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Reddy DS, Chuang SH, Hunn D, Crepeau AZ, Maganti R. Neuroendocrine aspects of improving sleep in epilepsy. Epilepsy Res 2018; 147:32-41. [PMID: 30212766 PMCID: PMC6192845 DOI: 10.1016/j.eplepsyres.2018.08.013] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Revised: 08/27/2018] [Accepted: 08/30/2018] [Indexed: 12/15/2022]
Abstract
Sleep plays an intricate role in epilepsy and can affect the frequency and occurrence of seizures. With nearly 35% of U.S. adults failing to obtain the recommended 7 h of sleep every night, understanding the complex relationship between sleep and epilepsy is of utmost relevance. Sleep deprivation is a common trigger of seizures in many persons with epilepsy and sleep patterns play a role in the occurrence of seizures. Some patients have their first seizure or repeated seizures after an "all-nighter" at college or after a long period of chronic sleep deprivation. The strength of the relationship between sleep and seizures varies between patients, but improving sleep and optimizing seizure control can have significant positive effects on the quality of life for all these patients. Research has shown that the changes in the brain's electrical and hormonal activity occurring during normal sleep-wake cycles can be linked to both sleep and seizure patterns. Many questions remain to be answered about sleep and epilepsy. How can sleep deprivation trigger an epileptic seizure? How do circadian and hormonal changes influence sleep pattern and seizure occurrence? Can hormones or sleeping pills help with sleep in epilepsy? In this article we discuss these and many other questions on sleep in epilepsy, with an emphasis on sleep architecture, hormone changes, mechanistic factors, and possible prevention strategies.
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Affiliation(s)
- Doodipala Samba Reddy
- Department of Neuroscience and Experimental Therapeutics, Texas A&M University Health Science Center College of Medicine, Bryan, TX 77807, USA.
| | - Shu-Hui Chuang
- Department of Neuroscience and Experimental Therapeutics, Texas A&M University Health Science Center College of Medicine, Bryan, TX 77807, USA
| | - Dayton Hunn
- Department of Neuroscience and Experimental Therapeutics, Texas A&M University Health Science Center College of Medicine, Bryan, TX 77807, USA
| | - Amy Z Crepeau
- Department of Neurology, Mayo Clinic Hospital, Phoenix, AZ 85054, USA
| | - Rama Maganti
- Department of Neurology, University of Wisconsin School of Medicine and Public Health, Madison, WI 53705, USA
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Soplata AE, McCarthy MM, Sherfey J, Lee S, Purdon PL, Brown EN, Kopell N. Thalamocortical control of propofol phase-amplitude coupling. PLoS Comput Biol 2017; 13:e1005879. [PMID: 29227992 PMCID: PMC5739502 DOI: 10.1371/journal.pcbi.1005879] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Revised: 12/21/2017] [Accepted: 10/02/2017] [Indexed: 11/18/2022] Open
Abstract
The anesthetic propofol elicits many different spectral properties on the EEG, including alpha oscillations (8-12 Hz), Slow Wave Oscillations (SWO, 0.1-1.5 Hz), and dose-dependent phase-amplitude coupling (PAC) between alpha and SWO. Propofol is known to increase GABAA inhibition and decrease H-current strength, but how it generates these rhythms and their interactions is still unknown. To investigate both generation of the alpha rhythm and its PAC to SWO, we simulate a Hodgkin-Huxley network model of a hyperpolarized thalamus and corticothalamic inputs. We find, for the first time, that the model thalamic network is capable of independently generating the sustained alpha seen in propofol, which may then be relayed to cortex and expressed on the EEG. This dose-dependent sustained alpha critically relies on propofol GABAA potentiation to alter the intrinsic spindling mechanisms of the thalamus. Furthermore, the H-current conductance and background excitation of these thalamic cells must be within specific ranges to exhibit any intrinsic oscillations, including sustained alpha. We also find that, under corticothalamic SWO UP and DOWN states, thalamocortical output can exhibit maximum alpha power at either the peak or trough of this SWO; this implies the thalamus may be the source of propofol-induced PAC. Hyperpolarization level is the main determinant of whether the thalamus exhibits trough-max PAC, which is associated with lower propofol dose, or peak-max PAC, associated with higher dose. These findings suggest: the thalamus generates a novel rhythm under GABAA potentiation such as under propofol, its hyperpolarization may determine whether a patient experiences trough-max or peak-max PAC, and the thalamus is a critical component of propofol-induced cortical spectral phenomena. Changes to the thalamus may be a critical part of how propofol accomplishes its effects, including unconsciousness.
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Affiliation(s)
- Austin E. Soplata
- Graduate Program for Neuroscience, Boston University, Boston, Massachusetts, United States of America
- * E-mail:
| | - Michelle M. McCarthy
- Department of Mathematics & Statistics, Boston University, Boston, Massachusetts, United States of America
| | - Jason Sherfey
- Department of Psychological and Brain Sciences, Boston University, Boston, Massachusetts, United States of America
| | - Shane Lee
- Department of Neuroscience, Brown University, Providence, Rhode Island, United States of America
| | - Patrick L. Purdon
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Emery N. Brown
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
- Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, Massachusetts, United States of America
| | - Nancy Kopell
- Department of Mathematics & Statistics, Boston University, Boston, Massachusetts, United States of America
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Fu B, Liu C, Zhang Y, Fu X, Zhang L, Yu T. Ketamine attenuates the glutamatergic neurotransmission in the ventral posteromedial nucleus slices of rats. BMC Anesthesiol 2017; 17:111. [PMID: 28835217 PMCID: PMC5569565 DOI: 10.1186/s12871-017-0404-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Accepted: 08/16/2017] [Indexed: 01/15/2023] Open
Abstract
Background Ketamine is a frequently used intravenous anesthetic, which can reversibly induce loss of consciousness (LOC). Previous studies have demonstrated that thalamocortical system is critical for information transmission and integration in the brain. The ventral posteromedial nucleus (VPM) is a critical component of thalamocortical system. Glutamate is an important excitatory neurotransmitter in the brain and may be involved in ketamine-induced LOC. Methods The study used whole-cell patch-clamp to observe the effect of ketamine (30 μM–1000 μM) on glutamatergic neurotransmission in VPM slices. Results Ketamine significantly decreased the amplitude of glutamatergic spontaneous excitatory postsynaptic currents (sEPSCs), but only higher concentration of ketamine (300 μM and 1000 μM) suppressed the frequency of sEPSCs. Ketamine (100 μM–1000 μM) also decreased the amplitude of glutamatergic miniature excitatory postsynaptic currents (mEPSCs), without altering the frequency. Conclusions In VPM neurons, ketamine attenuates the glutamatergic neurotransmission mainly through postsynaptic mechanism and action potential may be involved in the process. Electronic supplementary material The online version of this article (doi:10.1186/s12871-017-0404-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Bao Fu
- Department of Critical Care Medicine, Affiliated Hospital of Zunyi Medical College, Zunyi, Guizhou, China
| | - Chengxi Liu
- Guizhou Key Laboratory of Anesthesia and Organ Protection, Zunyi Medical College, Dalian Road, Zunyi, Guizhou, 201, China
| | - Yajun Zhang
- Guizhou Key Laboratory of Anesthesia and Organ Protection, Zunyi Medical College, Dalian Road, Zunyi, Guizhou, 201, China
| | - Xiaoyun Fu
- Department of Critical Care Medicine, Affiliated Hospital of Zunyi Medical College, Zunyi, Guizhou, China
| | - Lin Zhang
- Guizhou Key Laboratory of Anesthesia and Organ Protection, Zunyi Medical College, Dalian Road, Zunyi, Guizhou, 201, China
| | - Tian Yu
- Guizhou Key Laboratory of Anesthesia and Organ Protection, Zunyi Medical College, Dalian Road, Zunyi, Guizhou, 201, China.
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A Prospective Study of Age-dependent Changes in Propofol-induced Electroencephalogram Oscillations in Children. Anesthesiology 2017; 127:293-306. [PMID: 28657957 DOI: 10.1097/aln.0000000000001717] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND In adults, frontal electroencephalogram patterns observed during propofol-induced unconsciousness consist of slow oscillations (0.1 to 1 Hz) and coherent alpha oscillations (8 to 13 Hz). Given that the nervous system undergoes significant changes during development, anesthesia-induced electroencephalogram oscillations in children may differ from those observed in adults. Therefore, we investigated age-related changes in frontal electroencephalogram power spectra and coherence during propofol-induced unconsciousness. METHODS We analyzed electroencephalogram data recorded during propofol-induced unconsciousness in patients between 0 and 21 yr of age (n = 97), using multitaper spectral and coherence methods. We characterized power and coherence as a function of age using multiple linear regression analysis and within four age groups: 4 months to 1 yr old (n = 4), greater than 1 to 7 yr old (n = 16), greater than 7 to 14 yr old (n = 30), and greater than 14 to 21 yr old (n = 47). RESULTS Total electroencephalogram power (0.1 to 40 Hz) peaked at approximately 8 yr old and subsequently declined with increasing age. For patients greater than 1 yr old, the propofol-induced electroencephalogram structure was qualitatively similar regardless of age, featuring slow and coherent alpha oscillations. For patients under 1 yr of age, frontal alpha oscillations were not coherent. CONCLUSIONS Neurodevelopmental processes that occur throughout childhood, including thalamocortical development, may underlie age-dependent changes in electroencephalogram power and coherence during anesthesia. These age-dependent anesthesia-induced electroencephalogram oscillations suggest a more principled approach to monitoring brain states in pediatric patients.
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Fu B, Wang Y, Yang H, Yu T. Effects of Etomidate on GABAergic and Glutamatergic Transmission in Rat Thalamocortical Slices. Neurochem Res 2016; 41:3181-3191. [PMID: 27561291 DOI: 10.1007/s11064-016-2042-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Revised: 08/10/2016] [Accepted: 08/22/2016] [Indexed: 12/14/2022]
Abstract
Although accumulative evidence indicates that the thalamocortical system is an important target for general anesthetics, the underlying mechanisms of anesthetic action on thalamocortical neurotransmission are not fully understood. The aim of the study is to explore the action of etomidate on glutamatergic and GABAergic transmission in rat thalamocortical slices by using whole cell patch-clamp recording. We found that etomidate mainly prolonged the decay time of spontaneous GABAergic inhibitory postsynaptic currents (sIPSCs), without changing the frequency. Furthermore, etomidate not only prolonged the decay time of miniature inhibitory postsynaptic currents (mIPSCs) but also increased the amplitude. On the other hand, etomidate significantly decreased the frequency of spontaneous glutamatergic excitatory postsynaptic currents (sEPSCs), without altering the amplitude or decay time in the absence of bicuculline. When GABAA receptors were blocked using bicuculline, the effects of etomidate on sEPSCs were mostly eliminated. These results suggest that etomidate enhances GABAergic transmission mainly through postsynaptic mechanism in thalamocortical neuronal network. Etomidate attenuates glutamatergic transmission predominantly through presynaptic action and requires presynaptic GABAA receptors involvement.
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Affiliation(s)
- Bao Fu
- Department of Critical Care Medicine, Affiliated Hospital of Zunyi Medical College, Zunyi, Guizhou, China
| | - Yuan Wang
- Department of Anesthesiology, Affiliated Hospital of Zunyi Medical College, Zunyi, Guizhou, China
| | - Hao Yang
- Guizhou Key Laboratory of Anesthesia and Organ Protection, Zunyi Medical College, Dalian road 149, Zunyi, 563000, Guizhou, China
| | - Tian Yu
- Guizhou Key Laboratory of Anesthesia and Organ Protection, Zunyi Medical College, Dalian road 149, Zunyi, 563000, Guizhou, China.
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Li Z, Liu X, Zhang Y, Shi J, Zhang Y, Xie P, Yu T. Connection changes in somatosensory cortex induced by different doses of propofol. PLoS One 2014; 9:e87829. [PMID: 24516566 PMCID: PMC3917837 DOI: 10.1371/journal.pone.0087829] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2013] [Accepted: 01/01/2014] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND The mechanism by which general anesthetics, widely used in clinical practice for over 160 years, effects on sensory responsiveness has been unclear until now. In the present study, the authors sought to explore the effect of different doses of propofol on somatosensory cortex by whisker stimulation in rats. METHODS In a fixed cage, rats were anesthetized with propofol 80 mg/kg intraperitoneally and then cathetered tail vein with 23-gauge metal needle connected with a pump. Two holes (2 mm diameter) were drilled and recording electrodes implantated in the primary somatosensory cortex barrel field (S1BF) and secondary somatosensory cortex (S2). The extracellular (20 rats) and intracellular (8 rats) recordings were used to test the neuron activity in both cortices at different doses of propofol (20, 40 and 80 mg/kg/h) through tail vein by pump. Meantime, vibrissal, olfactory, corneal responses (VOCR, sedation), and tail-pinch response (TRP, analgesia) were tested every 10 min during the doses of propofol 20, 40 and 80 mg/kg/h. RESULTS VOCR and TRP were depressed by propofol in a dose-dependent manner. The amplitude by whisker stimulation in S1BF was stronger and the peak latency was shorter compared with that of in S2. The response latency of S1BF and S2 was increased by raising infusion rate of propofol with the response latency in S2 being longer than that in S1BF at the same doses of propofol. The cross-correlation between S1BF and S2 decreased as the propofol infusion rate increased. The input resistance was higher by increasing infusion rate of propofol. CONCLUSION The sedation and analgesia effects of propofol were dose-dependent. Both the connectivity and instinctive oscillation between S1BF and S2 were proportionally modulated by the different doses of propofol.
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Affiliation(s)
- Zhaoduan Li
- Department of Anesthesiology, Zunyi Medical College, Zunyi, Guizhou, People's Republic of China
| | - Xingkui Liu
- Department of Anesthesiology, Zunyi Medical College, Zunyi, Guizhou, People's Republic of China
| | - Yi Zhang
- Department of Anesthesiology, Zunyi Medical College, Zunyi, Guizhou, People's Republic of China
| | - Jinshan Shi
- Department of Anesthesiology, Zunyi Medical College, Zunyi, Guizhou, People's Republic of China
| | - Yu Zhang
- Department of Anesthesiology, Zunyi Medical College, Zunyi, Guizhou, People's Republic of China
| | - Peng Xie
- Department of Anesthesiology, Zunyi Medical College, Zunyi, Guizhou, People's Republic of China
| | - Tian Yu
- Department of Anesthesiology, Zunyi Medical College, Zunyi, Guizhou, People's Republic of China
- * E-mail:
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