to reflect underlying neural mechanisms of seizures. Here we studied the degree to which seizure patterns are consistent in a given patient, relate to particular brain regions and if two candidate biomarkers (high-frequency oscillations, HFOs; infraslow activity, ISA) and network activity, as assessed with cross-frequency interactions, can discriminate between seizure types. METHODS We analyzed temporal changes in low and high frequency oscillations recorded during seizures, as well as phase-amplitude coupling (PAC) to monitor the interactions between delta/theta and ripple/fast ripple frequency bands at seizure onset. RESULTS Seizures of multiple electrographic patterns were observed in a given patient and brain region. While there was an increase in HFO rate across different electrographic patterns, there are specific relationships between types of HFO activity and onset region. Similarly, changes in PAC dynamics were more closely related to seizure onset region than they were to electrographic patterns while ISA was a poor indicator for seizure onset. CONCLUSIONS Our findings suggest that the onset region sculpts neurodynamics at seizure initiation and that unique features of the cytoarchitecture and/or connectivity of that region play a significant role in determining seizure mechanism. SIGNIFICANCE To learn how seizures are initiated, researchers would do well to consider other aspects of their manifestation, in addition to their electrographic patterns. Examination of onset pattern in conjunction with the interactions between different oscillatory frequencies in the context of different brain regions might be more informative and lead to more reliable clinical inference as well as novel therapeutic approaches.
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Affiliation(s)
- Pariya Salami
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
| | - Noam Peled
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Jessica K Nadalin
- Department of Mathematics and Statistics, Boston University, Boston, MA, USA
| | - Louis-Emmanuel Martinet
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Mark A Kramer
- Department of Mathematics and Statistics, Boston University, Boston, MA, USA
| | - Jong W Lee
- Department of Neurology, Brigham and Women's Hospital, Boston, MA, USA
| | - Sydney S Cash
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
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Luft JG, Steffens L, Morás AM, da Rosa MS, Leipnitz G, Regner GG, Pflüger PF, Gonçalves D, Moura DJ, Pereira P. Rosmarinic acid improves oxidative stress parameters and mitochondrial respiratory chain activity following 4-aminopyridine and picrotoxin-induced seizure in mice. NAUNYN-SCHMIEDEBERG'S ARCHIVES OF PHARMACOLOGY 2019; 392:1347-1358. [PMID: 31201429 DOI: 10.1007/s00210-019-01675-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Accepted: 06/07/2019] [Indexed: 12/22/2022]
Abstract
Studies have indicated that epilepsy, an important neurological disease, can generate oxidative stress and mitochondrial dysfunction, among other damages to the brain. In this context, the use of antioxidant compounds could provide neuroprotection and help to reduce the damage caused by epileptic seizures and thereby the use of anticonvulsant drugs. Rosmarinic acid (RA) is an ester of caffeic acid and 3,4-dihydroxyphenylactic acid that prevents cell damage caused by free radicals, acting as an antioxidant. It also presents anti-inflammatory, antimutagenic, and antiapoptotic properties. In this work, we used two models of acute seizure, 4-aminopyridine (4-AP) and picrotoxin (PTX)-induced seizures in mice, to investigate the anticonvulsant, antioxidant, and neuroprotective profile of RA. Diazepam and valproic acid, antiepileptic drugs already used in the treatment of epilepsy, were used as positive controls. Although RA could not prevent seizures in the models used in this study, neither enhance the latency time to first seizure at the tested doses, it exhibited an antioxidant and neuroprotective effect. RA (8 and 16 mg/kg) decreased reactive oxygen species production, superoxide dismutase activity, and DNA damage, measured in hippocampus, after seizures induced by PTX and 4-AP. Catalase activity was decreased by RA only after seizures induced by 4-AP. The activity of the mitochondrial complex II was increased by RA in hippocampus samples after both seizure models. The results obtained in this study suggest that RA is able to reduce cell damage generated by the 4-AP and PTX seizures and therefore could represent a potential candidate in reducing pathophysiological processes involved in epilepsy.
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Affiliation(s)
- Jordana Griebler Luft
- Neuropharmacology and Preclinical Toxicology Laboratory, Institute of Basic Health Sciences, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, RS, 90050-170, Brazil
| | - Luiza Steffens
- Laboratory of Genetic Toxicology, Federal University of Health Sciences of Porto Alegre (UFCSPA), Sarmento Leite st., Porto Alegre, RS, 245, Brazil
| | - Ana Moira Morás
- Laboratory of Genetic Toxicology, Federal University of Health Sciences of Porto Alegre (UFCSPA), Sarmento Leite st., Porto Alegre, RS, 245, Brazil
| | - Mateus Strucker da Rosa
- Programa de Pós-Graduação em Ciências Biológicas: Bioquímica, Institute of Basic Health Sciences, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, RS, 90035-003, Brazil
| | - Guilhian Leipnitz
- Programa de Pós-Graduação em Ciências Biológicas: Bioquímica, Institute of Basic Health Sciences, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, RS, 90035-003, Brazil
- Programa de Pós-Graduação em Fisiologia, Institute of Basic Health Sciences, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, RS, 90035-190, Brazil
| | - Gabriela Gregory Regner
- Neuropharmacology and Preclinical Toxicology Laboratory, Institute of Basic Health Sciences, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, RS, 90050-170, Brazil
| | - Pricila Fernandes Pflüger
- Neuropharmacology and Preclinical Toxicology Laboratory, Institute of Basic Health Sciences, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, RS, 90050-170, Brazil
| | - Débora Gonçalves
- Neuropharmacology and Preclinical Toxicology Laboratory, Institute of Basic Health Sciences, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, RS, 90050-170, Brazil
| | - Dinara Jaqueline Moura
- Laboratory of Genetic Toxicology, Federal University of Health Sciences of Porto Alegre (UFCSPA), Sarmento Leite st., Porto Alegre, RS, 245, Brazil
| | - Patrícia Pereira
- Neuropharmacology and Preclinical Toxicology Laboratory, Institute of Basic Health Sciences, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, RS, 90050-170, Brazil.
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21
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Kandrács Á, Hofer KT, Tóth K, Tóth EZ, Entz L, Bagó AG, Erőss L, Jordán Z, Nagy G, Fabó D, Ulbert I, Wittner L. Presence of synchrony-generating hubs in the human epileptic neocortex. J Physiol 2019; 597:5639-5670. [PMID: 31523807 DOI: 10.1113/jp278499] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Accepted: 09/06/2019] [Indexed: 11/08/2022] Open
Abstract
KEY POINTS •Initiation of pathological synchronous events such as epileptic spikes and seizures is linked to the hyperexcitability of the neuronal network in both humans and animals. •In the present study, we show that epileptiform interictal-like spikes and seizures emerged in human neocortical slices by blocking GABAA receptors, following the disappearance of the spontaneously occurring synchronous population activity. •Large variability of temporally and spatially simple and complex spikes was generated by tissue from epileptic patients, whereas only simple events appeared in samples from non-epileptic patients. •Physiological population activity was associated with a moderate level of principal cell and interneuron firing, with a slight dominance of excitatory neuronal activity, whereas epileptiform events were mainly initiated by the synchronous and intense discharge of inhibitory cells. •These results help us to understand the role of excitatory and inhibitory neurons in synchrony-generating mechanisms, in both epileptic and non-epileptic conditions. ABSTRACT Understanding the role of different neuron types in synchrony generation is crucial for developing new therapies aiming to prevent hypersynchronous events such as epileptic seizures. Paroxysmal activity was linked to hyperexcitability and to bursting behaviour of pyramidal cells in animals. Human data suggested a leading role of either principal cells or interneurons, depending on the seizure morphology. In the present study, we aimed to uncover the role of excitatory and inhibitory processes in synchrony generation by analysing the activity of clustered single neurons during physiological and epileptiform synchronies in human neocortical slices. Spontaneous population activity was detected with a 24-channel laminar microelectrode in tissue derived from patients with or without preoperative clinical manifestations of epilepsy. This population activity disappeared by blocking GABAA receptors, and several variations of spatially and temporally simple or complex interictal-like spikes emerged in epileptic tissue, whereas peritumoural slices generated only simple spikes. Around one-half of the clustered neurons participated with an elevated firing rate in physiological synchronies with a slight dominance of excitatory cells. By contrast, more than 90% of the neurons contributed to interictal-like spikes and seizures, and an intense and synchronous discharge of inhibitory neurons was associated with the start of these events. Intrinsically bursting principal cells fired later than other neurons. Our data suggest that a balanced excitation and inhibition characterized physiological synchronies, whereas disinhibition-induced epileptiform events were initiated mainly by non-synaptically synchronized inhibitory neurons. Our results further highlight the differences between humans and animal models, and between in vivo and (pharmacologically manipulated) in vitro conditions.
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Affiliation(s)
- Ágnes Kandrács
- Institute of Cognitive Neuroscience and Psychology, Research Center for Natural Sciences, Hungarian Academy of Sciences, Budapest, Hungary.,Faculty of Information Technology and Bionics, Pázmány Péter Catholic University, Budapest, Hungary
| | - Katharina T Hofer
- Institute of Cognitive Neuroscience and Psychology, Research Center for Natural Sciences, Hungarian Academy of Sciences, Budapest, Hungary.,Faculty of Information Technology and Bionics, Pázmány Péter Catholic University, Budapest, Hungary
| | - Kinga Tóth
- Institute of Cognitive Neuroscience and Psychology, Research Center for Natural Sciences, Hungarian Academy of Sciences, Budapest, Hungary
| | - Estilla Z Tóth
- Institute of Cognitive Neuroscience and Psychology, Research Center for Natural Sciences, Hungarian Academy of Sciences, Budapest, Hungary
| | - László Entz
- National Institute of Clinical Neuroscience, Budapest, Hungary
| | - Attila G Bagó
- National Institute of Clinical Neuroscience, Budapest, Hungary
| | - Loránd Erőss
- National Institute of Clinical Neuroscience, Budapest, Hungary
| | - Zsófia Jordán
- National Institute of Clinical Neuroscience, Budapest, Hungary
| | - Gábor Nagy
- National Institute of Clinical Neuroscience, Budapest, Hungary
| | - Dániel Fabó
- National Institute of Clinical Neuroscience, Budapest, Hungary
| | - István Ulbert
- Institute of Cognitive Neuroscience and Psychology, Research Center for Natural Sciences, Hungarian Academy of Sciences, Budapest, Hungary.,Faculty of Information Technology and Bionics, Pázmány Péter Catholic University, Budapest, Hungary.,National Institute of Clinical Neuroscience, Budapest, Hungary
| | - Lucia Wittner
- Institute of Cognitive Neuroscience and Psychology, Research Center for Natural Sciences, Hungarian Academy of Sciences, Budapest, Hungary.,Faculty of Information Technology and Bionics, Pázmány Péter Catholic University, Budapest, Hungary.,National Institute of Clinical Neuroscience, Budapest, Hungary
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22
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Schönberger J, Frauscher B, von Ellenrieder N, Avoli M, Dubeau F, Gotman J. Fast ripple analysis in human mesial temporal lobe epilepsy suggests two different seizure-generating mechanisms. Neurobiol Dis 2019; 127:374-381. [DOI: 10.1016/j.nbd.2019.03.030] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 03/19/2019] [Accepted: 03/26/2019] [Indexed: 12/16/2022] Open
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Lévesque M, Avoli M. High-frequency oscillations and focal seizures in epileptic rodents. Neurobiol Dis 2018; 124:396-407. [PMID: 30590178 DOI: 10.1016/j.nbd.2018.12.016] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Revised: 11/26/2018] [Accepted: 12/22/2018] [Indexed: 01/09/2023] Open
Abstract
High-pass filtering (> 80 Hz) of EEG signals has enabled neuroscientists to analyze high-frequency oscillations (HFOs; i.e., ripples: 80-200 Hz and fast ripples: 250-500 Hz) in epileptic patients presenting with focal seizures and in animal models mimicking this condition. Evidence obtained from these studies indicate that HFOs mirror pathological network activity that may initiate and sustain ictogenesis and epileptogenesis. HFOs are observed in temporal lobe regions of epileptic animals during interictal periods but they also occur before seizure onset and during the ictal period, suggesting that they can pinpoint to the mechanisms of seizure generation. Accordingly, ripples and fast ripples predominate during two specific seizure onset patterns termed low-voltage fast and hypersynchronous, respectively. In this review we will: (i) summarize these experimental studies; (ii) consider the evolution of HFOs over time during epileptogenesis; (iii) address data obtained with optogenetic stimulating procedures both in vitro and in vivo, and (iv) take into account the impact of anti-epileptic drugs on HFOs. We expect these findings to contribute to understanding the neuronal mechanisms leading to ictogenesis and epileptogenesis thus leading to the development of mechanistically targeted anti-epileptic strategies.
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Affiliation(s)
| | - Massimo Avoli
- Montreal Neurological Institute, Canada; Departments of Neurology & Neurosurgery, and of Physiology, McGill University, Montréal, H3A 2B4 Québec, Canada; Department of Experimental Medicine, Facoltà di Medicina e Odontoiatria, Sapienza University of Rome, 00185 Roma, Italy
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24
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Li F, Lin J, Liu X, Li W, Ding Y, Zhang Y, Zhou S, Guo N, Li Q. Characterization of the locomotor activities of zebrafish larvae under the influence of various neuroactive drugs. ANNALS OF TRANSLATIONAL MEDICINE 2018; 6:173. [PMID: 29951495 DOI: 10.21037/atm.2018.04.25] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background Behavioral changes in animals reflect functional changes in their central nervous system. Neuroactive drugs that act on different neural pathways can induce specific behavioral responses; therefore, it is possible to infer the activities of neuroactive drugs by studying the behavioral changes induced by drugs of interest in animals. Methods In this study, AB strain zebrafish larvae at 7 days post fertilization (dpf) were treated with different concentrations of drugs that act on different neural pathways. Changes in the swimming distances of zebrafish larvae under different illumination conditions and the differences in locomotor activities between light and dark conditions (lighting motor index) were analyzed. Results Among the drugs studied, different concentrations of sulpiride had no effect on larval locomotor activity either under light or dark conditions. Progressively decreased spontaneous movements were observed in zebrafish larvae treated with increasing doses of MK-801 and valproic acid. With increasing concentrations of pentylenetetrazole and yohimbine, the spontaneous movement of larval zebrafish presented a bell-shaped response. When the illumination changed from light to dark, zebrafish larvae not treated with drugs demonstrated increased locomotor activities. However, high levels of yohimbine, pentylenetetrazole decreased the degree of change in the lighting motor index. Conclusions In conclusion, drugs that affect different neural pathways exert different influences on the locomotor activities of zebrafish larvae. This study presents an initial effort to establish a framework that correlates the drug activities and the behavioral responses of zebrafish larvae under drug treatments, which may provide a potential identification of the pathways of novel drugs with neurological activities through their behavioral influences.
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Affiliation(s)
- Fei Li
- Translational Medical Center for Development and Disease, Institute of Pediatrics, Shanghai Key Laboratory of Birth Defect, Children's Hospital of Fudan University, Shanghai 201102, China
| | - Jia Lin
- Translational Medical Center for Development and Disease, Institute of Pediatrics, Shanghai Key Laboratory of Birth Defect, Children's Hospital of Fudan University, Shanghai 201102, China
| | - Xiuyun Liu
- Translational Medical Center for Development and Disease, Institute of Pediatrics, Shanghai Key Laboratory of Birth Defect, Children's Hospital of Fudan University, Shanghai 201102, China
| | - Wenhui Li
- Department of Neurology, Children's Hospital of Fudan University, Shanghai 201102, China
| | - Yifeng Ding
- Department of Neurology, Children's Hospital of Fudan University, Shanghai 201102, China
| | - Yunjian Zhang
- Department of Neurology, Children's Hospital of Fudan University, Shanghai 201102, China
| | - Shuizhen Zhou
- Department of Neurology, Children's Hospital of Fudan University, Shanghai 201102, China
| | - Ning Guo
- Center for Chinese Medical Therapy and Systems Biology, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Qiang Li
- Translational Medical Center for Development and Disease, Institute of Pediatrics, Shanghai Key Laboratory of Birth Defect, Children's Hospital of Fudan University, Shanghai 201102, China
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25
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Pharmacological Modulation of Three Modalities of CA1 Hippocampal Long-Term Potentiation in the Ts65Dn Mouse Model of Down Syndrome. Neural Plast 2018; 2018:9235796. [PMID: 29849573 PMCID: PMC5914153 DOI: 10.1155/2018/9235796] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2018] [Accepted: 03/15/2018] [Indexed: 02/02/2023] Open
Abstract
The Ts65Dn mouse is the most studied animal model of Down syndrome. Past research has shown a significant reduction in CA1 hippocampal long-term potentiation (LTP) induced by theta-burst stimulation (TBS), but not in LTP induced by high-frequency stimulation (HFS), in slices from Ts65Dn mice compared with euploid mouse-derived slices. Additionally, therapeutically relevant doses of the drug memantine were shown to rescue learning and memory deficits in Ts65Dn mice. Here, we observed that 1 μM memantine had no detectable effect on HFS-induced LTP in either Ts65Dn- or control-derived slices, but it rescued TBS-induced LTP in Ts65Dn-derived slices to control euploid levels. Then, we assessed LTP induced by four HFS (4xHFS) and found that this form of LTP was significantly depressed in Ts65Dn slices when compared with LTP in euploid control slices. Memantine, however, did not rescue this phenotype. Because 4xHFS-induced LTP had not yet been characterized in Ts65Dn mice, we also investigated the effects of picrotoxin, amyloid beta oligomers, and soluble recombinant human prion protein (rPrP) on this form of LTP. Whereas ≥10 μM picrotoxin increased LTP to control levels, it also caused seizure-like oscillations. Neither amyloid beta oligomers nor rPrP had any effect on 4xHFS-induced LTP in Ts65Dn-derived slices.
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26
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High frequency oscillations in epileptic rodents: Are we doing it right? J Neurosci Methods 2018; 299:16-21. [PMID: 29476870 DOI: 10.1016/j.jneumeth.2018.02.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Revised: 02/16/2018] [Accepted: 02/20/2018] [Indexed: 11/24/2022]
Abstract
BACKGROUND The detection of high-frequency oscillations (HFOs, ripples: 80-200 Hz, fast ripples: 250-500 Hz) is often based on considering ripples or fast ripples in isolation; overlapping ripples and fast ripples are excluded from further analysis. Here, we studied overlapping HFOs during spontaneous seizures in pilocarpine-treated animals. NEW METHOD Spontaneous seizures (n = 6 animals) presented with either hypersynchronous- (HYP, n = 18) or low-voltage fast-onset (LVF, n = 21) pattern. Ripples and fast ripples overlapping by more than 30% were analysed. RESULTS Overlapping HFOs could show a unimodal power spectrum between 80-500 Hz (n = 188, 58.9%) or a bimodal power spectrum, with peaks in power between 80 and 200 Hz and between 250 and 500 Hz (n = 131, 41.1%,). Overlapping HFOs occurred at higher rates during HYP seizures compared to the pre-ictal period in seizure onset zones (p < 0.001) and regions of secondary spread (p < 0.001). When comparing HYP and LVF seizures, we found that overlapping HFOs occurred at higher rates before LVF seizures (p < 0.05) compared to HYP seizures but, during the ictal period, HYP seizures showed higher rates of overlapping HFOs than LVF seizures (p < 0.001). COMPARISON WITH EXISTING METHODS We have analysed overlapping ripples and fast ripples shortly before and during seizures. CONCLUSIONS Although overlapping ripples and fast ripples represent a minority of HFOs, they may provide additional information on the excitability of neuronal networks that generate seizures in animal models and patients presenting with mesial temporal lobe epilepsy.
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27
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Behr C, Lévesque M, Stroh T, Avoli M. Time-dependent evolution of seizures in a model of mesial temporal lobe epilepsy. Neurobiol Dis 2017; 106:205-213. [DOI: 10.1016/j.nbd.2017.07.008] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Revised: 07/03/2017] [Accepted: 07/10/2017] [Indexed: 01/21/2023] Open
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28
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Winter MJ, Windell D, Metz J, Matthews P, Pinion J, Brown JT, Hetheridge MJ, Ball JS, Owen SF, Redfern WS, Moger J, Randall AD, Tyler CR. 4-dimensional functional profiling in the convulsant-treated larval zebrafish brain. Sci Rep 2017; 7:6581. [PMID: 28747660 PMCID: PMC5529444 DOI: 10.1038/s41598-017-06646-6] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Accepted: 06/29/2017] [Indexed: 11/09/2022] Open
Abstract
Functional neuroimaging, using genetically-encoded Ca2+ sensors in larval zebrafish, offers a powerful combination of high spatiotemporal resolution and higher vertebrate relevance for quantitative neuropharmacological profiling. Here we use zebrafish larvae with pan-neuronal expression of GCaMP6s, combined with light sheet microscopy and a novel image processing pipeline, for the 4D profiling of chemoconvulsant action in multiple brain regions. In untreated larvae, regions associated with autonomic functionality, sensory processing and stress-responsiveness, consistently exhibited elevated spontaneous activity. The application of drugs targeting different convulsant mechanisms (4-Aminopyridine, Pentylenetetrazole, Pilocarpine and Strychnine) resulted in distinct spatiotemporal patterns of activity. These activity patterns showed some interesting parallels with what is known of the distribution of their respective molecular targets, but crucially also revealed system-wide neural circuit responses to stimulation or suppression. Drug concentration-response curves of neural activity were identified in a number of anatomically-defined zebrafish brain regions, and in vivo larval electrophysiology, also conducted in 4dpf larvae, provided additional measures of neural activity. Our quantification of network-wide chemoconvulsant drug activity in the whole zebrafish brain illustrates the power of this approach for neuropharmacological profiling in applications ranging from accelerating studies of drug safety and efficacy, to identifying pharmacologically-altered networks in zebrafish models of human neurological disorders.
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Affiliation(s)
- Matthew J Winter
- Biosciences, College of Life and Environmental Sciences, Exeter, Devon, EX4 4QD, United Kingdom.
| | - Dylan Windell
- Biosciences, College of Life and Environmental Sciences, Exeter, Devon, EX4 4QD, United Kingdom
| | - Jeremy Metz
- Biosciences, College of Life and Environmental Sciences, Exeter, Devon, EX4 4QD, United Kingdom
| | - Peter Matthews
- Medical School, University of Exeter, Exeter, Devon, EX4 4PS, United Kingdom
| | - Joe Pinion
- Medical School, University of Exeter, Exeter, Devon, EX4 4PS, United Kingdom
| | - Jonathan T Brown
- Medical School, University of Exeter, Exeter, Devon, EX4 4PS, United Kingdom
| | - Malcolm J Hetheridge
- Biosciences, College of Life and Environmental Sciences, Exeter, Devon, EX4 4QD, United Kingdom
| | - Jonathan S Ball
- Biosciences, College of Life and Environmental Sciences, Exeter, Devon, EX4 4QD, United Kingdom
| | - Stewart F Owen
- AstraZeneca, Global Compliance, Alderley Park, Macclesfield, Cheshire, SK10 4TF, United Kingdom
| | - Will S Redfern
- AstraZeneca R&D Innovative Medicines, Drug Safety & Metabolism, Babraham Research Campus, Cambridge, CB22 3AT, United Kingdom
| | - Julian Moger
- Physics and Medical Imaging, College of Engineering, Mathematics and Physical Sciences, University of Exeter, Exeter, Devon, EX4 4QL, United Kingdom
| | - Andrew D Randall
- Medical School, University of Exeter, Exeter, Devon, EX4 4PS, United Kingdom
| | - Charles R Tyler
- Biosciences, College of Life and Environmental Sciences, Exeter, Devon, EX4 4QD, United Kingdom
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29
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Lévesque M, Salami P, Shiri Z, Avoli M. Interictal oscillations and focal epileptic disorders. Eur J Neurosci 2017. [DOI: 10.1111/ejn.13628] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Affiliation(s)
- Maxime Lévesque
- Department of Neurology & Neurosurgery; Montreal Neurological Institute; McGill University; 3801 University Street Montréal QC Canada H3A 2B4
| | - Pariya Salami
- Department of Neurology & Neurosurgery; Montreal Neurological Institute; McGill University; 3801 University Street Montréal QC Canada H3A 2B4
| | - Zahra Shiri
- Department of Neurology & Neurosurgery; Montreal Neurological Institute; McGill University; 3801 University Street Montréal QC Canada H3A 2B4
| | - Massimo Avoli
- Department of Neurology & Neurosurgery; Montreal Neurological Institute; McGill University; 3801 University Street Montréal QC Canada H3A 2B4
- Dipartimento di Medicina Sperimentale; Sapienza University of Rome; Roma Italy
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Different seizure-onset patterns in mesiotemporal lobe epilepsy have a distinct interictal signature. Clin Neurophysiol 2017; 128:1282-1289. [DOI: 10.1016/j.clinph.2017.04.020] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Revised: 03/28/2017] [Accepted: 04/26/2017] [Indexed: 11/15/2022]
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Yang X, Lin J, Peng X, Zhang Q, Zhang Y, Guo N, Zhou S, Li Q. Effects of picrotoxin on zebrafish larvae behaviors: A comparison study with PTZ. Epilepsy Behav 2017; 70:224-231. [PMID: 28437751 DOI: 10.1016/j.yebeh.2017.03.023] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2016] [Revised: 02/09/2017] [Accepted: 03/17/2017] [Indexed: 12/22/2022]
Abstract
Larval zebrafish (Danio rerio) have been suggested as a high-throughput experimental animal model for epilepsy-related genetic and developmental studies. The behavioral manifestations in response to the seizure-inducing drugs picrotoxin (PTX) (1, 5, 25, 125, or 625μM) or pentylenetetrazole (PTZ) (1, 2, 4, 8, or 16mM) under light-dark conditions were studied using zebrafish larvae at 5days post-fertilization (dpf). Two behavioral parameters, locomotor activity and thigmotaxis behavior, were analyzed. We conclude that high concentrations of PTX treatment increased locomotion and thigmotaxis in 5 dpf zebrafish larvae under continuous illumination and the locomotion of PTX-treated zebrafish was decreased under the dark condition. High concentrations of PTX treatment also increased thigmotaxis (an indicator of increased anxiety levels) in zebrafish larvae under both continuous illumination and dark condition. PTZ treatment increased the locomotion of 5 dpf zebrafish larvae under continuous illumination. However, 2mM PTZ decreased locomotion, and high concentrations of PTZ decreased the locomotion of larvae under dark conditions. High concentrations of PTZ treatment also increased thigmotaxis in the zebrafish larvae under both continuous illumination and dark condition. Compared with PTZ, PTX leads to higher levels of movement under light conditions and lower levels of movement under dark condition. However, the level of thigmotaxis in the zebrafish larvae was similar between the two drug treatments.
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Affiliation(s)
- Xue Yang
- Department of Neurology, Children's Hospital of Fudan University, No. 399, Wanyuan Road, Minhang District, Shanghai 201102, China
| | - Jia Lin
- Translational Medical Center for Development and Disease, Shanghai Key Laboratory of Birth Defect, Institute of Pediatrics, Children's Hospital of Fudan University, 399 Wanyuan Road, Shanghai 201102, China
| | - Xiaolan Peng
- Translational Medical Center for Development and Disease, Shanghai Key Laboratory of Birth Defect, Institute of Pediatrics, Children's Hospital of Fudan University, 399 Wanyuan Road, Shanghai 201102, China
| | | | - Yinglan Zhang
- Translational Medical Center for Development and Disease, Shanghai Key Laboratory of Birth Defect, Institute of Pediatrics, Children's Hospital of Fudan University, 399 Wanyuan Road, Shanghai 201102, China
| | - Ning Guo
- Center for Chinese Medical Therapy and Systems Biology, Shanghai University of Traditional Chinese Medicine, 1200 Cailun Road, Shanghai 201203, China
| | - Shuizhen Zhou
- Department of Neurology, Children's Hospital of Fudan University, No. 399, Wanyuan Road, Minhang District, Shanghai 201102, China
| | - Qiang Li
- Translational Medical Center for Development and Disease, Shanghai Key Laboratory of Birth Defect, Institute of Pediatrics, Children's Hospital of Fudan University, 399 Wanyuan Road, Shanghai 201102, China.
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Lévesque M, Shiri Z, Chen LY, Avoli M. High-frequency oscillations and mesial temporal lobe epilepsy. Neurosci Lett 2017; 667:66-74. [PMID: 28115239 DOI: 10.1016/j.neulet.2017.01.047] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2016] [Revised: 01/18/2017] [Accepted: 01/19/2017] [Indexed: 01/25/2023]
Abstract
The interest of epileptologists has recently shifted from the macroscopic analysis of interictal spikes and seizures to the microscopic analysis of short events in the EEG that are not visible to the naked eye but are observed once the signal has been filtered in specific frequency bands. With the use of new technologies that allow multichannel recordings at high sampling rates and the development of computer algorithms that permit the automated analysis of extensive amounts of data, it is now possible to extract high-frequency oscillations (HFOs) between 80 and 500Hz from the EEG; HFOs have been further categorised as ripples (80-200Hz) and fast ripples (250-500Hz). Within the context of epileptic disorders, HFOs should reflect the pathological activity of neural networks that sustain seizure generation, and could serve as biomarkers of epileptogenesis and ictogenesis. We review here the presumptive cellular mechanisms of ripples and fast ripples in mesial temporal lobe epilepsy. We also focus on recent findings regarding the occurrence of HFOs during epileptiform activity observed in in vitro models of epileptiform synchronization, in in vivo models of mesial temporal lobe epilepsy and in epileptic patients. Finally, we address the effects of anti-epileptic drugs on HFOs and raise some questions and issues related to the definition of HFOs.
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Affiliation(s)
- Maxime Lévesque
- Montreal Neurological Institute and Department of Neurology & Neurosurgery, McGill University, 3801 University Street, Montréal, QC, H3A 2B4, Canada
| | - Zahra Shiri
- Montreal Neurological Institute and Department of Neurology & Neurosurgery, McGill University, 3801 University Street, Montréal, QC, H3A 2B4, Canada
| | - Li-Yuan Chen
- Montreal Neurological Institute and Department of Neurology & Neurosurgery, McGill University, 3801 University Street, Montréal, QC, H3A 2B4, Canada
| | - Massimo Avoli
- Montreal Neurological Institute and Department of Neurology & Neurosurgery, McGill University, 3801 University Street, Montréal, QC, H3A 2B4, Canada.
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Uva L, Boido D, Avoli M, de Curtis M, Lévesque M. High-frequency oscillations and seizure-like discharges in the entorhinal cortex of the in vitro isolated guinea pig brain. Epilepsy Res 2017; 130:21-26. [PMID: 28107659 DOI: 10.1016/j.eplepsyres.2017.01.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Revised: 12/07/2016] [Accepted: 01/04/2017] [Indexed: 10/20/2022]
Abstract
We analyzed the patterns of seizure-like activity and associated high-frequency oscillations (HFOs) induced by the K+ channel blocker 4-aminopyridine (4AP, 50μM) or the GABAA receptor antagonist bicuculline methiodide (BMI, 50μM) in the in vitro isolated guinea pig brain preparation. Extracellular field recordings were obtained from the medial entorhinal cortex (EC) using glass pipettes or silicon probes; 4AP or BMI were applied through the basilar artery. Ripples (80-200Hz) or fast ripples (250-500Hz) occurred at higher rates shortly before ictal events induced by 4AP or BMI, respectively. In addition, during the ictal period, ripples were mostly associated with 4AP-induced ictal events whereas fast ripples predominated during ictal discharges induced by BMI. Finally, ripples occurred at higher rates during the clonic phase of 4AP-induced ictal events compared to the tonic phase, while higher rates of fast ripples characterized the clonic phase in both 4AP- and BMI-induced ictal discharges. These differences in HFO occurrence presumably reflect the diverse action of these two convulsants on GABAA receptor signaling.
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Affiliation(s)
- Laura Uva
- Unit of Experimental Neurophysiology and Epileptology, Fondazione Istituto Neurologico, Carlo Besta, Milan, Italy
| | - Davide Boido
- Unit of Experimental Neurophysiology and Epileptology, Fondazione Istituto Neurologico, Carlo Besta, Milan, Italy
| | - Massimo Avoli
- Montreal Neurological Institute and Department of Neurology & Neurosurgery, McGill University, Montreal, Canada
| | - Marco de Curtis
- Unit of Experimental Neurophysiology and Epileptology, Fondazione Istituto Neurologico, Carlo Besta, Milan, Italy
| | - Maxime Lévesque
- Montreal Neurological Institute and Department of Neurology & Neurosurgery, McGill University, Montreal, Canada.
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Janáčková S, Boyd S, Yozawitz E, Tsuchida T, Lamblin MD, Gueden S, Pressler R. Electroencephalographic characteristics of epileptic seizures in preterm neonates. Clin Neurophysiol 2016; 127:2721-2727. [DOI: 10.1016/j.clinph.2016.05.006] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2016] [Revised: 04/28/2016] [Accepted: 05/09/2016] [Indexed: 10/21/2022]
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Avoli M, de Curtis M, Gnatkovsky V, Gotman J, Köhling R, Lévesque M, Manseau F, Shiri Z, Williams S. Specific imbalance of excitatory/inhibitory signaling establishes seizure onset pattern in temporal lobe epilepsy. J Neurophysiol 2016; 115:3229-37. [PMID: 27075542 DOI: 10.1152/jn.01128.2015] [Citation(s) in RCA: 102] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Accepted: 04/06/2016] [Indexed: 11/22/2022] Open
Abstract
Low-voltage fast (LVF) and hypersynchronous (HYP) patterns are the seizure-onset patterns most frequently observed in intracranial EEG recordings from mesial temporal lobe epilepsy (MTLE) patients. Both patterns also occur in models of MTLE in vivo and in vitro, and these studies have highlighted the predominant involvement of distinct neuronal network/neurotransmitter receptor signaling in each of them. First, LVF-onset seizures in epileptic rodents can originate from several limbic structures, frequently spread, and are associated with high-frequency oscillations in the ripple band (80-200 Hz), whereas HYP onset seizures initiate in the hippocampus and tend to remain focal with predominant fast ripples (250-500 Hz). Second, in vitro intracellular recordings from principal cells in limbic areas indicate that pharmacologically induced seizure-like discharges with LVF onset are initiated by a synchronous inhibitory event or by a hyperpolarizing inhibitory postsynaptic potential barrage; in contrast, HYP onset is associated with a progressive impairment of inhibition and concomitant unrestrained enhancement of excitation. Finally, in vitro optogenetic experiments show that, under comparable experimental conditions (i.e., 4-aminopyridine application), the initiation of LVF- or HYP-onset seizures depends on the preponderant involvement of interneuronal or principal cell networks, respectively. Overall, these data may provide insight to delineate better therapeutic targets in the treatment of patients presenting with MTLE and, perhaps, with other epileptic disorders as well.
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Affiliation(s)
- Massimo Avoli
- Montreal Neurological Institute and Departments of Neurology & Neurosurgery and of Physiology, McGill University, Montréal, Québec, Canada; Facoltà di Medicina e Odontoiatria, Sapienza Università di Roma, Rome, Italy;
| | - Marco de Curtis
- Epilepsy Unit, Fondazione Istituto Neurologico Carlo Besta, Milan, Italy
| | - Vadym Gnatkovsky
- Epilepsy Unit, Fondazione Istituto Neurologico Carlo Besta, Milan, Italy
| | - Jean Gotman
- Montreal Neurological Institute and Departments of Neurology & Neurosurgery and of Physiology, McGill University, Montréal, Québec, Canada
| | - Rüdiger Köhling
- Oscar-Langendorff-Institute of Physiology, Rostock University Medical Center, Rostock, Germany; and
| | - Maxime Lévesque
- Montreal Neurological Institute and Departments of Neurology & Neurosurgery and of Physiology, McGill University, Montréal, Québec, Canada
| | - Frédéric Manseau
- Douglas Mental Health University Institute, McGill University, Montréal, Québec, Canada
| | - Zahra Shiri
- Montreal Neurological Institute and Departments of Neurology & Neurosurgery and of Physiology, McGill University, Montréal, Québec, Canada
| | - Sylvain Williams
- Douglas Mental Health University Institute, McGill University, Montréal, Québec, Canada
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Salami P, Lévesque M, Avoli M. High frequency oscillations can pinpoint seizures progressing to status epilepticus. Exp Neurol 2016; 280:24-9. [PMID: 27018321 DOI: 10.1016/j.expneurol.2016.03.021] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2015] [Revised: 02/10/2016] [Accepted: 03/20/2016] [Indexed: 11/27/2022]
Abstract
Status epilepticus (SE) is defined as a seizure lasting more than 5min or a period of recurrent seizures without recovery between them. SE is a serious emergency condition that requires immediate intervention; therefore, identifying SE electrophysiological markers may translate in prompt care to stop it. Here, we analyzed the EEG signals recorded from the CA3 region of the hippocampus and the entorhinal cortex in rats that responded to systemic administration of 4-aminopyridine (4AP) by generating either isolated seizures or seizures progressing to SE. We found that high frequency oscillations (HFOs) - which can be categorized as ripples (80-200Hz) and fast ripples (250-500Hz) - had different patterns of occurrence in the two groups (n=5 for each group). Specifically, fast ripples in CA3 and entorhinal cortex of the SE group occurred at higher rates than ripples, both during the ictal and post-ictal periods when compared to the HFOs recorded from the isolated seizure group. Our data reveal that different patterns of HFO occurrence can pinpoint seizures progressing to SE, thus suggesting the involvement of different neuronal networks at the termination of seizure discharges.
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Affiliation(s)
- Pariya Salami
- Montreal Neurological Institute, McGill University, Montréal H3A 2B4 QC, Canada; Department of Neurology & Neurosurgery, McGill University, Montréal H3A 2B4 QC, Canada; Department of Physiology, McGill University, Montréal H3A 2B4 QC, Canada
| | - Maxime Lévesque
- Montreal Neurological Institute, McGill University, Montréal H3A 2B4 QC, Canada; Department of Neurology & Neurosurgery, McGill University, Montréal H3A 2B4 QC, Canada; Department of Physiology, McGill University, Montréal H3A 2B4 QC, Canada
| | - Massimo Avoli
- Montreal Neurological Institute, McGill University, Montréal H3A 2B4 QC, Canada; Department of Neurology & Neurosurgery, McGill University, Montréal H3A 2B4 QC, Canada; Department of Physiology, McGill University, Montréal H3A 2B4 QC, Canada.
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Synthesis of some new quinazolin-4(3H)-one derivatives and evaluation of their anticonvulsant activity. MONATSHEFTE FUR CHEMIE 2016. [DOI: 10.1007/s00706-016-1710-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Shiri Z, Manseau F, Lévesque M, Williams S, Avoli M. Activation of specific neuronal networks leads to different seizure onset types. Ann Neurol 2016; 79:354-65. [PMID: 26605509 DOI: 10.1002/ana.24570] [Citation(s) in RCA: 72] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Revised: 11/12/2015] [Accepted: 11/15/2015] [Indexed: 01/21/2023]
Abstract
OBJECTIVE Ictal events occurring in temporal lobe epilepsy patients and in experimental models mimicking this neurological disorder can be classified, based on their onset pattern, into low-voltage, fast versus hypersynchronous onset seizures. It has been suggested that the low-voltage, fast onset pattern is mainly contributed by interneuronal (γ-aminobutyric acidergic) signaling, whereas the hypersynchronous onset involves the activation of principal (glutamatergic) cells. METHODS Here, we tested this hypothesis using the optogenetic control of parvalbumin-positive or somatostatin-positive interneurons and of calmodulin-dependent, protein kinase-positive, principal cells in the mouse entorhinal cortex in the in vitro 4-aminopyridine model of epileptiform synchronization. RESULTS We found that during 4-aminopyridine application, both spontaneous seizure-like events and those induced by optogenetic activation of interneurons displayed low-voltage, fast onset patterns that were associated with a higher occurrence of ripples than of fast ripples. In contrast, seizures induced by the optogenetic activation of principal cells had a hypersynchronous onset pattern with fast ripple rates that were higher than those of ripples. INTERPRETATION Our results firmly establish that under a similar experimental condition (ie, bath application of 4-aminopyridine), the initiation of low-voltage, fast and of hypersynchronous onset seizures in the entorhinal cortex depends on the preponderant involvement of interneuronal and principal cell networks, respectively.
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Affiliation(s)
- Zahra Shiri
- Montreal Neurological Institute, Department of Neurology and Neurosurgery, and Department of Physiology, McGill University, Montreal, Quebec, Canada
| | - Frédéric Manseau
- Douglas Mental Health University Institute, McGill University, Montreal, Quebec, Canada
| | - Maxime Lévesque
- Montreal Neurological Institute, Department of Neurology and Neurosurgery, and Department of Physiology, McGill University, Montreal, Quebec, Canada
| | - Sylvain Williams
- Douglas Mental Health University Institute, McGill University, Montreal, Quebec, Canada
| | - Massimo Avoli
- Montreal Neurological Institute, Department of Neurology and Neurosurgery, and Department of Physiology, McGill University, Montreal, Quebec, Canada
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Wagner FB, Eskandar EN, Cosgrove GR, Madsen JR, Blum AS, Potter NS, Hochberg LR, Cash SS, Truccolo W. Microscale spatiotemporal dynamics during neocortical propagation of human focal seizures. Neuroimage 2015; 122:114-30. [PMID: 26279211 DOI: 10.1016/j.neuroimage.2015.08.019] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2015] [Revised: 07/22/2015] [Accepted: 08/06/2015] [Indexed: 10/23/2022] Open
Abstract
Some of the most clinically consequential aspects of focal epilepsy, e.g. loss of consciousness, arise from the generalization or propagation of seizures through local and large-scale neocortical networks. Yet, the dynamics of such neocortical propagation remain poorly understood. Here, we studied the microdynamics of focal seizure propagation in neocortical patches (4×4 mm) recorded via high-density microelectrode arrays (MEAs) implanted in people with pharmacologically resistant epilepsy. Our main findings are threefold: (1) a newly developed stage segmentation method, applied to local field potentials (LFPs) and multiunit activity (MUA), revealed a succession of discrete seizure stages, each lasting several seconds. These different stages showed characteristic evolutions in overall activity and spatial patterns, which were relatively consistent across seizures within each of the 5 patients studied. Interestingly, segmented seizure stages based on LFPs or MUA showed a dissociation of their spatiotemporal dynamics, likely reflecting different contributions of non-local synaptic inputs and local network activity. (2) As previously reported, some of the seizures showed a peak in MUA that happened several seconds after local seizure onset and slowly propagated across the MEA. However, other seizures had a more complex structure characterized by, for example, several MUA peaks, more consistent with the succession of discrete stages than the slow propagation of a simple wavefront of increased MUA. In both cases, nevertheless, seizures characterized by spike-wave discharges (SWDs, ~2-3 Hz) eventually evolved into patterns of phase-locked MUA and LFPs. (3) Individual SWDs or gamma oscillation cycles (25-60 Hz), characteristic of two different types of recorded seizures, tended to propagate with varying degrees of directionality, directions of propagation and speeds, depending on the identified seizure stage. However, no clear relationship was observed between the MUA peak onset time (in seizures where such peak onset occurred) and changes in MUA or LFP propagation patterns. Overall, our findings indicate that the recruitment of neocortical territories into ictal activity undergoes complex spatiotemporal dynamics evolving in slow discrete states, which are consistent across seizures within each patient. Furthermore, ictal states at finer spatiotemporal scales (individual SWDs or gamma oscillations) are organized by slower time scale network dynamics evolving through these discrete stages.
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Affiliation(s)
- Fabien B Wagner
- Department of Neuroscience, Brown University, Providence, RI, 02912, United States.
| | - Emad N Eskandar
- Department of Neurosurgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA, 02114, United States; Nayef Al-Rodhan Laboratories for Cellular Neurosurgery and Neurosurgical Technology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, 02114, United States
| | - G Rees Cosgrove
- Department of Neurosurgery, Alpert Medical School, Brown University, Providence, RI, 02912, United States; Norman Prince Neurosciences Institute, Brown University, Providence, RI, 02912, United States
| | - Joseph R Madsen
- Department of Neurosurgery, Children's Hospital and Harvard Medical School, Boston, MA, 02114, United States; Department of Neurosurgery, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, 02114, United States
| | - Andrew S Blum
- Department of Neurology, Alpert Medical School, Brown University, Providence, RI, 02912, United States
| | - N Stevenson Potter
- Department of Neurology, Alpert Medical School, Brown University, Providence, RI, 02912, United States
| | - Leigh R Hochberg
- School of Engineering, Brown University, Providence, RI, 02912, United States; Institute for Brain Science, Brown University, Providence, RI, 02912, United States; Center for Neurorestoration and Neurotechnology, U.S. Department of Veterans Affairs, Providence, RI, United States; Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, 02114, United States; Department of Neurology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, 02114, United States
| | - Sydney S Cash
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, 02114, United States
| | - Wilson Truccolo
- Department of Neuroscience, Brown University, Providence, RI, 02912, United States; Institute for Brain Science, Brown University, Providence, RI, 02912, United States; Center for Neurorestoration and Neurotechnology, U.S. Department of Veterans Affairs, Providence, RI, United States.
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MRI characterization of temporal lobe epilepsy using rapidly measurable spatial indices with hemisphere asymmetries and gender features. Neuroradiology 2015; 57:873-86. [PMID: 26032924 DOI: 10.1007/s00234-015-1540-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2015] [Accepted: 05/04/2015] [Indexed: 10/23/2022]
Abstract
INTRODUCTION The paucity of morphometric markers for hemispheric asymmetries and gender variations in hippocampi and amygdalae in temporal lobe epilepsy (TLE) calls for better characterization of TLE by finding more useful prognostic MRI parameter(s). METHODS T1-weighted MRI (3 T) morphometry using multiple parameters of hippocampus-parahippocampus (angular and linear measures, volumetry) and amygdalae (volumetry) including their hemispheric asymmetry indices (AI) were evaluated in both genders. The cutoff values of parameters were statistically estimated from measurements of healthy subjects to characterize TLE (57 patients, 55% male) alterations. RESULTS TLE had differential categories with hippocampal atrophy, parahippocampal angle (PHA) acuteness, and several other parametric changes. Bilateral TLE categories were much more prevalent compared to unilateral TLE categories. Female patients were considerably more disposed to bilateral TLE categories than male patients. Male patients displayed diverse categories of unilateral abnormalities. Few patients (both genders) had combined bilateral appearances of hippocampal atrophy, amygdala atrophy, PHA acuteness, and increase in hippocampal angle (HA) where medial distance ratio (MDR) varied among genders. TLE had gender-specific and hemispheric dominant alterations in AI of parameters. Maximum magnitude of parametric changes in TLE includes (a) AI increase in HA of both genders, (b) HA increase (bilateral) in female patients, and (c) increase in ratio of amygdale/hippocampal volume (unilateral, right hemispheric), and AI decrease in MDR, in male patients. CONCLUSION Multiparametric MRI studies of hippocampus and amygdalae, including their hemispheric asymmetry, underscore better characterization of TLE. Rapidly measurable single-slice parameters (HA, PHA, MDR) can readily delineate TLE in a time-constrained clinical setting, which contrasts with customary three-dimensional hippocampal volumetry that requires many slice computation.
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