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Dusing MR, LaSarge CL, Drake AW, Westerkamp GC, McCoy C, Hetzer SM, Kraus KL, Pedapati EV, Danzer SC. Transient Seizure Clusters and Epileptiform Activity Following Widespread Bilateral Hippocampal Interneuron Ablation. eNeuro 2024; 11:ENEURO.0317-23.2024. [PMID: 38575351 PMCID: PMC11036118 DOI: 10.1523/eneuro.0317-23.2024] [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: 08/02/2023] [Revised: 03/28/2024] [Accepted: 03/29/2024] [Indexed: 04/06/2024] Open
Abstract
Interneuron loss is a prominent feature of temporal lobe epilepsy in both animals and humans and is hypothesized to be critical for epileptogenesis. As loss occurs concurrently with numerous other potentially proepileptogenic changes, however, the impact of interneuron loss in isolation remains unclear. For the present study, we developed an intersectional genetic approach to induce bilateral diphtheria toxin-mediated deletion of Vgat-expressing interneurons from dorsal and ventral hippocampus. In a separate group of mice, the same population was targeted for transient neuronal silencing with DREADDs. Interneuron ablation produced dramatic seizure clusters and persistent epileptiform activity. Surprisingly, after 1 week seizure activity declined precipitously and persistent epileptiform activity disappeared. Occasional seizures (≈1/day) persisted to the end of the experiment at 4 weeks. In contrast to the dramatic impact of interneuron ablation, transient silencing produced large numbers of interictal spikes, a significant but modest increase in seizure occurrence and changes in EEG frequency band power. Taken together, findings suggest that the hippocampus regains relative homeostasis-with occasional breakthrough seizures-in the face of an extensive and abrupt loss of interneurons.
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Affiliation(s)
- Mary R Dusing
- Department of Anesthesia, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio 45229-3039
| | - Candi L LaSarge
- Department of Anesthesia, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio 45229-3039
- Neuroscience Graduate Program, University of Cincinnati, Cincinnati, Ohio 45229-3039
| | - Austin W Drake
- Department of Anesthesia, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio 45229-3039
- Neuroscience Graduate Program, University of Cincinnati, Cincinnati, Ohio 45229-3039
- Medical Scientist Training Program, University of Cincinnati College of Medicine, Cincinnati, Ohio 45229-3039
| | - Grace C Westerkamp
- Division of Child Psychiatry, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio 45229-3039
| | - Carlie McCoy
- Division of Neurosurgery, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio 45229-3039
| | - Shelby M Hetzer
- Neuroscience Graduate Program, University of Cincinnati, Cincinnati, Ohio 45229-3039
| | - Kimberly L Kraus
- Department of Anesthesia, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio 45229-3039
- Neuroscience Graduate Program, University of Cincinnati, Cincinnati, Ohio 45229-3039
- Medical Scientist Training Program, University of Cincinnati College of Medicine, Cincinnati, Ohio 45229-3039
| | - Ernest V Pedapati
- Division of Child Psychiatry, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio 45229-3039
| | - Steve C Danzer
- Department of Anesthesia, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio 45229-3039
- Neuroscience Graduate Program, University of Cincinnati, Cincinnati, Ohio 45229-3039
- Medical Scientist Training Program, University of Cincinnati College of Medicine, Cincinnati, Ohio 45229-3039
- Department of Anesthesiology, University of Cincinnati College of Medicine, Cincinnati, Ohio 45229-3039
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Baykan AH, Aydın E, Şahin Ş, Altunışık E. Quantitative analysis of the olfactory system in pediatric epilepsy: a magnetic resonance imaging study. Diagn Interv Radiol 2023; 29:396-401. [PMID: 36988051 PMCID: PMC10679695 DOI: 10.5152/dir.2022.21287] [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: 03/30/2021] [Accepted: 10/15/2021] [Indexed: 01/14/2023]
Abstract
PURPOSE Olfactory dysfunction is a well-known complication in epilepsy. Studies have demonstrated that olfactory bulb volume (OBV), olfactory tract length (OTL), and olfactory sulcus depth (OSD) can be reliably evaluated using magnetic resonance imaging (MRI). In this study, we compared the OBV, OTL, and OSD values of children with epilepsy and those of healthy children (controls) of similar age. Our aim was to determine the presence of olfactory dysfunction in children with epilepsy and demonstrate the effects of the epilepsy type and treatment on olfactory function in these patients. METHODS Cranial MRI images of 36 patients with epilepsy and 108 controls (3-17 years) were evaluated. The patients with epilepsy were divided into groups according to the type of disease and treatment method. Subsequently, OBV and OSD were measured from the coronal section and OTL from the sagittal section. The OBV, OTL, and OSD values were compared between the epilepsy group, subgroups, and controls. RESULTS OBV was significantly reduced in the children with epilepsy compared with the control group (P < 0.001). No significant difference between the healthy children and those with epilepsy was determined in terms of OTL and OSD. Although OBV was moderately positively correlated with age in the control group (r = 0.561, P < 0.001), it was poorly correlated with age in children with epilepsy (r = 0.393, P = 0.018). CONCLUSION The results of our study indicate that OBV decreases in children with epilepsy, but epilepsy type and treatment method do not affect OBV, OTL, or OSD (P > 0.05).
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Affiliation(s)
- Ali Haydar Baykan
- Department of Radiology, Adıyaman University Faculty of Medicine, Adıyaman, Turkey
| | - Elçin Aydın
- Department of Radiology, University of Health Sciences Turkey, Tepecik Training and Research Hospital, İzmir, Turkey
| | - Şükrü Şahin
- Department of Radiology, Adıyaman Training and Research Hospital, Adıyaman, Turkey
| | - Erman Altunışık
- Department of Neurology, Adıyaman University Faculty of Medicine, Adıyaman, Turkey
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Seizure treatment with olfactory training: a preliminary trial. Neurol Sci 2022; 43:6901-6907. [DOI: 10.1007/s10072-022-06376-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 08/27/2022] [Indexed: 10/14/2022]
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Epps SA. Commonalities for comorbidity: Overlapping features of the endocannabinoid system in depression and epilepsy. Front Psychiatry 2022; 13:1041460. [PMID: 36339877 PMCID: PMC9626804 DOI: 10.3389/fpsyt.2022.1041460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Accepted: 09/29/2022] [Indexed: 11/13/2022] Open
Abstract
A wealth of clinical and pre-clinical data supports a bidirectional comorbidity between depression and epilepsy. This suggests commonalities in underlying mechanisms that may serve as targets for more effective treatment strategies. Unfortunately, many patients with this comorbidity are highly refractory to current treatment strategies, while others experience a worsening of one arm of the comorbidity when treating the other arm. This highlights the need for novel pharmaceutical targets that may provide safe and effective relief for both depression and epilepsy symptoms. The endocannabinoid system (ECS) of the brain has become an area of intense interest for possible roles in depression and epilepsy. Several existing literature reviews have provided in-depth analysis of the involvement of various aspects of the ECS in depression or epilepsy separately, while others have addressed the effectiveness of different treatment strategies targeting the ECS in either condition individually. However, there is not currently a review that considers the ECS when both conditions are comorbid. This mini-review will address areas of common overlap between the ECS in depression and in epilepsy, such as commonalities in endocannabinoids themselves, their receptors, and degradative enzymes. These areas of overlap will be discussed alongside their implications for treatment of this challenging comorbidity.
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Affiliation(s)
- S Alisha Epps
- Department of Psychology, Whitworth University, Spokane, WA, United States
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Singh T, Goel RK. Epilepsy Associated Depression: An Update on Current Scenario, Suggested Mechanisms, and Opportunities. Neurochem Res 2021; 46:1305-1321. [PMID: 33665775 DOI: 10.1007/s11064-021-03274-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 02/07/2021] [Accepted: 02/10/2021] [Indexed: 12/21/2022]
Abstract
Depression is one of the most frequent psychiatric comorbidities associated with epilepsy having a major impact on the patient's quality of life. Several screening tools are available to identify and follow up psychiatric disorders in epilepsy. Out of various psychiatric disorders, people with epilepsy (PWE) are at greater risk of developing depression. This bidirectional relationship further hinders pharmacotherapy of comorbid depression in PWE as some antiepileptic drugs (AEDs) worsen associated depression and coadministration of existing antidepressants (ADs) to alleviate comorbid depression has been reported to worsen seizures. Selective serotonin reuptake inhibitors (SSRIs) and selective serotonin and norepinephrine reuptake inhibitors (SNRIs) are first choice of ADs and are considered safe in PWE, but there are no high-quality evidences. Similar to observations in people with depression, PWE also showed pharmacoresistant to available SSRI/SNRIs, which further complicates the disease prognosis. Randomized double-blind placebo-controlled clinical trials are necessary to report efficacy and safety of available ADs in PWE. We should also move beyond ADs, and therefore, we reviewed common pathological mechanisms such as neuroinflammation, dysregulated hypothalamus pituitary adrenal (HPA) axis, altered neurogenesis, and altered tryptophan metabolism responsible for coexistent relationship of epilepsy and depression. Based on these common pertinent pathways involved in the genesis of epilepsy and depression, we suggested novel targets and therapeutic approaches for safe management of comorbid depression in epilepsy.
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Affiliation(s)
- Tanveer Singh
- Department of Pharmaceutical Sciences and Drug Research, Punjabi University, Patiala, Punjab, 147002, India
| | - Rajesh Kumar Goel
- Department of Pharmaceutical Sciences and Drug Research, Punjabi University, Patiala, Punjab, 147002, India.
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Association between olfactory function and inhibition of emotional competing distractors in major depressive disorder. Sci Rep 2020; 10:6322. [PMID: 32286450 PMCID: PMC7156747 DOI: 10.1038/s41598-020-63416-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Accepted: 03/30/2020] [Indexed: 01/10/2023] Open
Abstract
We aimed to investigate the changes of olfaction of major depressive disorder (MDD) before and after medical treatment, and to preliminarily scrutinize the association between the olfactory function and the severity of depressive symptoms, response inhibition, and emotional responding. Forty-eight medicine-naïve MDD patients plus 33 healthy controls (HC) matched on gender, ages, and level of education, were recruited in the test group. The Chinese Smell Identification Test (CSIT), Self-reported Olfactory Scale (SROS), 17-item Hamilton Depression Rating Scale (HAMD-17), Hamilton Anxiety Rating Scale (HAMA), and mean reaction time/accuracy rate (ΔMRT) of emotional Stroop test were measured. The patients were assessed before the treatment (baseline) and 3 months after the treatment (follow-up). The data at the baseline level were measured then associated using multiple linear regression stepwise analysis. The MDD patients had lower scores of the CSIT and SROS and longer ΔMRT at baseline level compared to HC while the ΔMRT of MDD patients remained longer after 3-month treatment (p’s < 0.05). At the baseline level, the regression equation including age and ΔMRT of negative word-color congruent (NEG-C), was finally observed as follows: y(CSIT) = 10.676–0.063 × 1–0.002 × 2, [x1 = the age(y), x2 = the NEG-C (ms)]. The olfactory function of MDD appears to be correlated negatively with the age and the ΔMRT of negative stimuli before treatment. After the remission of MDD, the olfactory dysfunction was improved, which might be regarded as a responding phenotype of brain function of MDD rather than the emotional responding.
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Sarnat HB, Flores-Sarnat L, Wei XC. Olfactory Development, Part 1: Function, From Fetal Perception to Adult Wine-Tasting. J Child Neurol 2017; 32:566-578. [PMID: 28424010 DOI: 10.1177/0883073817690867] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Discrimination of odorous molecules in amniotic fluid occur after 30 weeks' gestation; fetuses exhibit differential responses to maternal diet. Olfactory reflexes enable reliable neonatal testing. Olfactory bulbs can be demonstrated reliably by MRI after 30 weeks' gestation, and their hypoplasia or aplasia also documented by late prenatal and postnatal MRI. Olfactory axons project from nasal epithelium to telencephalon before olfactory bulbs form. Fetal olfactory maturation remains incomplete at term for neuronal differentiation, synaptogenesis, myelination, and persistence of the transitory fetal ventricular recess. Immaturity does not signify nonfunction. Olfaction is the only sensory system without thalamic projection because of its own intrinsic thalamic equivalent. Diverse malformations of the olfactory bulb can be diagnosed by clinical examination, imaging, and neuropathology. Some epileptic auras might be primarily generated in the olfactory bulb. Cranial nerve 1 should be tested in all neonates and especially in patients with brain malformations, endocrinopathies, chromosomopathies, and genetic/metabolic diseases.
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Affiliation(s)
- Harvey B Sarnat
- 1 Department of Paediatrics, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada.,2 Department of Clinical Neurosciences, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada.,3 Department of Pathology and Laboratory Medicine (Neuropathology), University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada.,5 Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada
| | - Laura Flores-Sarnat
- 1 Department of Paediatrics, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada.,2 Department of Clinical Neurosciences, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada.,3 Department of Pathology and Laboratory Medicine (Neuropathology), University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada.,5 Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada
| | - Xing-Chang Wei
- 4 Department of Radiology and Diagnostic Imaging, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada.,5 Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada
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Christian CA. A Nose for Seizures: A Potential Role for Olfaction in the Co-Morbidity of Depression and Epilepsy? Epilepsy Curr 2016; 16:256-7. [PMID: 27582667 PMCID: PMC4988077 DOI: 10.5698/1535-7511-16.4.256] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Impact of rapamycin on status epilepticus induced hippocampal pathology and weight gain. Exp Neurol 2016; 280:1-12. [PMID: 26995324 DOI: 10.1016/j.expneurol.2016.03.015] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2015] [Revised: 03/11/2016] [Accepted: 03/14/2016] [Indexed: 02/07/2023]
Abstract
Growing evidence implicates the dentate gyrus in temporal lobe epilepsy (TLE). Dentate granule cells limit the amount of excitatory signaling through the hippocampus and exhibit striking neuroplastic changes that may impair this function during epileptogenesis. Furthermore, aberrant integration of newly-generated granule cells underlies the majority of dentate restructuring. Recently, attention has focused on the mammalian target of rapamycin (mTOR) signaling pathway as a potential mediator of epileptogenic change. Systemic administration of the mTOR inhibitor rapamycin has promising therapeutic potential, as it has been shown to reduce seizure frequency and seizure severity in rodent models. Here, we tested whether mTOR signaling facilitates abnormal development of granule cells during epileptogenesis. We also examined dentate inflammation and mossy cell death in the dentate hilus. To determine if mTOR activation is necessary for abnormal granule cell development, transgenic mice that harbored fluorescently-labeled adult-born granule cells were treated with rapamycin following pilocarpine-induced status epilepticus. Systemic rapamycin effectively blocked phosphorylation of S6 protein (a readout of mTOR activity) and reduced granule cell mossy fiber axon sprouting. However, the accumulation of ectopic granule cells and granule cells with aberrant basal dendrites was not significantly reduced. Mossy cell death and reactive astrocytosis were also unaffected. These data suggest that anti-epileptogenic effects of mTOR inhibition may be mediated by mechanisms other than inhibition of these common dentate pathologies. Consistent with this conclusion, rapamycin prevented pathological weight gain in epileptic mice, suggesting that rapamycin might act on central circuits or even peripheral tissues controlling weight gain in epilepsy.
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