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Traub-Weidinger T, Arbizu J, Barthel H, Boellaard R, Borgwardt L, Brendel M, Cecchin D, Chassoux F, Fraioli F, Garibotto V, Guedj E, Hammers A, Law I, Morbelli S, Tolboom N, Van Weehaeghe D, Verger A, Van Paesschen W, von Oertzen TJ, Zucchetta P, Semah F. EANM practice guidelines for an appropriate use of PET and SPECT for patients with epilepsy. Eur J Nucl Med Mol Imaging 2024; 51:1891-1908. [PMID: 38393374 PMCID: PMC11139752 DOI: 10.1007/s00259-024-06656-3] [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: 11/01/2023] [Accepted: 02/13/2024] [Indexed: 02/25/2024]
Abstract
Epilepsy is one of the most frequent neurological conditions with an estimated prevalence of more than 50 million people worldwide and an annual incidence of two million. Although pharmacotherapy with anti-seizure medication (ASM) is the treatment of choice, ~30% of patients with epilepsy do not respond to ASM and become drug resistant. Focal epilepsy is the most frequent form of epilepsy. In patients with drug-resistant focal epilepsy, epilepsy surgery is a treatment option depending on the localisation of the seizure focus for seizure relief or seizure freedom with consecutive improvement in quality of life. Beside examinations such as scalp video/electroencephalography (EEG) telemetry, structural, and functional magnetic resonance imaging (MRI), which are primary standard tools for the diagnostic work-up and therapy management of epilepsy patients, molecular neuroimaging using different radiopharmaceuticals with single-photon emission computed tomography (SPECT) and positron emission tomography (PET) influences and impacts on therapy decisions. To date, there are no literature-based praxis recommendations for the use of Nuclear Medicine (NM) imaging procedures in epilepsy. The aims of these guidelines are to assist in understanding the role and challenges of radiotracer imaging for epilepsy; to provide practical information for performing different molecular imaging procedures for epilepsy; and to provide an algorithm for selecting the most appropriate imaging procedures in specific clinical situations based on current literature. These guidelines are written and authorized by the European Association of Nuclear Medicine (EANM) to promote optimal epilepsy imaging, especially in the presurgical setting in children, adolescents, and adults with focal epilepsy. They will assist NM healthcare professionals and also specialists such as Neurologists, Neurophysiologists, Neurosurgeons, Psychiatrists, Psychologists, and others involved in epilepsy management in the detection and interpretation of epileptic seizure onset zone (SOZ) for further treatment decision. The information provided should be applied according to local laws and regulations as well as the availability of various radiopharmaceuticals and imaging modalities.
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Affiliation(s)
- Tatjana Traub-Weidinger
- Division of Nuclear Medicine, Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Javier Arbizu
- Department of Nuclear Medicine, University of Navarra Clinic, Pamplona, Spain
| | - Henryk Barthel
- Department of Nuclear Medicine, Leipzig University Medical Centre, Leipzig, Germany
| | - Ronald Boellaard
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, Location VUmc, Amsterdam, The Netherlands
| | - Lise Borgwardt
- Department of Clinical Physiology and Nuclear Medicine, University of Copenhagen, Blegdamsvej 9, DK-2100, RigshospitaletCopenhagen, Denmark
| | - Matthias Brendel
- Department of Nuclear Medicine, Ludwig Maximilian-University of Munich, Munich, Germany
- DZNE-German Center for Neurodegenerative Diseases, Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Diego Cecchin
- Nuclear Medicine Unit, Department of Medicine-DIMED, University-Hospital of Padova, Padova, Italy
| | - Francine Chassoux
- Université Paris-Saclay, CEA, CNRS, Inserm, BioMaps, 91401, Orsay, France
| | - Francesco Fraioli
- Institute of Nuclear Medicine, University College London (UCL), London, UK
| | - Valentina Garibotto
- Division of Nuclear Medicine and Molecular Imaging, Geneva University Hospitals, Geneva, Switzerland
- NIMTLab, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Center for Biomedical Imaging (CIBM), Geneva, Switzerland
| | - Eric Guedj
- APHM, CNRS, Centrale Marseille, Institut Fresnel, Timone Hospital, CERIMED, Nuclear Medicine Department, Aix Marseille Univ, Marseille, France
| | - Alexander Hammers
- School of Biomedical Engineering and Imaging Sciences, Faculty of Life Sciences and Medicine, King's College London & Guy's and St Thomas' PET Centre, King's College London, London, UK
| | - Ian Law
- Department of Clinical Physiology and Nuclear Medicine, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, DK-2100, Copenhagen, Denmark
| | - Silvia Morbelli
- Nuclear Medicine Unit, IRCCS Ospedale Policlinico San Martino, Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
| | - Nelleke Tolboom
- Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | | | - Antoine Verger
- Department of Nuclear Medicine and Nancyclotep Imaging Platform, CHRU Nancy, Université de Lorraine, IADI, INSERM U1254, Nancy, France
| | - Wim Van Paesschen
- Laboratory for Epilepsy Research, KU Leuven and Department of Neurology, University Hospitals, Leuven, Belgium
| | - Tim J von Oertzen
- Depts of Neurology 1&2, Kepler University Hospital, Johannes Kepler University, Linz, Austria
| | - Pietro Zucchetta
- Nuclear Medicine Unit, Department of Medicine-DIMED, University-Hospital of Padova, Padova, Italy
| | - Franck Semah
- Nuclear Medicine Department, University Hospital, Inserm, CHU Lille, U1172-LilNCog-Lille, F-59000, Lille, France.
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Cai L, Xu Z, Luo H, He Q, Diao L, Gui X, Wei L. The association between 5-HT1A binding and temporal lobe epilepsy: A meta-analysis of molecular imaging studies. Epilepsy Behav 2023; 145:109354. [PMID: 37473654 DOI: 10.1016/j.yebeh.2023.109354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Revised: 07/03/2023] [Accepted: 07/06/2023] [Indexed: 07/22/2023]
Abstract
BACKGROUND Studies have shown conflicting results in the correlation between serotonin-1A (5-HT1A) receptor binding levels in the brain and temporal lobe epilepsy (TLE). There is a need to systematically evaluate the correlation between the 5-HT1A binding level and TLE from the perspective of the brain using molecular imaging. METHODS Chinese and English databases, such as the China National Knowledge Infrastructure (CNKI), the China Science and Technology Journal Database (VIP), WanFang, the Chinese Biomedical Literature Service System (SinoMed), PubMed and Web of Science, were searched. RESULTS Two evaluators independently screened the literature, extracted data, and evaluated the risk of bias in the included studies according to the inclusion and exclusion criteria. RevMan 5.4.1 was used to analyze the data. A total of 196 participants were included; of these, 95 had TLE and 131 were healthy controls who had never had a seizure before participating in the study. Meta-analysis results suggested that 1) decreased 5-HT1A binding was found on the affected side of patients with TLE (standard mean difference (SMD) = -1.45, 95% confidence interval (CI) [-2.27, -0.64], Z = 3.48, P = 0.0005); 2) decreased 5-HT1A binding was found in the ipsilateral hippocampus of patients with TLE (SMD = -1.76, 95% CI [-2.51, -1.00], Z = 4.57, P<0.00001); 3) decreased 5-HT1A binding was found in the ipsilateral temporal lobe cortex of patients with TLE (SMD = -0.46, 95% CI [-0.80, -0.12], Z = 2.66, P = 0.008); 4) decreased 5-HT1A binding was found in the ipsilateral amygdala in patients with TLE (SMD = -1.36, 95% CI [-2.48, -0.23], Z = 2.37, P = 0.02); and 5) decreased 5-HT1A binding was found in the frontal lobe of patients with TLE(SMD = -0.75, 95% CI [-1.29, -0.20], Z = 2.67, P = 0.008). CONCLUSION A reduction in 5-HT1A binding in the hippocampus, temporal cortex, amygdala, and frontal lobe was observed on the affected side of patients with TLE. The decrease in 5-HT1A binding can be considered related to TLE. Potentially relevant factors should be considered in future molecular imaging studies.
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Affiliation(s)
- Lun Cai
- Department of Neurology, The First Affiliated Hospital of Guangxi University of Chinese Medicine, Guangxi University of Chinese Medicine, Nanning 530023, PR China.
| | - Zihao Xu
- Department of Neurology, The First Affiliated Hospital of Guangxi University of Chinese Medicine, Guangxi University of Chinese Medicine, Nanning 530023, PR China.
| | - Huazheng Luo
- Department of Neurology, The First Affiliated Hospital of Guangxi University of Chinese Medicine, Guangxi University of Chinese Medicine, Nanning 530023, PR China.
| | - Qianchao He
- Department of Neurology, The First Affiliated Hospital of Guangxi University of Chinese Medicine, Guangxi University of Chinese Medicine, Nanning 530023, PR China.
| | - Limei Diao
- Department of Neurology, The First Affiliated Hospital of Guangxi University of Chinese Medicine, Guangxi University of Chinese Medicine, Nanning 530023, PR China.
| | - Xiongbin Gui
- Department of Surgery, The First Affiliated Hospital of Guangxi University of Chinese Medicine, Guangxi University of Chinese Medicine, Nanning 530023, PR China.
| | - Liping Wei
- Department of Surgery, The First Affiliated Hospital of Guangxi University of Chinese Medicine, Guangxi University of Chinese Medicine, Nanning 530023, PR China.
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3
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Tallarico M, Pisano M, Leo A, Russo E, Citraro R, De Sarro G. Antidepressant Drugs for Seizures and Epilepsy: Where do we Stand? Curr Neuropharmacol 2023; 21:1691-1713. [PMID: 35761500 PMCID: PMC10514547 DOI: 10.2174/1570159x20666220627160048] [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: 02/26/2022] [Revised: 06/13/2022] [Accepted: 06/18/2022] [Indexed: 11/22/2022] Open
Abstract
People with epilepsy (PWE) are more likely to develop depression and both these complex chronic diseases greatly affect health-related quality of life (QOL). This comorbidity contributes to the deterioration of the QOL further than increasing the severity of epilepsy worsening prognosis. Strong scientific evidence suggests the presence of shared pathogenic mechanisms. The correct identification and management of these factors are crucial in order to improve patients' QOL. This review article discusses recent original research on the most common pathogenic mechanisms of depression in PWE and highlights the effects of antidepressant drugs (ADs) against seizures in PWE and animal models of seizures and epilepsy. Newer ADs, such as selective serotonin reuptake inhibitors (SRRI) or serotonin-noradrenaline reuptake inhibitors (SNRI), particularly sertraline, citalopram, mirtazapine, reboxetine, paroxetine, fluoxetine, escitalopram, fluvoxamine, venlafaxine, duloxetine may lead to improvements in epilepsy severity whereas the use of older tricyclic antidepressant (TCAs) can increase the occurrence of seizures. Most of the data demonstrate the acute effects of ADs in animal models of epilepsy while there is a limited number of studies about the chronic antidepressant effects in epilepsy and epileptogenesis or on clinical efficacy. Much longer treatments are needed in order to validate the effectiveness of these new alternatives in the treatment and the development of epilepsy, while further clinical studies with appropriate protocols are warranted in order to understand the real potential contribution of these drugs in the management of PWE (besides their effects on mood).
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Affiliation(s)
- Martina Tallarico
- System and Applied Pharmacology, Science of Health Department, School of Medicine, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Maria Pisano
- System and Applied Pharmacology, Science of Health Department, School of Medicine, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Antonio Leo
- System and Applied Pharmacology, Science of Health Department, School of Medicine, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Emilio Russo
- System and Applied Pharmacology, Science of Health Department, School of Medicine, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Rita Citraro
- System and Applied Pharmacology, Science of Health Department, School of Medicine, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Giovambattista De Sarro
- System and Applied Pharmacology, Science of Health Department, School of Medicine, Magna Graecia University of Catanzaro, Catanzaro, Italy
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Remonde CG, Gonzales EL, Adil KJ, Jeon SJ, Shin CY. Augmented impulsive behavior in febrile seizure-induced mice. Toxicol Res 2023; 39:37-51. [PMID: 36726823 PMCID: PMC9839938 DOI: 10.1007/s43188-022-00145-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 04/04/2022] [Accepted: 07/01/2022] [Indexed: 02/04/2023] Open
Abstract
Febrile seizure (FS) is one of the most prevalent etiological events in childhood affecting 2-5% of children from 3 months to 5 years old. Debates on whether neurodevelopmental consequences rise in later life following a febrile seizure or not are still ongoing however there is limited evidence of its effect, especially in a laboratory setting. Moreover, the comparative study using both male and female animal models is sparse. To examine the effect of FS on the behavioral features of mice, both sexes of ICR mice were induced with hyperthermic seizures through exposure to an infrared heat lamp. The mice were divided into two groups, one receiving a single febrile seizure at postnatal day 11 (P11) and one receiving three FS at P11, P13, and P15. Starting at P30 the FS-induced mice were subjected to a series of behavioral tests. Mice with seizures showed no locomotor and motor coordination deficits, repetitive, and depressive-like behavior. However, the FS-induced mice showed impulsive-like behavior in both elevated plus maze and cliff avoidance tests, which is more prominent in male mice. A greater number of mice displayed impaired CAT in both males and females in the three-time FS-induced group compared to the single induction group. These results demonstrate that after induction of FS, male mice have a higher susceptibility to consequences of febrile seizure than female mice and recurrent febrile seizure has a higher chance of subsequent disorders associated with decreased anxiety and increased impulsivity. We confirmed the dysregulated expression of impulsivity-related genes such as 5-HT1A and tryptophan hydroxylase 2 from the prefrontal cortices of FS-induced mice implying that the 5-HT system would be one of the mechanisms underlying the increased impulsivity after FS. Taken together, these findings are useful in unveiling future discoveries about the effect of childhood febrile seizure and the mechanism behind it.
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Affiliation(s)
- Chilly Gay Remonde
- School of Medicine and Center for Neuroscience Research, Konkuk University, Seoul, 05029 Republic of Korea
| | - Edson Luck Gonzales
- School of Medicine and Center for Neuroscience Research, Konkuk University, Seoul, 05029 Republic of Korea
| | - Keremkleroo Jym Adil
- School of Medicine and Center for Neuroscience Research, Konkuk University, Seoul, 05029 Republic of Korea
| | - Se Jin Jeon
- School of Medicine and Center for Neuroscience Research, Konkuk University, Seoul, 05029 Republic of Korea
| | - Chan Young Shin
- School of Medicine and Center for Neuroscience Research, Konkuk University, Seoul, 05029 Republic of Korea
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5
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Leitner DF, Devore S, Laze J, Friedman D, Mills JD, Liu Y, Janitz M, Anink JJ, Baayen JC, Idema S, van Vliet EA, Diehl B, Scott C, Thijs R, Nei M, Askenazi M, Sivathamboo S, O’Brien T, Wisniewski T, Thom M, Aronica E, Boldrini M, Devinsky O. Serotonin receptor expression in hippocampus and temporal cortex of temporal lobe epilepsy patients by postictal generalized electroencephalographic suppression duration. Epilepsia 2022; 63:2925-2936. [PMID: 36053862 PMCID: PMC9669210 DOI: 10.1111/epi.17400] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 08/18/2022] [Accepted: 08/18/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Prolonged postictal generalized electroencephalographic suppression (PGES) is a potential biomarker for sudden unexpected death in epilepsy (SUDEP), which may be associated with dysfunctional autonomic responses and serotonin signaling. To better understand molecular mechanisms, PGES duration was correlated to 5HT1A and 5HT2A receptor protein expression and RNAseq from resected hippocampus and temporal cortex of temporal lobe epilepsy patients with seizures recorded in preoperative evaluation. METHODS Analyses included 36 cases (age = 14-64 years, age at epilepsy onset = 0-51 years, epilepsy duration = 2-53 years, PGES duration = 0-93 s), with 13 cases in all hippocampal analyses. 5HT1A and 5HT2A protein was evaluated by Western blot and histologically in hippocampus (n = 16) and temporal cortex (n = 9). We correlated PGES duration to our previous RNAseq dataset for serotonin receptor expression and signaling pathways, as well as weighted gene correlation network analysis (WGCNA) to identify correlated gene clusters. RESULTS In hippocampus, 5HT2A protein by Western blot positively correlated with PGES duration (p = .0024, R2 = .52), but 5HT1A did not (p = .87, R2 = .0020). In temporal cortex, 5HT1A and 5HT2A had lower expression and did not correlate with PGES duration. Histologically, PGES duration did not correlate with 5HT1A or 5HT2A expression in hippocampal CA4, dentate gyrus, or temporal cortex. RNAseq identified two serotonin receptors with expression that correlated with PGES duration in an exploratory analysis: HTR3B negatively correlated (p = .043, R2 = .26) and HTR4 positively correlated (p = .049, R2 = .25). WGCNA identified four modules correlated with PGES duration, including positive correlation with synaptic transcripts (p = .040, Pearson correlation r = .52), particularly potassium channels (KCNA4, KCNC4, KCNH1, KCNIP4, KCNJ3, KCNJ6, KCNK1). No modules were associated with serotonin receptor signaling. SIGNIFICANCE Higher hippocampal 5HT2A receptor protein and potassium channel transcripts may reflect underlying mechanisms contributing to or resulting from prolonged PGES. Future studies with larger cohorts should assess functional analyses and additional brain regions to elucidate mechanisms underlying PGES and SUDEP risk.
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Affiliation(s)
- Dominique F. Leitner
- Comprehensive Epilepsy Center, NYU Grossman School of Medicine, New York, NY, USA
- Center for Cognitive Neurology, NYU Grossman School of Medicine, New York, NY, USA
- Department of Neurology, NYU Grossman School of Medicine, New York, NY, USA
| | - Sasha Devore
- Comprehensive Epilepsy Center, NYU Grossman School of Medicine, New York, NY, USA
- Department of Neurology, NYU Grossman School of Medicine, New York, NY, USA
| | - Juliana Laze
- Comprehensive Epilepsy Center, NYU Grossman School of Medicine, New York, NY, USA
- Department of Neurology, NYU Grossman School of Medicine, New York, NY, USA
| | - Daniel Friedman
- Comprehensive Epilepsy Center, NYU Grossman School of Medicine, New York, NY, USA
- Department of Neurology, NYU Grossman School of Medicine, New York, NY, USA
| | - James D. Mills
- Amsterdam UMC location University of Amsterdam, Department of (Neuro)pathology, Amsterdam Neuroscience, Meibergdreef 9, Amsterdam, the Netherlands
- Department of Clinical and Experimental Epilepsy, University College London Institute of Neurology, London, UK
- Chalfont Centre for Epilepsy, Bucks, UK
| | - Yan Liu
- Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, New York, NY, USA
| | - Michael Janitz
- School of Biotechnology and Biomolecular Sciences, University of New South Wales, Sydney, New South Wales, Australia
| | - Jasper J. Anink
- Amsterdam UMC location University of Amsterdam, Department of (Neuro)pathology, Amsterdam Neuroscience, Meibergdreef 9, Amsterdam, the Netherlands
| | - Johannes C. Baayen
- Amsterdam UMC location Vrije Universiteit Amsterdam, Department of Neurosurgery, Amsterdam Neuroscience, De Boelelaan 1117, Amsterdam, the Netherlands
| | - Sander Idema
- Amsterdam UMC location Vrije Universiteit Amsterdam, Department of Neurosurgery, Amsterdam Neuroscience, De Boelelaan 1117, Amsterdam, the Netherlands
| | - Erwin A. van Vliet
- Amsterdam UMC location University of Amsterdam, Department of (Neuro)pathology, Amsterdam Neuroscience, Meibergdreef 9, Amsterdam, the Netherlands
- Swammerdam Institute for Life Sciences, Center for Neuroscience, University of Amsterdam, Amsterdam, the Netherlands
| | - Beate Diehl
- Department of Clinical and Experimental Epilepsy, University College London Institute of Neurology, London, UK
| | - Catherine Scott
- Department of Clinical and Experimental Epilepsy, University College London Institute of Neurology, London, UK
| | - Roland Thijs
- Stichting Epilepsie Instellingen Nederland (SEIN), Heemstede, the Netherlands
| | - Maromi Nei
- Department of Neurology, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, USA
| | - Manor Askenazi
- Biomedical Hosting LLC, Arlington, MA, USA
- Department of Biochemistry and Molecular Pharmacology, NYU Grossman School of Medicine, New York, NY, USA
| | - Shobi Sivathamboo
- Department of Neuroscience, Alfred Health, Central Clinical School, Melbourne, Victoria, Australia
- Department Medicine, Royal Melbourne Hospital, University of Melbourne, Parkville, Victoria, Australia
| | - Terence O’Brien
- Department of Neuroscience, Alfred Health, Central Clinical School, Melbourne, Victoria, Australia
- Department Medicine, Royal Melbourne Hospital, University of Melbourne, Parkville, Victoria, Australia
| | - Thomas Wisniewski
- Center for Cognitive Neurology, NYU Grossman School of Medicine, New York, NY, USA
- Department of Neurology, NYU Grossman School of Medicine, New York, NY, USA
- Department of Pathology, NYU Grossman School of Medicine, New York, NY, USA
- Department of Psychiatry, NYU Grossman School of Medicine, New York, NY, USA
| | - Maria Thom
- Department of Clinical and Experimental Epilepsy, University College London Institute of Neurology, London, UK
| | - Eleonora Aronica
- Amsterdam UMC location University of Amsterdam, Department of (Neuro)pathology, Amsterdam Neuroscience, Meibergdreef 9, Amsterdam, the Netherlands
- Stichting Epilepsie Instellingen Nederland (SEIN), Heemstede, the Netherlands
| | - Maura Boldrini
- Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, New York, NY, USA
- Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA
| | - Orrin Devinsky
- Comprehensive Epilepsy Center, NYU Grossman School of Medicine, New York, NY, USA
- Department of Neurology, NYU Grossman School of Medicine, New York, NY, USA
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Juliá-Palacios N, Molina-Anguita C, Sigatulina Bondarenko M, Cortès-Saladelafont E, Aparicio J, Cuadras D, Horvath G, Fons C, Artuch R, García-Cazorla À, Darling A, O’Callaghan M, Pías‐Peleteiro L, Ormazabal A, Mussarra CO, Valera C, Ramírez‐Camacho A. Monoamine neurotransmitters in early epileptic encephalopathies: New insights into pathophysiology and therapy. Dev Med Child Neurol 2022; 64:915-923. [PMID: 35833444 DOI: 10.1111/dmcn.15140] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 11/22/2021] [Accepted: 11/23/2021] [Indexed: 01/29/2023]
Abstract
AIM To study neurotransmitter status in children with early epileptic and developmental and epileptic encephalopathy (DEE) and to explore the clinical response to dopaminergic and serotoninergic therapies in a group of patients. METHOD Two hundred and five patients (111 males [54.1.%] and 94 females [45.9%], mean age 10 months at the onset of epilepsy [SD 1 year 1 month], range 0-3 year) with epileptic encephalopathy/DEE were recruited, including those with West syndrome, Ohtahara syndrome, early myoclonic encephalopathy, epilepsy of infancy with migrating focal seizures, myoclonic encephalopathy in non-progressive disorders, infantile spasms, Doose syndrome, Lennox-Gastaut syndrome, Landau-Kleffner syndrome, and those unclassified. Cerebrospinal fluid (CSF) neurotransmitter studies and patients' medical records were reviewed. Additionally, we present clinical data of 10 patients with low CSF neurotransmitter levels who received dopaminergic/serotoninergic treatments. RESULTS Abnormal neurotransmitter values were identified in 68 (33%) patients. 5-Hydroxyindoleacetic acid (5-HIAA) deficit was the most prevalent alteration (91%). Low CSF 5-HIAA levels were significantly higher in 1- to 3-year-old children. A negative significant correlation was found between 5-HIAA levels and epilepsy duration before CSF study (Spearman's ρ=-0.191, p=0.007). Abnormalities in deep grey matter were associated with low levels of CSF homovanillic acid and 5-HIAA. Ten patients with low CSF neurotransmitter levels received dopamine and/or serotonin therapies. Six of them showed initial decrease of seizure frequency and severity and maintained improvement in some neurodevelopmental skills. INTERPRETATION A considerable number of patients showed neurotransmitter abnormalities. Age at seizure onset and duration of epilepsy before CSF study were the principal factors related to neurotransmitter depletion. Early monoamine supplementation would seem advisable as a neuroprotective strategy. WHAT THIS PAPER ADDS 5-Hydroxyindoleacetic acid homeostasis is especially vulnerable in patients with epileptic encephalopathy/developmental and epileptic encephalopathy. Age of seizure onset and duration of epilepsy are determinants of neurotransmitter depletion.
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Affiliation(s)
- Natalia Juliá-Palacios
- Neurology Department, Neurometabolic Unit, Institut de Recerca, CIBERER and MetabERN, Hospital Sant Joan de Déu, Barcelona, Spain
| | | | - María Sigatulina Bondarenko
- Neurology Department, Neurometabolic Unit, Institut de Recerca, CIBERER and MetabERN, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Elisenda Cortès-Saladelafont
- Neurology Department, Neurometabolic Unit, Institut de Recerca, CIBERER and MetabERN, Hospital Sant Joan de Déu, Barcelona, Spain.,Unit of Inherited Metabolic Diseases and Neuropediatrics, Department of Pediatrics, Hospital Universitari Germans Trias i Pujol, Barcelona, Spain
| | - Javier Aparicio
- Neurology Department, Epilepsy Unit, Institut de Recerca and EpiCare, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Daniel Cuadras
- Statistics Department, Institut de Recerca Sant Joan de Déu, Barcelona, Spain
| | - Gabriella Horvath
- Department of Pediatrics, Division of Biochemical Genetics, University of British Columbia, Vancouver, BC, Canada
| | - Carmen Fons
- Neurology Department, Fetal, Neonatal Neurology and Early Epilepsy Unit, Institut de Recerca, Hospital Sant Joan de Déu, Barcelona, Spain
| | - Rafael Artuch
- Department of Clinical Biochemistry, IPR and CIBERER-ISCIII, Hospital Sant Joan de Déu Barcelona, Barcelona, Spain
| | - Àngels García-Cazorla
- Neurology Department, Neurometabolic Unit, Institut de Recerca, CIBERER and MetabERN, Hospital Sant Joan de Déu, Barcelona, Spain
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7
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Patodia S, Somani A, Liu J, Cattaneo A, Paradiso B, Garcia M, Othman M, Diehl B, Devinsky O, Mills JD, Foong J, Thom M. Serotonin transporter in the temporal lobe, hippocampus and amygdala in SUDEP. Brain Pathol 2022; 32:e13074. [PMID: 35478467 PMCID: PMC9425018 DOI: 10.1111/bpa.13074] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 03/17/2022] [Accepted: 03/31/2022] [Indexed: 11/30/2022] Open
Abstract
Several lines of evidence link deficient serotonin function and SUDEP. Chronic treatment with serotonin reuptake inhibitors (SRIs) reduces ictal central apnoea, a risk factor for SUDEP. Reduced medullary serotonergic neurones, modulators of respiration in response to hypercapnia, were reported in a SUDEP post‐mortem series. The amygdala and hippocampus have high serotonergic innervation and are functionally implicated in seizure‐related respiratory dysregulation. We explored serotonergic networks in mesial temporal lobe structures in a surgical and post‐mortem epilepsy series in relation to SUDEP risk. We stratified 75 temporal lobe epilepsy patients with hippocampal sclerosis (TLE/HS) into high (N = 16), medium (N = 11) and low risk (N = 48) groups for SUDEP based on generalised seizure frequency. We also included the amygdala in 35 post‐mortem cases, including SUDEP (N = 17), epilepsy controls (N = 10) and non‐epilepsy controls (N = 8). The immunohistochemistry labelling index (LI) and axonal length (AL) of serotonin transporter (SERT)‐positive axons were quantified in 13 regions of interest with image analysis. SERT LI was highest in amygdala and subiculum regions. In the surgical series, higher SERT LI was observed in high risk than low risk cases in the dentate gyrus, CA1 and subiculum (p < 0.05). In the post‐mortem cases higher SERT LI and AL was observed in the basal and accessory basal nuclei of the amygdala and peri‐amygdala cortex in SUDEP compared to epilepsy controls (p < 0.05). Patients on SRI showed higher SERT in the dentate gyrus (p < 0.005) and CA4 (p < 0.05) but there was no difference in patients with or without a psychiatric history. Higher SERT in hippocampal subfields in TLE/HS cases with SUDEP risk factors and higher amygdala SERT in post‐mortem SUDEP cases than epilepsy controls supports a role for altered serotonergic networks involving limbic regions in SUDEP. This may be of functional relevance through reduced 5‐HT availability.
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Affiliation(s)
- Smriti Patodia
- Department of clinical and experimental epilepsy, UCL Queen Square Institute of Neurology, London, UK
| | - Alyma Somani
- Department of clinical and experimental epilepsy, UCL Queen Square Institute of Neurology, London, UK
| | - Joan Liu
- Department of clinical and experimental epilepsy, UCL Queen Square Institute of Neurology, London, UK
| | - Alice Cattaneo
- Department of clinical and experimental epilepsy, UCL Queen Square Institute of Neurology, London, UK
| | - Beatrice Paradiso
- Department of clinical and experimental epilepsy, UCL Queen Square Institute of Neurology, London, UK
| | - Maria Garcia
- Department of clinical and experimental epilepsy, UCL Queen Square Institute of Neurology, London, UK
| | - Muhammad Othman
- Department of clinical and experimental epilepsy, UCL Queen Square Institute of Neurology, London, UK
| | - Beate Diehl
- Department of clinical and experimental epilepsy, UCL Queen Square Institute of Neurology, London, UK.,Departments of Neurology, National Hospital for Neurology and Neurosurgery, London, UK
| | - Orrin Devinsky
- NYU Langone Comprehensive Epilepsy Center, New York University, New York City, New York, USA
| | - James D Mills
- Department of clinical and experimental epilepsy, UCL Queen Square Institute of Neurology, London, UK.,Chalfont Centre for Epilepsy, Chalfont St Peter, UK.,Department of (Neuro)Pathology, Amsterdam Neuroscience, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Jackie Foong
- Department of clinical and experimental epilepsy, UCL Queen Square Institute of Neurology, London, UK.,Departments of Psychiatry, National Hospital for Neurology and Neurosurgery, London, UK
| | - Maria Thom
- Department of clinical and experimental epilepsy, UCL Queen Square Institute of Neurology, London, UK.,Departments of Neuropathology, National Hospital for Neurology and Neurosurgery, London, UK
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8
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Bandeira IC, Giombelli L, Werlang IC, Abujamra AL, Secchi TL, Brondani R, Bragatti JA, Bizzi JWJ, Leistner-Segal S, Bianchin MM. Methylation of BDNF and SLC6A4 Gene Promoters in Brazilian Patients With Temporal Lobe Epilepsy Presenting or Not Psychiatric Comorbidities. Front Integr Neurosci 2021; 15:764742. [PMID: 34912196 PMCID: PMC8667271 DOI: 10.3389/fnint.2021.764742] [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] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 10/25/2021] [Indexed: 01/09/2023] Open
Abstract
The relationship between epilepsy and psychiatric comorbidities has been recognized for centuries, but its pathophysiological mechanisms are still misunderstood. It is biologically plausible that genetic or epigenetic variations in genes that codify important neurotransmitters involved in epilepsy as well as in psychiatric disorders may influence the development of the latter in patients with epilepsy. However, this possibility remains poorly investigated. The aim of this study was to evaluate the methylation profile of the BDNF and SLC6A4, two genes importantly involved in neuroplasticity, in patients with temporal lobe epilepsy (TLE) regarding the development or not of psychiatric comorbidities. One hundred and thirty-nine patients with TLE, 90 females and 45 males, were included in the study. The mean age of patients was 44.0 (+12.0) years, and mean duration of epilepsy was 25.7 (+13.3) years. The Structured Clinical Interview for DSM-IV shows that 83 patients (59.7%) had neuropsychiatric disorders and 56 (40.3%) showed no psychiatric comorbidity. Mood disorders were the most common psychiatric disorder observed, being present in 64 (46.0%) of all 139 patients. Thirty-three (23.7%) patients showed anxiety disorders, 10 (7.2%) patients showed history of psychosis and 8 (5.8%) patients showed history of alcohol//drug abuse. Considering all 139 patients, 18 (12.9%) demonstrated methylation of the promoter region of both BDNF and SLC6A4 genes. A significant decreased methylation profile was observed only in TLE patients with mood disorders when compared with TLE patients without a history of mood disorders (O.R. = 3.45; 95% C.I. = 1.08–11.11; p = 0.04). A sub-analysis showed that TLE patients with major depressive disorder mostly account for this result (O.R. = 7.20; 95% C.I. = 1.01–56.16; p = 0.042). A logistic regression analysis showed that the independent factors associated with a history of depression in our TLE patients was female sex (O.R. = 2.30; 95% C.I. = 1.02–5.18; p = 0.044), not controlled seizures (O.R. = 2.51; 95% C.I. = 1.16–5.41; p = 0.019) and decreased methylation in BDNF and SLC6A4 genes (O.R. = 5.32; 95% C.I. = 1.14–25.00; p = 0.033). Our results suggest that BDNF or SLC6A4 genes profile methylation is independently associated with depressive disorders in patients with epilepsy. Further studies are necessary to clarify these matters.
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Affiliation(s)
- Isabel Cristina Bandeira
- Graduate Program in Medicine: Medical Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Basic Research and Advanced Investigations in Neurosciences, Experimental Research Center, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Lucas Giombelli
- Basic Research and Advanced Investigations in Neurosciences, Experimental Research Center, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Isabel Cristina Werlang
- Graduate Program in Medicine: Medical Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Basic Research and Advanced Investigations in Neurosciences, Experimental Research Center, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Ana Lucia Abujamra
- Graduate Program in Medicine: Medical Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Thais Leite Secchi
- Graduate Program in Medicine: Medical Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Rosane Brondani
- Graduate Program in Medicine: Medical Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Division of Neurology, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | | | | | - Sandra Leistner-Segal
- Basic Research and Advanced Investigations in Neurosciences, Experimental Research Center, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.,Medical Genetics Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Marino Muxfeldt Bianchin
- Graduate Program in Medicine: Medical Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Basic Research and Advanced Investigations in Neurosciences, Experimental Research Center, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.,Division of Neurology, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.,Centro de Tratamento de Epilepsia Refratária (CETER), Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
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9
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Bandopadhyay R, Singh T, Ghoneim MM, Alshehri S, Angelopoulou E, Paudel YN, Piperi C, Ahmad J, Alhakamy NA, Alfaleh MA, Mishra A. Recent Developments in Diagnosis of Epilepsy: Scope of MicroRNA and Technological Advancements. BIOLOGY 2021; 10:1097. [PMID: 34827090 PMCID: PMC8615191 DOI: 10.3390/biology10111097] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 10/21/2021] [Accepted: 10/21/2021] [Indexed: 12/18/2022]
Abstract
Epilepsy is one of the most common neurological disorders, characterized by recurrent seizures, resulting from abnormally synchronized episodic neuronal discharges. Around 70 million people worldwide are suffering from epilepsy. The available antiepileptic medications are capable of controlling seizures in around 60-70% of patients, while the rest remain refractory. Poor seizure control is often associated with neuro-psychiatric comorbidities, mainly including memory impairment, depression, psychosis, neurodegeneration, motor impairment, neuroendocrine dysfunction, etc., resulting in poor prognosis. Effective treatment relies on early and correct detection of epileptic foci. Although there are currently a few well-established diagnostic techniques for epilepsy, they lack accuracy and cannot be applied to patients who are unsupportive or harbor metallic implants. Since a single test result from one of these techniques does not provide complete information about the epileptic foci, it is necessary to develop novel diagnostic tools. Herein, we provide a comprehensive overview of the current diagnostic tools of epilepsy, including electroencephalography (EEG) as well as structural and functional neuroimaging. We further discuss recent trends and advances in the diagnosis of epilepsy that will enable more effective diagnosis and clinical management of patients.
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Affiliation(s)
- Ritam Bandopadhyay
- Department of Pharmacology, School of Pharmaceutical Sciences, Lovely Professional University, Phagwara 144411, Punjab, India;
| | - Tanveer Singh
- Department of Neuroscience and Experimental Therapeutics, College of Medicine, Texas A&M University Health Science Center, Bryan, TX 77807, USA;
| | - Mohammed M. Ghoneim
- Department of Pharmacy Practice, College of Pharmacy, AlMaarefa University, Ad Diriyah 13713, Saudi Arabia;
| | - Sultan Alshehri
- Department of Pharmaceutics, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia;
| | - Efthalia Angelopoulou
- Department of Biological Chemistry, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (E.A.); (C.P.)
| | - Yam Nath Paudel
- Neuropharmacology Research Strength, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Subang Jaya 47500, Selangor, Malaysia;
| | - Christina Piperi
- Department of Biological Chemistry, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (E.A.); (C.P.)
| | - Javed Ahmad
- Department of Pharmaceutics, College of Pharmacy, Najran University, Najran 11001, Saudi Arabia;
| | - Nabil A. Alhakamy
- Department of Pharmaceutics, Faculty of Pharmacy, King Abdulaziz University, Jeddah 21589, Saudi Arabia; (N.A.A.); (M.A.A.)
| | - Mohamed A. Alfaleh
- Department of Pharmaceutics, Faculty of Pharmacy, King Abdulaziz University, Jeddah 21589, Saudi Arabia; (N.A.A.); (M.A.A.)
- Vaccines and Immunotherapy Unit, King Fahd Medical Research Center, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Awanish Mishra
- Department of Pharmacology, School of Pharmaceutical Sciences, Lovely Professional University, Phagwara 144411, Punjab, India;
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER)—Guwahati, Changsari, Guwahati 781101, Assam, India
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10
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Elkommos S, Mula M. A systematic review of neuroimaging studies of depression in adults with epilepsy. Epilepsy Behav 2021; 115:107695. [PMID: 33348194 DOI: 10.1016/j.yebeh.2020.107695] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 12/03/2020] [Accepted: 12/03/2020] [Indexed: 01/15/2023]
Abstract
OBJECTIVE Depression is a relatively common comorbidity in people with epilepsy with a lifetime history identified in 1 in 4 individuals. In this paper, we aimed to provide a systematic review of structural and functional brain region-specific group differences of adults with epilepsy and depression and to discuss existing evidence as compared to that in people with depression. METHODS We undertook a systematic review of neuroimaging studies of depression in adults with epilepsy through MEDLINE/PubMed, Embase and PsycInfo searches until June 2020. RESULTS A total of 44 studies were included in the qualitative synthesis: 21 on structural neuroimaging, 9 on functional, and 14 on pharmaco/metabolic neuroimaging. Almost all studies focused on temporal lobe epilepsy (TLE). Patterns of changes in the hippocampi and subcortical structures seem to be different from those reported in depression outside epilepsy. Cortical changes are grossly similar as well as the lack of any laterality effect. Serotonin dysfunction seems to be due to different mechanisms with reduced synaptic availability for depression in epilepsy as compared to reduced 5HT1 receptor density outside epilepsy. Depressive symptoms seem to correlate with a dysfunction in temporolimbic structures contralateral to the epileptogenic zone especially in patients with de novo postsurgical depression. CONCLUSIONS Depression, at least in TLE, seems to be associated with a different pattern of brain changes as compared to major depression, potentially supporting the notion of phenomenological peculiarities of depression in epilepsy.
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Affiliation(s)
- Samia Elkommos
- Atkinson Morley Regional Neuroscience Centre, St George's University Hospitals NHS Foundation Trust, London, United Kingdom
| | - Marco Mula
- Atkinson Morley Regional Neuroscience Centre, St George's University Hospitals NHS Foundation Trust, London, United Kingdom; Institute of Medical and Biomedical Education, St George's University of London, United Kingdom.
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11
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Pillai RLI, Bartlett EA, Ananth MR, Zhu C, Yang J, Hajcak G, Parsey RV, DeLorenzo C. Examining the underpinnings of loudness dependence of auditory evoked potentials with positron emission tomography. Neuroimage 2020; 213:116733. [PMID: 32169543 DOI: 10.1016/j.neuroimage.2020.116733] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 03/07/2020] [Accepted: 03/09/2020] [Indexed: 11/30/2022] Open
Abstract
Loudness dependence of auditory evoked potentials (LDAEP) has long been considered to reflect central basal serotonin transmission. However, the relationship between LDAEP and individual serotonin receptors and transporters has not been fully explored in humans and may involve other neurotransmitter systems. To examine LDAEP's relationship with the serotonin system, we performed PET using serotonin-1A (5-HT1A) imaging via [11C]CUMI-101 and serotonin transporter (5-HTT) imaging via [11C]DASB on a mixed sample of healthy controls (n = 4: 4 females, 0 males), patients with unipolar (MDD, n = 11: 4 females, 7 males) and bipolar depression (BD, n = 8: 4 females, 4 males). On these same participants, we also performed electroencephalography (EEG) within a week of PET scanning, using 1000 Hz tones of varying intensity to evoke LDAEP. We then evaluated the relationship between LDAEP and 5-HT1A or 5-HTT binding in both the raphe (5-HT1A)/midbrain (5-HTT) areas and in the temporal cortex. We found that LDAEP was significantly correlated with 5-HT1A positively and with 5-HTT negatively in the temporal cortex (p < 0.05), but not correlated with either in midbrain or raphe. In males only, exploratory analysis showed multiple regions in which LDAEP significantly correlated with 5-HT1A throughout the brain; we did not find this with 5-HTT. This multimodal study partially validates preclinical models of a serotonergic influence on LDAEP. Replication in larger samples is necessary to further clarify our understanding of the role of serotonin in perception of auditory tones.
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Affiliation(s)
| | - Elizabeth A Bartlett
- Department of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, United States
| | - Mala R Ananth
- Department of Psychiatry, Stony Brook University, United States
| | - Chencan Zhu
- Department of Applied Mathematics and Statistics, Stony Brook University, United States
| | - Jie Yang
- Department of Family, Population, and Preventive Medicine, Stony Brook University, United States
| | - Greg Hajcak
- Department of Biomedical Sciences and Psychology, Florida State University, United States
| | - Ramin V Parsey
- Department of Psychiatry, Stony Brook University, United States
| | - Christine DeLorenzo
- Department of Psychiatry, Stony Brook University, United States; Department of Biomedical Engineering, Stony Brook University, United States
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12
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Petrucci AN, Joyal KG, Purnell BS, Buchanan GF. Serotonin and sudden unexpected death in epilepsy. Exp Neurol 2020; 325:113145. [PMID: 31866464 PMCID: PMC7029792 DOI: 10.1016/j.expneurol.2019.113145] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 11/12/2019] [Accepted: 12/10/2019] [Indexed: 12/20/2022]
Abstract
Epilepsy is a highly prevalent disease characterized by recurrent, spontaneous seizures. Approximately one-third of epilepsy patients will not achieve seizure freedom with medical management and become refractory to conventional treatments. These patients are at greatest risk for sudden unexpected death in epilepsy (SUDEP). The exact etiology of SUDEP is unknown, but a combination of respiratory, cardiac, neuronal electrographic dysfunction, and arousal impairment is thought to underlie SUDEP. Serotonin (5-HT) is involved in regulation of breathing, sleep/wake states, arousal, and seizure modulation and has been implicated in the pathophysiology of SUDEP. This review explores the current state of understanding of the relationship between 5-HT, epilepsy, and respiratory and autonomic control processes relevant to SUDEP in epilepsy patients and in animal models.
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Affiliation(s)
- Alexandra N Petrucci
- Interdisciplinary Graduate Program in Neuroscience, University of Iowa, Iowa City, IA 52242, United States of America; Iowa Neuroscience Institute, Carver College of Medicine, University of Iowa, Iowa City, IA 52242, United States of America
| | - Katelyn G Joyal
- Interdisciplinary Graduate Program in Neuroscience, University of Iowa, Iowa City, IA 52242, United States of America; Iowa Neuroscience Institute, Carver College of Medicine, University of Iowa, Iowa City, IA 52242, United States of America
| | - Benton S Purnell
- Interdisciplinary Graduate Program in Neuroscience, University of Iowa, Iowa City, IA 52242, United States of America; Iowa Neuroscience Institute, Carver College of Medicine, University of Iowa, Iowa City, IA 52242, United States of America
| | - Gordon F Buchanan
- Interdisciplinary Graduate Program in Neuroscience, University of Iowa, Iowa City, IA 52242, United States of America; Department of Neurology, University of Iowa, Iowa City, IA 52242, United States of America; Iowa Neuroscience Institute, Carver College of Medicine, University of Iowa, Iowa City, IA 52242, United States of America.
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13
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Lai CH. Major Depressive Disorder in Neuroimaging: What is Beyond Fronto-limbic Model? CURRENT PSYCHIATRY RESEARCH AND REVIEWS 2019. [DOI: 10.2174/1573400515666181213155225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background:
The major depressive disorder (MDD) is a chronic illness with major manifestations
in cognitive, social and occupational functions. The pathophysiological model is an intrigue
issue for scientists to understand the origin of MDD.
Objective:
In the beginning, the cortico-limbic-striato-pallidal-thalamic model has been proposed to
link the clinical symptoms with the abnormalities in brain structure and function. However, the
model is still evolving due to recent advances in the neuroimaging techniques, especially for functional
magnetic resonance imaging (fMRI). The recent findings in the fMRI studies in MDD showed
the importance of fronto-limbic model for the modulations between cognitive function and primitive
and negative emotions.
Method:
This review will focus on the literature of fMRI studies in MDD with findings not in the
fronto-limbic structures.
Results:
Additional regions beyond the fronto-limbic model have been observed in some literature of
MDD. Some regions in the parietal, temporal and occipital lobes have been shown with the alterations
in gray matter, white matter and brain function. The importance of sensory detection, visuospatial function,
language reception, motor response and emotional memories in these regions might provide the
clues to understand the cognitive misinterpretations related to altered reception of outside information,
behavioral responses related to biased cognition and emotional memories and clinical symptoms related
to the significant alterations of interactions between different brain regions.
Conclusion:
Future studies to establish a more comprehensive model for MDD will be warranted,
especially for the model beyond the fronto-limbic structures.
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Affiliation(s)
- Chien-Han Lai
- Institute of Biophotonics, National Yang-Ming University, Taipei City, Taiwan
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14
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The Feasibility and Impact of the EMOVE Intervention on Self-efficacy and Outcome Expectations for Exercise in Epilepsy. J Neurosci Nurs 2019; 51:95-100. [PMID: 30649092 DOI: 10.1097/jnn.0000000000000425] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The purpose of this pilot study was to evaluate the feasibility of the self-efficacy based Epilepsy-Motivate and Outcome Expectations for Vigorous Exercise (EMOVE) intervention and report on the preliminary efficacy of this intervention aimed at improving exercise behaviors in adults with epilepsy. Methods: A single-group, repeated-measures design was used in 30 outpatients. Data were collected at baseline and 12 weeks after the intervention. Participant outcomes included Self-Efficacy and Outcome Expectations for Exercise in Epilepsy, Beck Depression Inventory-II, Quality of Life in Epilepsy Inventory-31, seizure frequency, average daily steps, and body mass index. Daily number of steps was measured using a wrist-worn activity monitor. Feasibility data were assessed using evidence of treatment fidelity including intervention delivery, receipt, and enactment. Results: Participants were single (63%), white (53%), female (63%), had a mean (SD) age of 46.7 (13) years (range, 26-68 years), had low levels of self-efficacy (mean, 5.10; range, 0-10) and high outcome expectations (mean, 3.90; range, 0-5), took under the recommended 10 000 steps per day (mean, 5107), and had an average of 6 seizures per month. Postintervention testing showed statistical improvement in depressive symptoms (mean [SD], 9.95 [9.47]; P < .05). There were no significant differences found for the other study outcomes. Our study showed the EMOVE intervention was feasible. Study participants had improved depressive symptoms. Future research should focus on increasing the sample size, improving exercise performance through group or individualized exercise sessions, and adding a control group to better evaluate the relationship between the intervention and improved depressive symptoms.
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15
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Socała K, Mogilski S, Pieróg M, Nieoczym D, Abram M, Szulczyk B, Lubelska A, Latacz G, Doboszewska U, Wlaź P, Kamiński K. KA-11, a Novel Pyrrolidine-2,5-dione Derived Broad-Spectrum Anticonvulsant: Its Antiepileptogenic, Antinociceptive Properties and in Vitro Characterization. ACS Chem Neurosci 2019; 10:636-648. [PMID: 30247871 DOI: 10.1021/acschemneuro.8b00476] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Recently, compound KA-11 was identified as a promising candidate for a new broad-spectrum anticonvulsant. This compound revealed wide protective activity across the most important animal models of seizures such as the maximal electroshock test (MES), the subcutaneous pentylenetetrazole test ( scPTZ), and the six-hertz test (6 Hz, 32 mA). Importantly, KA-11 was devoid of acute neurological activity, which was assessed by applying the chimney test (TD50 value higher than 1500 mg/kg). The preliminary in vivo results confirmed favorable anticonvulsant and safety properties of KA-11. With the aim of further biological characterization of KA-11, in the current studies we evaluated its antiepileptogenic activity in the kindling model of epilepsy induced by repeated injection of PTZ in mice. Furthermore, we assessed the antinociceptive activity of KA-11 in several animal pain models. As a result, KA-11 (at all doses applied: 25, 50, and 100 mg/kg) significantly delayed the progression of kindling induced by repeated injection of PTZ in mice. Additionally, KA-11 revealed potent antinociceptive activity in the formalin-induced tonic pain and, importantly, in the oxaliplatin-induced neuropathic pain model in mice. Moreover, KA-11 did not induce motor deficits in the rotarod test. Patch-clamp experiments revealed that one of the mechanisms of action of KA-11 is inhibition of voltage-gated sodium currents. Compound KA-11 appeared to be safe in relation to hepatotoxic properties as no phospholipidosis induction was determined in HepG2 cells at 50 μM, and a small, statistically significant decrease of cell viability was observed only at the highest used dose of 100 μM. Moreover, KA-11 did not affect the function of CYP2D6. The aforementioned hybrid substance proved to penetrate the biological membranes in the in vitro permeability assays.
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Affiliation(s)
- Katarzyna Socała
- Department of Animal Physiology, Institute of Biology and Biochemistry, Faculty of Biology and Biotechnology, Maria Curie-Skłodowska University, Akademicka 19, 20-033 Lublin, Poland
| | - Szczepan Mogilski
- Department of Pharmacodynamics, Faculty of Pharmacy, Jagiellonian University Medical College, Medyczna 9, 30-688 Kraków, Poland
| | - Mateusz Pieróg
- Department of Animal Physiology, Institute of Biology and Biochemistry, Faculty of Biology and Biotechnology, Maria Curie-Skłodowska University, Akademicka 19, 20-033 Lublin, Poland
| | - Dorota Nieoczym
- Department of Animal Physiology, Institute of Biology and Biochemistry, Faculty of Biology and Biotechnology, Maria Curie-Skłodowska University, Akademicka 19, 20-033 Lublin, Poland
| | - Michał Abram
- Department of Medicinal Chemistry, Faculty of Pharmacy, Jagiellonian University Medical College, Medyczna 9, 30-688 Kraków, Poland
| | - Bartłomiej Szulczyk
- Department of Drug Technology and Pharmaceutical Biotechnology, Medical University of Warsaw, Banacha 1, 02-097 Warsaw, Poland
- Department of Physiology and Pathophysiology, Medical University of Warsaw, Banacha 1B, 02-097 Warsaw, Poland
| | - Annamaria Lubelska
- Department of Technology and Biotechnology of Drugs, Faculty of Pharmacy, Jagiellonian University Medical College, Medyczna 9, 30-688 Kraków, Poland
| | - Gniewomir Latacz
- Department of Technology and Biotechnology of Drugs, Faculty of Pharmacy, Jagiellonian University Medical College, Medyczna 9, 30-688 Kraków, Poland
| | - Urszula Doboszewska
- Department of Animal Physiology, Institute of Biology and Biochemistry, Faculty of Biology and Biotechnology, Maria Curie-Skłodowska University, Akademicka 19, 20-033 Lublin, Poland
| | - Piotr Wlaź
- Department of Animal Physiology, Institute of Biology and Biochemistry, Faculty of Biology and Biotechnology, Maria Curie-Skłodowska University, Akademicka 19, 20-033 Lublin, Poland
| | - Krzysztof Kamiński
- Department of Medicinal Chemistry, Faculty of Pharmacy, Jagiellonian University Medical College, Medyczna 9, 30-688 Kraków, Poland
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16
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Vrinda M, Arun S, Srikumar B, Kutty BM, Shankaranarayana Rao B. Temporal lobe epilepsy-induced neurodegeneration and cognitive deficits: Implications for aging. J Chem Neuroanat 2019; 95:146-153. [DOI: 10.1016/j.jchemneu.2018.02.005] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2017] [Revised: 02/16/2018] [Accepted: 02/16/2018] [Indexed: 12/12/2022]
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17
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Iscan Z, Rakesh G, Rossano S, Yang J, Zhang M, Miller J, Sullivan GM, Sharma P, McClure M, Oquendo MA, Mann JJ, Parsey RV, DeLorenzo C. A positron emission tomography study of the serotonergic system in relation to anxiety in depression. Eur Neuropsychopharmacol 2017; 27:1011-1021. [PMID: 28811068 PMCID: PMC5623123 DOI: 10.1016/j.euroneuro.2017.07.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2017] [Revised: 06/02/2017] [Accepted: 07/29/2017] [Indexed: 12/17/2022]
Abstract
Symptoms of anxiety are highly comorbid with major depressive disorder (MDD) and are known to alter the course of the disease. To help elucidate the biological underpinnings of these prevalent disorders, we previously examined the relationship between components of anxiety (somatic, psychic and motoric) and serotonin 1A receptor (5-HT1A) binding in MDD and found that higher psychic and lower somatic anxiety was associated with greater 5-HT1A binding. In this work, we sought to examine the correlation between these anxiety symptom dimensions and 5-HTT binding. Positron emission tomography with [11C]-3-amino-4-(3-dimethylamino-methylphenylsulfanyl)-benzonitrile ([11C]DASB) and a metabolite-corrected arterial input function were used to estimate regional 5-HTT binding in 55 subjects with MDD and anxiety symptoms. Somatic anxiety was negatively correlated with 5-HTT binding in the thalamus (β=-.33, p=.025), amygdala (β=-.31, p=.007) and midbrain (β=-.72, p<.001). Psychic anxiety was positively correlated with 5-HTT binding in midbrain only (β=.46, p=.0025). To relate to our previous study, correlation between 5-HT1A and 5-HTT binding was examined, and none was found. We also examined how much of the variance in anxiety symptom dimensions could be explained by both 5-HTT and 5-HT1A binding. The developed model was able to explain 68% (p<.001), 38% (p=.012) and 32% (p=.038) of the total variance in somatic, psychic, and motoric anxiety, respectively. Results indicate the tight coupling between the serotonergic system and anxiety components, which may be confounded when using aggregate anxiety measures. Uncovering serotonin's role in anxiety and depression in this way may give way to a new generation of therapeutics and treatment strategies.
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Affiliation(s)
- Zafer Iscan
- Centre for Cognition and Decision Making, National Research University, Higher School of Economics, Russian Federation; Cognitive Neuroimaging Unit, CEA DRF/Joliot Institute, INSERM, Université Paris-Sud, Université Paris-Saclay, NeuroSpin Center, 91191 Gif-sur-Yvette, France.
| | | | - Samantha Rossano
- Department of Psychiatry, Stony Brook University, Stony Brook, NY, USA
| | - Jie Yang
- Family, Population and Preventive Medicine, Stony Brook University, Stony Brook, NY, USA
| | - Mengru Zhang
- Applied Mathematics and Statistics, Stony Brook University, Stony Brook, NY, USA
| | - Jeffrey Miller
- New York State Psychiatric Institute and Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - Gregory M Sullivan
- Tonix Pharmaceuticals, Inc., 509 Madison Avenue Suite 306, New York, NY, USA
| | - Priya Sharma
- Department of Psychiatry, Stony Brook University, Stony Brook, NY, USA
| | - Matthew McClure
- Department of Psychiatry, Stony Brook University, Stony Brook, NY, USA
| | - Maria A Oquendo
- New York State Psychiatric Institute and Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - J John Mann
- New York State Psychiatric Institute and Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - Ramin V Parsey
- Department of Psychiatry, Stony Brook University, Stony Brook, NY, USA; Radiology, Stony Brook University, Stony Brook, NY, USA
| | - Christine DeLorenzo
- Department of Psychiatry, Stony Brook University, Stony Brook, NY, USA; New York State Psychiatric Institute and Columbia University College of Physicians and Surgeons, New York, NY, USA
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Lin WH, Li XF, Lin MX, Zhou Y, Huang HP. Novel insights into the effect of paroxetine administration in pilocarpine‑induced chronic epileptic rats. Mol Med Rep 2017; 16:8245-8252. [PMID: 28983622 DOI: 10.3892/mmr.2017.7659] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Accepted: 05/09/2017] [Indexed: 11/05/2022] Open
Abstract
The aim of the present study was to investigate the role of paroxetine intervention in epilepsy, and its association with the expression of serotonin transporter (SERT) and hippocampal apoptosis. Thirty adult male Sprague Dawley rats were divided into control vehicle (n=6) and epileptic (n=24) groups. Status epilepticus (SE) was induced via systemic injection of pilocarpine, and seizure activity was monitored via video electroencephalogram. The epileptic group was then randomly divided into two groups; Four weeks following SE induction, paroxetine (5 mg/kg/day; SE + paroxetine group) or normal saline (SE group) was intraperitoneally injected for 4 weeks. Brain tissue was collected to evaluate apoptosis via terminal deoxynucleotidyl transferase dUTP nick‑end labeling. SERT, B‑cell lymphoma‑2 (Bcl‑2) and brain derived neurotropic factor (BDNF) expression levels were evaluated by western blotting, and miR‑16 expression was evaluated by reverse transcription‑quantitative polymerase chain reaction. Paroxetine did not affect the mortality of the pilocarpine‑induced chronic epileptic rats. Spontaneous recurrent seizures (SSRs) were observed 7‑28 days following SE induction. The frequency and stage of the SSRs were reduced by paroxetine administration. Apoptotic cells were observed in the epileptic hippocampus. Following paroxetine intervention, the staining intensity and number of apoptotic cells were significantly decreased. Expression levels of BDNF and Bcl‑2 were lower in the SE group compared with the vehicle group. The former was not altered by paroxetine injection; however, the latter was increased. In the SE group, SERT expression was not altered in the raphe nucleus but was decreased in the hippocampus. Following paroxetine administration, SERT expression was decreased in the raphe nucleus and increased in the hippocampus. In the SE group, miR‑16 expression was decreased in the raphe nucleus and increased in the hippocampus. Following paroxetine administration, miR‑16 expression was not altered in the raphe nucleus but was reduced in the hippocampus. In conclusion, the seizures and hippocampal apoptosis observed in chronic epileptic rats were alleviated by paroxetine treatment. This effect may be associated with the reduced Bcl‑2 and BDNF expression and the modulation of SERT expression. The alterations in miR‑16 expression may provide a potential explanation for the modulation of apoptosis; however, further research is required to determine the complete underlying molecular mechanism.
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Affiliation(s)
- Wan-Hui Lin
- Department of Neurology and Geriatrics, Union Hospital of Fujian Medical University, Fuzhou, Fujian 350001, P.R. China
| | - Xiao-Feng Li
- Department of Neurology, Union Hospital of Fujian Medical University, Fuzhou, Fujian 350001, P.R. China
| | - Ming-Xing Lin
- Department of Pediatrics, Union Hospital of Fujian Medical University, Fuzhou, Fujian 350001, P.R. China
| | - Ying Zhou
- Neuroscience Research Center of Fujian Medical University, Fuzhou, Fujian 350001, P.R. China
| | - Hua-Pin Huang
- Department of Neurology and Geriatrics, Union Hospital of Fujian Medical University, Fuzhou, Fujian 350001, P.R. China
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Fonseca NC, Joaquim HPG, Talib LL, Vincentiis S, Gattaz WF, Valente KD. 5-hydroxytryptamine1A receptor density in the hippocampus of patients with temporal lobe epilepsy is associated with disease duration. Eur J Neurol 2017; 24:602-608. [DOI: 10.1111/ene.13252] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Accepted: 01/04/2017] [Indexed: 11/30/2022]
Affiliation(s)
- N. C. Fonseca
- Institute and Department of Psychiatry; University of São Paulo; São Paulo
| | - H. P. G. Joaquim
- Laboratory of Neuroscience; Institute and Department of Psychiatry; Clinical Hospital; University of São Paulo; São Paulo
| | - L. L. Talib
- Laboratory of Neuroscience; Institute and Department of Psychiatry; Clinical Hospital; University of São Paulo; São Paulo
| | - S. Vincentiis
- Institute and Department of Psychiatry; University of São Paulo; São Paulo
- Laboratory of Neuroimaging; Institute and Department of Psychiatry; University of São Paulo; São Paulo Brazil
| | - W. F. Gattaz
- Laboratory of Neuroscience; Institute and Department of Psychiatry; Clinical Hospital; University of São Paulo; São Paulo
| | - K. D. Valente
- Institute and Department of Psychiatry; University of São Paulo; São Paulo
- Laboratory of Neuroimaging; Institute and Department of Psychiatry; University of São Paulo; São Paulo Brazil
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Abstract
This paper reviews advances in epilepsy in recent years with an emphasis on therapeutics and underlying mechanisms, including status epilepticus, drug and surgical treatments. Lessons from rarer epilepsies regarding the relationship between epilepsy type, mechanisms and choice of antiepileptic drugs (AED) are explored and data regarding AED use in pregnancy are reviewed. Concepts evolving towards a move from treating seizures to treating epilepsy are discussed, both in terms of the mechanisms of epileptogenesis, and in terms of epilepsy's broader comorbidity, especially depression.
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Abstract
Positron emission tomography (PET) is a neuroimaging method that offers insights into the molecular functioning of a human brain. It has been widely used to study metabolic and neurotransmitter abnormalities in people with epilepsy. This article reviews the development of several PET radioligands and their application in studying the molecular mechanisms of epilepsy. Over the last decade, tracers binding to serotonin and γ-aminobutyric acid (GABA) receptors have been used to delineate the location of the epileptic focus. PET studies have examined the role of opioids, cannabinoids, acetylcholine, and dopamine in modulating neuronal hyperexcitability and seizure termination. In vivo analyses of drug transporters, e.g., P-glycoprotein, have increased our understanding of pharmacoresistance that could inform new therapeutic strategies. Finally, PET experiments targeting neuroinflammation and glutamate receptors might guide the development of novel biomarkers of epileptogenesis.
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Affiliation(s)
- Marian Galovic
- Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, 33 Queen Square, London, WC1N 3BG, United Kingdom.,Epilepsy Society MRI Unit, Epilepsy Society, Chalfont St Peter, Buckinghamshire, United Kingdom
| | - Matthias Koepp
- Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, 33 Queen Square, London, WC1N 3BG, United Kingdom. .,Epilepsy Society MRI Unit, Epilepsy Society, Chalfont St Peter, Buckinghamshire, United Kingdom.
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Mazarati A, Sankar R. Common Mechanisms Underlying Epileptogenesis and the Comorbidities of Epilepsy. Cold Spring Harb Perspect Med 2016; 6:6/7/a022798. [PMID: 27371669 DOI: 10.1101/cshperspect.a022798] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
The importance of comorbidities in determining the quality of life of individuals with epilepsy and their families has received increasing attention in the past decade. Along with it has come a recognition that in some individuals, certain comorbidities may have preexisted, and may have contributed to their developing epilepsy. Many mechanisms are capable of interconnecting different dysfunctions that manifest as distinct disorders, often diagnosed and managed by different specialists. We review the human data from the perspective of epidemiology as well as insights gathered from neurodiagnostic and endocrine studies. Animal studies are reviewed to refine our mechanistic understanding of the connections, because they permit the narrowing of variables, which is not possible when studying humans.
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Affiliation(s)
- Andrey Mazarati
- Department of Pediatrics, Division of Pediatric Neurology, David Geffen School of Medicine at UCLA, UCLA Medical Center, Los Angeles, California 90095-1752
| | - Raman Sankar
- Department of Pediatrics, Division of Pediatric Neurology, David Geffen School of Medicine at UCLA, UCLA Medical Center, Los Angeles, California 90095-1752 Department of Neurology, David Geffen School of Medicine at UCLA, UCLA Medical Center, Los Angeles, California 90095-1752
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Abstract
Imaging is pivotal in the evaluation and management of patients with seizure disorders. Elegant structural neuroimaging with magnetic resonance imaging (MRI) may assist in determining the etiology of focal epilepsy and demonstrating the anatomical changes associated with seizure activity. The high diagnostic yield of MRI to identify the common pathological findings in individuals with focal seizures including mesial temporal sclerosis, vascular anomalies, low-grade glial neoplasms and malformations of cortical development has been demonstrated. Positron emission tomography (PET) is the most commonly performed interictal functional neuroimaging technique that may reveal a focal hypometabolic region concordant with seizure onset. Single photon emission computed tomography (SPECT) studies may assist performance of ictal neuroimaging in patients with pharmacoresistant focal epilepsy being considered for neurosurgical treatment. This chapter highlights neuroimaging developments and innovations, and provides a comprehensive overview of the imaging strategies used to improve the care and management of people with epilepsy.
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Yilmazer-Hanke D, O'Loughlin E, McDermott K. Contribution of amygdala pathology to comorbid emotional disturbances in temporal lobe epilepsy. J Neurosci Res 2015; 94:486-503. [DOI: 10.1002/jnr.23689] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Revised: 10/07/2015] [Accepted: 10/16/2015] [Indexed: 12/19/2022]
Affiliation(s)
- Deniz Yilmazer-Hanke
- Department of Biomedical Sciences, School of Medicine; Creighton University; Omaha Nebraska
- Department of Anatomy and Neuroscience; University College; Cork Ireland
| | - Elaine O'Loughlin
- Department of Anatomy and Neuroscience; University College; Cork Ireland
- Ann Romney Centre for Neurologic Diseases, Brigham and Women's Hospital; Harvard Medical School; Boston Massachusetts
| | - Kieran McDermott
- Department of Anatomy and Neuroscience; University College; Cork Ireland
- Graduate Entry Medical School; University of Limerick; Limerick Ireland
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Sarikaya I. PET studies in epilepsy. AMERICAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING 2015; 5:416-430. [PMID: 26550535 PMCID: PMC4620171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Accepted: 06/23/2015] [Indexed: 06/05/2023]
Abstract
Various PET studies, such as measurements of glucose, serotonin and oxygen metabolism, cerebral blood flow and receptor bindings are availabe for epilepsy. (18)Fluoro-2-deoxyglucose ((18)F-FDG) PET imaging of brain glucose metabolism is a well established and widely available technique. Studies have demonstrated that the sensitivity of interictal FDG-PET is higher than interictal SPECT and similar to ictal SPECT for the lateralization and localization of epileptogenic foci in presurgical patients refractory to medical treatments who have noncontributory EEG and MRI. In addition to localizing epileptogenic focus, FDG-PET provide additional important information on the functional status of the rest of the brain. The main limitation of interictal FDG-PET is that it cannot precisely define the surgical margin as the area of hypometabolism usually extends beyond the epileptogenic zone. Various neurotransmitters (GABA, glutamate, opiates, serotonin, dopamine, acethylcholine, and adenosine) and receptor subtypes are involved in epilepsy. PET receptor imaging studies performed in limited centers help to understand the role of neurotransmitters in epileptogenesis, identify epileptic foci and investigate new treatment approaches. PET receptor imaging studies have demonstrated reduced (11)C-flumazenil (GABAA-cBDZ) and (18)F-MPPF (5-HT1A serotonin) and increased (11)C-cerfentanil (mu opiate) and (11)C-MeNTI (delta opiate) bindings in the area of seizure. (11)C-flumazenil has been reported to be more sensitive than FDG-PET for identifying epileptic foci. The area of abnormality on GABAAcBDZ and opiate receptor images is usually smaller and more circumscribed than the area of hypometabolism on FDG images. Studies have demonstrated that (11)C-alpha-methyl-L-tryptophan PET (to study synthesis of serotonin) can detect the epileptic focus within malformations of cortical development and helps in differentiating epileptogenic from non-epileptogenic tubers in patients with tuberous sclerosis complex. (15)O-H2O PET was reported to have a similar sensitivity to FDG-PET in detecting epileptic foci.
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Affiliation(s)
- Ismet Sarikaya
- Nuclear Medicine Section, Baskent University Hospital Istanbul, Turkey
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27
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Recent imaging advances in neurology. J Neurol 2015; 262:2182-94. [PMID: 25808503 DOI: 10.1007/s00415-015-7711-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Revised: 03/13/2015] [Accepted: 03/14/2015] [Indexed: 01/08/2023]
Abstract
Over the recent years, the application of neuroimaging techniques such as magnetic resonance imaging (MRI) and positron emission tomography (PET) has considerably advanced the understanding of complex neurological disorders. PET is a powerful molecular imaging tool, which investigates the distribution and binding of radiochemicals attached to biologically relevant molecules; as such, this technique is able to give information on biochemistry and metabolism of the brain in health and disease. MRI uses high intensity magnetic fields and radiofrequency pulses to provide structural and functional information on tissues and organs in intact or diseased individuals, including the evaluation of white matter integrity, grey matter thickness and brain perfusion. The aim of this article is to review the most recent advances in neuroimaging research in common neurological disorders such as movement disorders, dementia, epilepsy, traumatic brain injury and multiple sclerosis, and to evaluate their contribution in the diagnosis and management of patients.
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McKean J, Watts H, Mokszycki R. Breakthrough Seizures after Starting Vilazodone for Depression. Pharmacotherapy 2015; 35:e6-8. [DOI: 10.1002/phar.1549] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Affiliation(s)
- James McKean
- Advocate Christ Medical Center; Oak Lawn Illinois
- Department of Emergency Medicine; Advocate Christ Medical Center; Oak Lawn Illinois
- Department of Emergency Medicine; Advocate BroMenn Medical Center; Normal Illinois
| | - Hannah Watts
- Advocate Christ Medical Center; Oak Lawn Illinois
- Department of Emergency Medicine; Advocate Christ Medical Center; Oak Lawn Illinois
| | - Robert Mokszycki
- Advocate Christ Medical Center; Oak Lawn Illinois
- Department of Pharmacy; Advocate Christ Medical Center; Oak Lawn Illinois
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29
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Stretton J, Pope RA, Winston GP, Sidhu MK, Symms M, Duncan JS, Koepp M, Thompson PJ, Foong J. Temporal lobe epilepsy and affective disorders: the role of the subgenual anterior cingulate cortex. J Neurol Neurosurg Psychiatry 2015; 86:144-51. [PMID: 24876189 PMCID: PMC4316913 DOI: 10.1136/jnnp-2013-306966] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Reduced deactivation within the default mode network (DMN) is common in individuals with primary affective disorders relative to healthy volunteers (HVs). It is unknown whether similar network abnormalities are present in temporal lobe epilepsy (TLE) patients with a history of affective psychopathology. METHODS 17 TLE patients with a lifetime affective diagnosis, 31 TLE patients with no formal psychiatric history and 30 HVs were included. We used a visuo-spatial 'n-back' paradigm to compare working memory (WM) network activation between these groups. Post hoc analyses included voxel-based morphometry and diffusion tensor imaging. The Beck Depression Inventory-Fast Screen and Beck Anxiety Inventory were completed on the day of scanning. FINDINGS Each group activated the fronto-parietal WM networks and deactivated the typical DMN in response to increasing task demands. Group comparison revealed that TLE patients with lifetime affective morbidity showed significantly greater deactivation in subgenual anterior cingulate cortex (sACC) than either the TLE-only or the HVs (p<0.001). This effect persisted after covarying for current psychotropic medication and severity of current depressive/anxiety symptoms (all p<0.001). Correlational analysis revealed that this finding was not driven by differences in task performance. There were no significant differences in grey matter volume or structural connectivity between the TLE groups. CONCLUSIONS Our results provide novel evidence suggesting that affective psychopathology in TLE has a neurobiological correlate, and in this context the sACC performs differently compared with network activity in primary affective disorders.
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Affiliation(s)
- J Stretton
- Epilepsy Society MRI Unit, Department of Clinical and Experimental Epilepsy, Institute of Neurology, University College London, London, UK MRC Cognition and Brain Science Unit, Cambridge, UK
| | - R A Pope
- Epilepsy Society MRI Unit, Department of Clinical and Experimental Epilepsy, Institute of Neurology, University College London, London, UK Clinical Psychopharmacology Unit, University College London, London, UK
| | - G P Winston
- Epilepsy Society MRI Unit, Department of Clinical and Experimental Epilepsy, Institute of Neurology, University College London, London, UK
| | - M K Sidhu
- Epilepsy Society MRI Unit, Department of Clinical and Experimental Epilepsy, Institute of Neurology, University College London, London, UK
| | - M Symms
- Epilepsy Society MRI Unit, Department of Clinical and Experimental Epilepsy, Institute of Neurology, University College London, London, UK
| | - J S Duncan
- Epilepsy Society MRI Unit, Department of Clinical and Experimental Epilepsy, Institute of Neurology, University College London, London, UK
| | - M Koepp
- Epilepsy Society MRI Unit, Department of Clinical and Experimental Epilepsy, Institute of Neurology, University College London, London, UK
| | - P J Thompson
- Epilepsy Society MRI Unit, Department of Clinical and Experimental Epilepsy, Institute of Neurology, University College London, London, UK
| | - J Foong
- Epilepsy Society MRI Unit, Department of Clinical and Experimental Epilepsy, Institute of Neurology, University College London, London, UK
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Kemmotsu N, Kucukboyaci NE, Leyden KM, Cheng CE, Girard HM, Iragui VJ, Tecoma ES, McDonald CR. Frontolimbic brain networks predict depressive symptoms in temporal lobe epilepsy. Epilepsy Res 2014; 108:1554-63. [PMID: 25223729 PMCID: PMC4194230 DOI: 10.1016/j.eplepsyres.2014.08.018] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2014] [Revised: 07/10/2014] [Accepted: 08/21/2014] [Indexed: 01/10/2023]
Abstract
Psychiatric co-morbidities in epilepsy are of great concern. The current study investigated the relative contribution of structural and functional connectivity (FC) between medial temporal (MT) and prefrontal regions in predicting levels of depressive symptoms in patients with temporal lobe epilepsy (TLE). Twenty-one patients with TLE [11 left TLE (LTLE); 10 right TLE (RTLE)] and 20 controls participated. Diffusion tensor imaging was performed to obtain fractional anisotropy (FA) of the uncinate fasciculus (UF), and mean diffusivity (MD) of the amygdala (AM) and hippocampus (HC). Functional MRI was performed to obtain FC strengths between the AM and HC and prefrontal regions of interest including anterior prefrontal (APF), orbitofrontal, and inferior frontal regions. Participants self-reported depression symptoms on the Beck Depression Inventory-II. Greater depressive symptoms were associated with stronger FC of ipsilateral HC-APF, lower FA of the bilateral UF, and higher MD of the ipsilateral HC in LTLE, and with lower FA of the contralateral UF in RTLE. Regression analyses indicated that FC of the ipsilateral HC-APF was the strongest contributor to depression in LTLE, explaining 68.7% of the variance in depression scores. Both functional and microstructural measures of frontolimbic dysfunction were associated with depressive symptoms. These connectivity variables may be moderating which patients present with depression symptoms. In particular, FC MRI may provide a more sensitive measure of depression-related dysfunction, at least in patients with LTLE. Employing sensitive measures of frontolimbic network dysfunction in TLE may help provide new insight into mood disorders in epilepsy that could eventually guide treatment planning.
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Affiliation(s)
- Nobuko Kemmotsu
- Multimodal Imaging Laboratory, University of California, San Diego, La Jolla, CA, USA; Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA.
| | - N Erkut Kucukboyaci
- Multimodal Imaging Laboratory, University of California, San Diego, La Jolla, CA, USA; SDSU/UCSD Joint Doctoral Program in Clinical Psychology, San Diego, San Diego, CA, USA.
| | - Kelly M Leyden
- Multimodal Imaging Laboratory, University of California, San Diego, La Jolla, CA, USA.
| | - Christopher E Cheng
- Multimodal Imaging Laboratory, University of California, San Diego, La Jolla, CA, USA.
| | - Holly M Girard
- SDSU/UCSD Joint Doctoral Program in Clinical Psychology, San Diego, San Diego, CA, USA.
| | - Vicente J Iragui
- Department of Neuroscience, University of California, San Diego, La Jolla, CA, USA.
| | - Evelyn S Tecoma
- SDSU/UCSD Joint Doctoral Program in Clinical Psychology, San Diego, San Diego, CA, USA; Department of Neuroscience, University of California, San Diego, La Jolla, CA, USA.
| | - Carrie R McDonald
- Multimodal Imaging Laboratory, University of California, San Diego, La Jolla, CA, USA; Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA; SDSU/UCSD Joint Doctoral Program in Clinical Psychology, San Diego, San Diego, CA, USA.
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31
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Abstract
PURPOSE OF REVIEW Drug resistance is an important clinical problem: it is associated with higher rates of somatic and psychiatric comorbidities and cognitive/memory decline, with seizures being just the 'tip of the iceberg'. This review summarizes recent developments in imaging research, focusing specifically on the functional consequence of chronic epilepsies and mechanisms of drug resistance, restricted to work published in 2013. RECENT FINDINGS Functional imaging approaches reliably identify underlying specific networks in patients with different epileptic syndromes, show specific responses to certain antiepileptic drugs and differentiate between responder and nonresponder. Functional MRI (fMRI) and the intracarotid amobarbital test (IAT) are generally congruent, but fMRI may be more sensitive than IAT to right hemisphere language processing. In addition, memory fMRI supports the functional adequacy of ipsilateral structures rather than functional reserve of the contralateral hemisphere. There is further evidence from group analysis of fMRI data for a node within the ipsilateral piriform cortex to be important for seizure modulation in focal refractory epilepsies of different cortical origin. Molecular imaging with verapamil-PET identifies P-glycprotein overexpression as a mechanism contributing to drug resistance in individual patients. SUMMARY Neuroimaging in epilepsy has progressed from correlations with demographic, semiologic, neuropsychological and other observational data primarily in patients undergoing presurgical investigations to imaging network connectivity changes in epilepsy syndromes, and testing specific mechanisms underlying drug-resistant epilepsy.
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Orban G, Bombardi C, Marino Gammazza A, Colangeli R, Pierucci M, Pomara C, Pessia M, Bucchieri F, Arcangelo B, Smolders I, De Deurwaerdère P, Di Giovanni G. Role(s) of the 5-HT2C receptor in the development of maximal dentate activation in the hippocampus of anesthetized rats. CNS Neurosci Ther 2014; 20:651-61. [PMID: 24935789 PMCID: PMC6493041 DOI: 10.1111/cns.12285] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2014] [Revised: 04/23/2014] [Accepted: 04/26/2014] [Indexed: 11/29/2022] Open
Abstract
AIMS Substantial evidence indicates that 5-HT2C receptors are involved in the control of neuronal network excitability and in seizure pathophysiology. Here, we have addressed the relatively unexplored relationship between temporal lobe epilepsy (TLE), the most frequent type of intractable epilepsy, and 5-HT2CRs. METHODS In this study, we investigated this issue using a model of partial complex (limbic) seizures in urethane-anesthetized rat, based on the phenomenon of maximal dentate activation (MDA) using 5-HT2C compounds, electrophysiology, immunohistochemistry, and western blotting techniques. RESULTS The 5-HT2C agonists mCPP (1 mg/kg, i.p) and lorcaserin (3 mg/kg, i.p), but not RO60-0175 (1-3 mg/kg i.p.), were antiepileptogenic reducing the MDA response duration. The selective 5-HT2C antagonist SB242084 (2 mg/kg, i.p) unveiled antiepileptogenic effects of RO60-0175 (3 mg/kg, i.p) but did not alter those induced by mCPP and lorcaserin. Compared with control rats, electrically stimulated rats showed an increase in glutamic acid decarboxylase levels and a heterogeneous decrease in 5-HT2CR immunoreactivity in different hippocampal areas. CONCLUSIONS In our animal model of TLE, mCPP and lorcaserin were anticonvulsant; likely acting on receptor subtypes other than 5-HT2C. Epileptogenesis induced early adaptive changes and reorganization in the 5-HT2CR and GABA systems.
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Affiliation(s)
- Gergely Orban
- Dipartimento di Biomedicina Sperimentale e Neuroscienze ClinicheUniversità degli Studi di PalermoPalermoItaly
- Istituto Euro‐Mediterraneo di Scienza e Tecnologia (IEMEST)PalermoItaly
| | - Cristiano Bombardi
- Department of Veterinary Medical ScienceUniversity of BolognaBolognaItaly
| | - Antonella Marino Gammazza
- Dipartimento di Biomedicina Sperimentale e Neuroscienze ClinicheUniversità degli Studi di PalermoPalermoItaly
- Istituto Euro‐Mediterraneo di Scienza e Tecnologia (IEMEST)PalermoItaly
| | - Roberto Colangeli
- Department of Physiology and BiochemistryUniversity of MaltaMsidaMalta
| | - Massimo Pierucci
- Istituto Euro‐Mediterraneo di Scienza e Tecnologia (IEMEST)PalermoItaly
- Department of Physiology and BiochemistryUniversity of MaltaMsidaMalta
| | - Cristoforo Pomara
- Department of AnatomyFaculty of Medicine and SurgeryUniversity of MaltaMsidaMalta
- Department of Forensic PathologyUniversity of FoggiaFoggiaItaly
| | - Mauro Pessia
- Department of Internal MedicineSection of Human PhysiologyUniversity of PerugiaPerugiaItaly
| | - Fabio Bucchieri
- Dipartimento di Biomedicina Sperimentale e Neuroscienze ClinicheUniversità degli Studi di PalermoPalermoItaly
- Istituto Euro‐Mediterraneo di Scienza e Tecnologia (IEMEST)PalermoItaly
| | - Benigno Arcangelo
- Dipartimento di Biomedicina Sperimentale e Neuroscienze ClinicheUniversità degli Studi di PalermoPalermoItaly
| | - Ilse Smolders
- Center for Neurosciences C4NVrije Universiteit BrusselBrusselsBelgium
| | | | - Giuseppe Di Giovanni
- Istituto Euro‐Mediterraneo di Scienza e Tecnologia (IEMEST)PalermoItaly
- Department of Physiology and BiochemistryUniversity of MaltaMsidaMalta
- School of BiosciencesCardiff UniversityCardiffUK
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Advanced Imaging Techniques in the Diagnosis of Nonlesional Epilepsy: MRI, MRS, PET, and SPECT. Epilepsy Curr 2014; 14:121-4. [PMID: 24940151 DOI: 10.5698/1535-7597-14.3.121] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Once patients have a diagnosis of localization related epilepsy (LRE), it is critical to further classify those patients into lesional or nonlesional for treatment and prognostic reasons. An individual with LRE may be classified as nonlesional for two reasons: 1) a lesion may not exist; that is, the structural abnormality that gives rise to seizures may be at the channel level or be spatially distributed in such a way that it would not be accurately termed a lesion, or 2) a lesion exists but is so subtle that standard clinical imaging is not sensitive enough to discriminate between the lesion and surrounding healthy brain tissue. As with any technology and disease process, this definition is dynamic, as we know that future imaging techniques will be developed and new disease mechanisms will be discovered, making detection of the epileptogenic underlying abnormality an ever-changing target.
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Abstract
The last decade has witnessed a significant shift on our understanding of the relationship between psychiatric disorders and epilepsy. While traditionally psychiatric disorders were considered as a complication of the underlying seizure disorder, new epidemiologic data, supported by clinical and experimental research, have suggested the existence of a bidirectional relation between the two types of conditions: not only are patients with epilepsy at greater risk of experiencing a psychiatric disorder, but patients with primary psychiatric disorders are at greater risk of developing epilepsy. Do these data suggest that some of the pathogenic mechanisms operant in psychiatric comorbidities play a role in epileptogenesis? The aim of this article is to review the epidemiologic data that demonstrate that primary psychiatric disorders are more frequent in people who develop epilepsy, before the onset of the seizure disorder than among controls. The next question looks at the available data of pathogenic mechanisms of primary mood disorders and their potential for facilitating the development and/or exacerbation in the severity of epileptic seizures. Finally, we review data derived from experimental studies in animal models of depression and epilepsy that support a potential role of pathogenic mechanisms of mood disorders in the development of epileptic seizures and epileptogenesis. The data presented in this article do not yet establish conclusive evidence of a pathogenic role of psychiatric comorbidities in epileptogenesis, but raise important research questions that need to be investigated in experimental, clinical, and population-based epidemiologic research studies.
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Affiliation(s)
- Andres M Kanner
- Department of Neurology, University of Miami, Miller School of Medicine, 1120 NW, 14th Street, Room 1324, Miami, FL, 33136, USA,
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Serotonin metabolites in the cerebrospinal fluid in sudden infant death syndrome. J Neuropathol Exp Neurol 2014; 73:115-22. [PMID: 24423636 DOI: 10.1097/nen.0000000000000034] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Forensic biomarkers are needed in sudden infant death syndrome (SIDS) to help identify this group among other sudden unexpected deaths in infancy. Previously, we reported multiple serotonergic (5-HT) abnormalities in nuclei of the medulla oblongata that help mediate protective responses to homeostatic stressors. As a first step toward their assessment as forensic biomarkers of medullary pathology, here we test the hypothesis that 5-HT-related measures are abnormal in the cerebrospinal fluid (CSF) of SIDS infants compared with those of autopsy controls. Levels of CSF 5-hydroxyindoleacetic acid (5-HIAA) and homovanillic acid (HVA), the degradative products of 5-HT and dopamine, respectively, were measured by high-performance liquid chromatography in 52 SIDS and 29 non-SIDS autopsy cases. Tryptophan (Trp) and tyrosine (Tyr), the substrates of 5-HT and dopamine, respectively, were also measured. There were no significant differences in 5-HIAA, Trp, HVA, or Tyr levels between the SIDS and non-SIDS groups. These data preclude the use of 5-HIAA, HVA, Trp, or Tyr measurements as CSF autopsy biomarkers of 5-HT medullary pathology in infants who have died suddenly and unexpectedly. They do, however, provide important information about monoaminergic measurements in human CSF at autopsy and their developmental profile in infancy that is applicable to multiple pediatric disorders beyond SIDS.
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Xie W, Cai L, Yu Y, Gao L, Xiao L, He Q, Ren Z, Liu Y. Activation of brain indoleamine 2,3-dioxygenase contributes to epilepsy-associated depressive-like behavior in rats with chronic temporal lobe epilepsy. J Neuroinflammation 2014; 11:41. [PMID: 24594021 PMCID: PMC3975854 DOI: 10.1186/1742-2094-11-41] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2013] [Accepted: 02/13/2014] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Depression has most often been diagnosed in patients with temporal lobe epilepsy (TLE), but the mechanism underlying this association remains unclear. In this study, we report that indoleamine 2,3-dioxygenase 1 (IDO1), a rate-limiting enzyme in tryptophan metabolism, plays a key role in epilepsy-associated depressive-like behavior. METHODS Rats which develop chronic epilepsy following pilocarpine status epilepticus exhibited a set of interictal disorders consistent with depressive-like behavior. Changes of depressive behavior were examined by taste preference test and forced swim test; brain IL-1β, IL-6 and IDO1 expression were quantified using real-time reverse transcriptase PCR; brain kynurenine/tryptophan and serotonin/tryptophan ratios were analyzed by liquid chromatography-mass spectrometry. Oral gavage of minocycline or subcutaneous injection of 1-methyltryptophan (1-MT) were used to inhibite IDO1 expression. RESULTS We observed the induction of IL-1β and IL-6 expression in rats with chronic TLE, which further induced the upregulation of IDO1 expression in the hippocampus. The upregulation of IDO1 subsequently increased the kynurenine/tryptophan ratio and decreased the serotonin/tryptophan ratio in the hippocampus, which contributed to epilepsy-associated depressive-like behavior. The blockade of IDO1 activation prevented the development of depressive-like behavior but failed to influence spontaneous seizures. This effect was achieved either indirectly, through the anti-inflammatory tetracycline derivative minocycline, or directly, through the IDO antagonist 1-MT, which normalizes kynurenine/tryptophan and serotonin/tryptophan ratios. CONCLUSION Brain IDO1 activity plays a key role in epileptic rats with epilepsy-associated depressive-like behavior.
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Affiliation(s)
- Wei Xie
- Department of Traditional Chinese Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, People's Republic of China.
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Choi JY, Lee M, Jeon TJ, Choi SH, Choi YJ, Lee YK, Kim JJ, Ryu YH. Determination of optimal acquisition time of [(18)F]FCWAY PET for imaging serotonin 1A receptors in the healthy male subjects. Appl Radiat Isot 2014; 89:141-5. [PMID: 24631746 DOI: 10.1016/j.apradiso.2014.02.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2013] [Revised: 01/28/2014] [Accepted: 02/16/2014] [Indexed: 11/25/2022]
Abstract
The purpose of this research is to find optimal acquisition time point of [(18)F]FCWAY PET for the assessment of serotonin 1A receptor (5-HT1A) density. To achieve this goal, we examined the specific-to-nonspecific ratios in various brain regions. The cerebellum has very few 5-HT1A receptors in the brain, so we set this region as the reference tissue. As a result, specific-to-nonspecific binding ratios in the frontal, temporal cortex and the hippocampus were steadily increased at 90 min after injection and remained stable at 120 min. In addition, the binding ratio of the late time was significantly higher than that of the previous time points. From these results, we recommend that 90 min p.i. is a better single time point for the analysis rather than previous time points for assessing [(18)F]FCWAY binding to 5-HT1A receptors.
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Affiliation(s)
- Jae Yong Choi
- Department of Nuclear Medicine, Yonsei University College of Medicine, Gangnam Severance Hospital, Seoul 135-720, Republic of Korea
| | - Minkyung Lee
- Department of Nuclear Medicine, Yonsei University College of Medicine, Gangnam Severance Hospital, Seoul 135-720, Republic of Korea
| | - Tae Joo Jeon
- Department of Nuclear Medicine, Yonsei University College of Medicine, Gangnam Severance Hospital, Seoul 135-720, Republic of Korea
| | - Soo-Hee Choi
- Department of Psychiatry and Institute of Human Behavioral Sciences, Seoul National University College of Medicine, Seoul, 120-752, Republic of Korea
| | - Ye Ji Choi
- Hwaam High School, Ulsan, 682-020, Republic of Korea
| | - Yu Kyung Lee
- Department of Nuclear Medicine, Yonsei University College of Medicine, Gangnam Severance Hospital, Seoul 135-720, Republic of Korea
| | - Jae-Jin Kim
- Department of Psychiatry and Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul,135-720, Republic of Korea
| | - Young Hoon Ryu
- Department of Nuclear Medicine, Yonsei University College of Medicine, Gangnam Severance Hospital, Seoul 135-720, Republic of Korea.
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Hesse S, Moeller F, Petroff D, Lobsien D, Luthardt J, Regenthal R, Becker GA, Patt M, Thomae E, Seese A, Meyer PM, Bergh FT, Sabri O. Altered serotonin transporter availability in patients with multiple sclerosis. Eur J Nucl Med Mol Imaging 2014; 41:827-35. [DOI: 10.1007/s00259-013-2636-z] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2013] [Accepted: 11/06/2013] [Indexed: 01/20/2023]
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