1
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Călin A, Waseem T, Raimondo JV, Newey SE, Akerman CJ. A genetically targeted ion sensor reveals distinct seizure-related chloride and pH dynamics in GABAergic interneuron populations. iScience 2023; 26:106363. [PMID: 37034992 PMCID: PMC10074576 DOI: 10.1016/j.isci.2023.106363] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Revised: 02/03/2023] [Accepted: 03/05/2023] [Indexed: 03/12/2023] Open
Abstract
Intracellular chloride and pH play fundamental roles in determining a neuron's synaptic inhibition and excitability. Yet it has been difficult to measure changes in these ions during periods of heightened network activity, such as occur in epilepsy. Here we develop a version of the fluorescent reporter, ClopHensorN, to enable simultaneous quantification of chloride and pH in genetically defined neurons during epileptiform activity. We compare pyramidal neurons to the major GABAergic interneuron subtypes in the mouse hippocampus, which express parvalbumin (PV), somatostatin (SST), or vasoactive intestinal polypeptide (VIP). Interneuron populations exhibit higher baseline chloride, with PV interneurons exhibiting the highest levels. During an epileptiform discharge, however, all subtypes converge upon a common elevated chloride level. Concurrent with these dynamics, epileptiform activity leads to different degrees of intracellular acidification, which reflect baseline pH. Thus, a new optical tool for dissociating chloride and pH reveals neuron-specific ion dynamics during heightened network activity.
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Affiliation(s)
- Alexandru Călin
- Department of Pharmacology, University of Oxford, Oxford OX1 3QT, UK
| | - Tatiana Waseem
- Department of Pharmacology, University of Oxford, Oxford OX1 3QT, UK
| | - Joseph V. Raimondo
- Division of Cell Biology, Department of Human Biology, Neuroscience Institute and Institute of Infectious Disease and Molecular Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town 7925, South Africa
| | - Sarah E. Newey
- Department of Pharmacology, University of Oxford, Oxford OX1 3QT, UK
| | - Colin J. Akerman
- Department of Pharmacology, University of Oxford, Oxford OX1 3QT, UK
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2
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Avoli M, de Curtis M, Lévesque M, Librizzi L, Uva L, Wang S. GABAA signaling, focal epileptiform synchronization and epileptogenesis. Front Neural Circuits 2022; 16:984802. [PMID: 36275847 PMCID: PMC9581276 DOI: 10.3389/fncir.2022.984802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Accepted: 09/13/2022] [Indexed: 12/04/2022] Open
Abstract
Under physiological conditions, neuronal network synchronization leads to different oscillatory EEG patterns that are associated with specific behavioral and cognitive functions. Excessive synchronization can, however, lead to focal or generalized epileptiform activities. It is indeed well established that in both epileptic patients and animal models, focal epileptiform EEG patterns are characterized by interictal and ictal (seizure) discharges. Over the last three decades, employing in vitro and in vivo recording techniques, several experimental studies have firmly identified a paradoxical role of GABAA signaling in generating interictal discharges, and in initiating—and perhaps sustaining—focal seizures. Here, we will review these experiments and we will extend our appraisal to evidence suggesting that GABAA signaling may also contribute to epileptogenesis, i.e., the development of plastic changes in brain excitability that leads to the chronic epileptic condition. Overall, we anticipate that this information should provide the rationale for developing new specific pharmacological treatments for patients presenting with focal epileptic disorders such as mesial temporal lobe epilepsy (MTLE).
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Affiliation(s)
- Massimo Avoli
- Montreal Neurological Institute-Hospital, Montreal, QC, Canada
- Departments of Neurology and Neurosurgery, Montreal, QC, Canada
- Department of Physiology, McGill University, Montreal, QC, Canada
- *Correspondence: Massimo Avoli,
| | - Marco de Curtis
- Epilepsy Unit, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Istituto Neurologico Carlo Besta, Milan, Italy
| | - Maxime Lévesque
- Montreal Neurological Institute-Hospital, Montreal, QC, Canada
- Departments of Neurology and Neurosurgery, Montreal, QC, Canada
| | - Laura Librizzi
- Epilepsy Unit, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Istituto Neurologico Carlo Besta, Milan, Italy
| | - Laura Uva
- Epilepsy Unit, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Istituto Neurologico Carlo Besta, Milan, Italy
| | - Siyan Wang
- Montreal Neurological Institute-Hospital, Montreal, QC, Canada
- Departments of Neurology and Neurosurgery, Montreal, QC, Canada
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3
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Why won't it stop? The dynamics of benzodiazepine resistance in status epilepticus. Nat Rev Neurol 2022; 18:428-441. [PMID: 35538233 DOI: 10.1038/s41582-022-00664-3] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/19/2022] [Indexed: 11/08/2022]
Abstract
Status epilepticus is a life-threatening neurological emergency that affects both adults and children. Approximately 36% of episodes of status epilepticus do not respond to the current preferred first-line treatment, benzodiazepines. The proportion of episodes that are refractory to benzodiazepines is higher in low-income and middle-income countries (LMICs) than in high-income countries (HICs). Evidence suggests that longer episodes of status epilepticus alter brain physiology, thereby contributing to the emergence of benzodiazepine resistance. Such changes include alterations in GABAA receptor function and in the transmembrane gradient for chloride, both of which erode the ability of benzodiazepines to enhance inhibitory synaptic signalling. Often, current management guidelines for status epilepticus do not account for these duration-related changes in pathophysiology, which might differentially impact individuals in LMICs, where the average time taken to reach medical attention is longer than in HICs. In this Perspective article, we aim to combine clinical insights and the latest evidence from basic science to inspire a new, context-specific approach to efficiently managing status epilepticus.
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4
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Disrupting Epileptiform Activity by Preventing Parvalbumin Interneuron Depolarization Block. J Neurosci 2021; 41:9452-9465. [PMID: 34611025 DOI: 10.1523/jneurosci.1002-20.2021] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 09/21/2021] [Accepted: 09/26/2021] [Indexed: 11/21/2022] Open
Abstract
Inhibitory synaptic mechanisms oppose epileptic network activity in the brain. The breakdown in this inhibitory restraint and propagation of seizure activity has been linked to the overwhelming of feedforward inhibition, which is provided in large part by parvalbumin-expressing (PV) interneurons in the cortex. The underlying cellular processes therefore represent potential targets for understanding and preventing the propagation of seizure activity. Here we use an optogenetic strategy to test the hypothesis that depolarization block in PV interneurons is a significant factor during the loss of inhibitory restraint. Depolarization block results from the inactivation of voltage-gated sodium channels and leads to impaired action potential firing. We used focal NMDA stimulation to elicit reproducible epileptiform discharges in hippocampal organotypic brain slices from male and female mice and combined this with targeted recordings from defined neuronal populations. Simultaneous patch-clamp recordings from PV interneurons and pyramidal neurons revealed epileptiform activity that was associated with an overwhelming of inhibitory synaptic mechanisms and the emergence of a partial, and then complete, depolarization block in PV interneurons. To counteract this depolarization block, we developed protocols for eliciting pulsed membrane hyperpolarization via the inhibitory opsin, archaerhodopsin. This optical approach was effective in counteracting cumulative inactivation of voltage-gated channels, maintaining PV interneuron action potential firing properties during the inhibitory restraint period, and reducing the probability of initiating epileptiform activity. These experiments support the idea that depolarization block is a point of weakness in feedforward inhibitory synaptic mechanisms and represents a target for preventing the initiation and spread of seizure activity.SIGNIFICANCE STATEMENT GABAA receptor-mediated synaptic transmission opposes seizure activity by establishing an inhibitory restraint against spreading excitation. Parvalbumin-expressing (PV) interneurons contribute significantly to this inhibitory restraint, but it has been suggested that these cells are overwhelmed as they enter a state of "depolarization block." Here we test the importance of this process by devising an optogenetic strategy to selectively relieve depolarization block in PV interneurons. By inducing brief membrane hyperpolarization, we show that it is possible to reduce depolarization block in PV interneurons, maintain their action potential firing in the face of strong excitation, and disrupt epileptiform activity in an in vitro model. This represents a proof of principle that targeting rate-limiting processes can strengthen the inhibitory restraint of epileptiform activity.
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5
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Dzhala VI, Staley KJ. KCC2 Chloride Transport Contributes to the Termination of Ictal Epileptiform Activity. eNeuro 2021; 8:ENEURO.0208-20.2020. [PMID: 33239270 PMCID: PMC7986536 DOI: 10.1523/eneuro.0208-20.2020] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 11/02/2020] [Accepted: 11/03/2020] [Indexed: 01/10/2023] Open
Abstract
Recurrent seizures intensely activate GABAA receptors (GABAA-Rs), which induces transient neuronal chloride ([Cl-]i) elevations and depolarizing GABA responses that contribute to the failure of inhibition that engenders further seizures and anticonvulsant resistance. The K+-Cl- cotransporter KCC2 is responsible for Cl- extrusion and restoration of [Cl-]i equilibrium (ECl) after synaptic activity, but at the cost of increased extracellular potassium which may retard K+-Cl- extrusion, depolarize neurons, and potentiate seizures. Thus, KCC2 may either diminish or facilitate seizure activity, and both proconvulsant and anticonvulsant effects of KCC2 inhibition have been reported. It is now necessary to identify the loci of these divergent responses by assaying both the electrographic effects and the ionic effects of KCC2 manipulation. We therefore determined the net effects of KCC2 transport activity on cytoplasmic chloride elevation and Cl- extrusion rates during spontaneous recurrent ictal-like epileptiform discharges (ILDs) in organotypic hippocampal slices in vitro, as well as the correlation between ionic and electrographic effects. We found that the KCC2 antagonist VU0463271 reduced Cl- extrusion rates, increased ictal [Cl-]i elevation, increased ILD duration, and induced status epilepticus (SE). In contrast, the putative KCC2 upregulator CLP257 improved chloride homeostasis and reduced the duration and frequency of ILDs in a concentration-dependent manner. Our results demonstrate that measuring both the ionic and electrographic effects of KCC2 transport clarify the impact of KCC2 modulation in specific models of epileptiform activity. Anticonvulsant effects predominate when KCC2-mediated chloride transport rather than potassium buffering is the rate-limiting step in restoring ECl and the efficacy of GABAergic inhibition during recurrent ILDs.
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Affiliation(s)
- Volodymyr I Dzhala
- Department of Neurology, Massachusetts General Hospital, Boston, MA 02114
- Harvard Medical School, Boston, MA 02114
| | - Kevin J Staley
- Department of Neurology, Massachusetts General Hospital, Boston, MA 02114
- Harvard Medical School, Boston, MA 02114
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6
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Yang YC, Wang GH, Chuang AY, Hsueh SW. Perampanel reduces paroxysmal depolarizing shift and inhibitory synaptic input in excitatory neurons to inhibit epileptic network oscillations. Br J Pharmacol 2020; 177:5177-5194. [PMID: 32901915 DOI: 10.1111/bph.15253] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Revised: 08/10/2020] [Accepted: 08/28/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND AND PURPOSE Perampanel is a newly approved anticonvulsant uniquely targeting AMPA receptors, which mediate the most abundant form of excitatory synaptic transmission in the brain. However, the network mechanism underlying the anti-epileptic effect of the AMPAergic inhibition remains to be explored. EXPERIMENTAL APPROACH The mechanism of perampanel action was studied with the basolateral amygdala network containing pyramidal-inhibitory neuronal resonators in seizure models of 4-aminopyridine (4-AP) and electrical kindling. KEY RESULTS Application of either 4-AP or electrical kindling to the basolateral amygdala readily induces AMPAergic transmission-dependent reverberating activities between pyramidal-inhibitory neuronal resonators, which are chiefly characterized by burst discharges in inhibitory neurons and corresponding recurrent inhibitory postsynaptic potentials in pyramidal neurons. Perampanel reduces post-kindling "paroxysmal depolarizing shift" especially in pyramidal neurons and, counterintuitively, eliminates burst activities in inhibitory neurons and inhibitory synaptic inputs onto excitatory pyramidal neurons to result in prevention of epileptiform discharges and seizure behaviours. Intriguingly, similar effects can be obtained with not only the AMPA receptor antagonist CNQX but also the GABAA receptor antagonist bicuculline, which is usually considered as a proconvulsant. CONCLUSION AND IMPLICATIONS Ictogenesis depends on the AMPA receptor-dependent recruitment of pyramidal-inhibitory neuronal network oscillations tuned by dynamic glutamatergic and GABAergic transmission. The anticonvulsant effect of perampanel then stems from disruption of the coordinated network activities rather than simply decreased neuronal excitability or excitatory transmission. Positive or negative modulation of epileptic network reverberations may be pro-ictogenic or anti-ictogenic, respectively, constituting a more applicable rationale for the therapy against seizures.
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Affiliation(s)
- Ya-Chin Yang
- Department of Biomedical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Graduate Institute of Biomedical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Neuroscience Research Center, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan
| | - Guan-Hsun Wang
- Department of Biomedical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan.,School of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Department of Medical Education, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan, Taiwan
| | - Ai-Yu Chuang
- Department of Biomedical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Shu-Wei Hsueh
- Graduate Institute of Biomedical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
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7
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Burman RJ, Selfe JS, Lee JH, van den Berg M, Calin A, Codadu NK, Wright R, Newey SE, Parrish RR, Katz AA, Wilmshurst JM, Akerman CJ, Trevelyan AJ, Raimondo JV. Excitatory GABAergic signalling is associated with benzodiazepine resistance in status epilepticus. Brain 2020; 142:3482-3501. [PMID: 31553050 DOI: 10.1093/brain/awz283] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Revised: 06/10/2019] [Accepted: 07/11/2019] [Indexed: 01/17/2023] Open
Abstract
Status epilepticus is defined as a state of unrelenting seizure activity. Generalized convulsive status epilepticus is associated with a rapidly rising mortality rate, and thus constitutes a medical emergency. Benzodiazepines, which act as positive modulators of chloride (Cl-) permeable GABAA receptors, are indicated as first-line treatment, but this is ineffective in many cases. We found that 48% of children presenting with status epilepticus were unresponsive to benzodiazepine treatment, and critically, that the duration of status epilepticus at the time of treatment is an important predictor of non-responsiveness. We therefore investigated the cellular mechanisms that underlie acquired benzodiazepine resistance, using rodent organotypic and acute brain slices. Removing Mg2+ ions leads to an evolving pattern of epileptiform activity, and eventually to a persistent state of repetitive discharges that strongly resembles clinical EEG recordings of status epilepticus. We found that diazepam loses its antiseizure efficacy and conversely exacerbates epileptiform activity during this stage of status epilepticus-like activity. Interestingly, a low concentration of the barbiturate phenobarbital had a similar exacerbating effect on status epilepticus-like activity, while a high concentration of phenobarbital was effective at reducing or preventing epileptiform discharges. We then show that the persistent status epilepticus-like activity is associated with a reduction in GABAA receptor conductance and Cl- extrusion capability. We explored the effect on intraneuronal Cl- using both gramicidin, perforated-patch clamp recordings and Cl- imaging. This showed that during status epilepticus-like activity, reduced Cl- extrusion capacity was further exacerbated by activity-dependent Cl- loading, resulting in a persistently high intraneuronal Cl-. Consistent with these results, we found that optogenetic stimulation of GABAergic interneurons in the status epilepticus-like state, actually enhanced epileptiform activity in a GABAAR dependent manner. Together our findings describe a novel potential mechanism underlying benzodiazepine-resistant status epilepticus, with relevance to how this life-threatening condition should be managed in the clinic.
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Affiliation(s)
- Richard J Burman
- Division of Cell Biology, Department of Human Biology, Neuroscience Institute and Institute of Infectious Disease and Molecular Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.,Department of Paediatric Neurology, Red Cross War Memorial Children's Hospital, Neuroscience Institute, University of Cape Town, Cape Town, South Africa.,Department of Pharmacology, University of Oxford, Oxford, UK
| | - Joshua S Selfe
- Division of Cell Biology, Department of Human Biology, Neuroscience Institute and Institute of Infectious Disease and Molecular Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - John Hamin Lee
- Division of Cell Biology, Department of Human Biology, Neuroscience Institute and Institute of Infectious Disease and Molecular Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Maurits van den Berg
- Division of Cell Biology, Department of Human Biology, Neuroscience Institute and Institute of Infectious Disease and Molecular Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Alexandru Calin
- Department of Pharmacology, University of Oxford, Oxford, UK
| | - Neela K Codadu
- Institute of Neuroscience, Medical School, Framlington Place, Newcastle upon Tyne, NE24HH, UK
| | - Rebecca Wright
- Department of Pharmacology, University of Oxford, Oxford, UK
| | - Sarah E Newey
- Department of Pharmacology, University of Oxford, Oxford, UK
| | - R Ryley Parrish
- Institute of Neuroscience, Medical School, Framlington Place, Newcastle upon Tyne, NE24HH, UK
| | - Arieh A Katz
- Division of Medical Biochemistry, Department of Integrated Biomedical Sciences and Institute of Infectious Disease and Molecular Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Jo M Wilmshurst
- Department of Paediatric Neurology, Red Cross War Memorial Children's Hospital, Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Colin J Akerman
- Department of Pharmacology, University of Oxford, Oxford, UK
| | - Andrew J Trevelyan
- Institute of Neuroscience, Medical School, Framlington Place, Newcastle upon Tyne, NE24HH, UK
| | - Joseph V Raimondo
- Division of Cell Biology, Department of Human Biology, Neuroscience Institute and Institute of Infectious Disease and Molecular Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
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8
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Chen LY, Lévesque M, Avoli M. KCC2 antagonism and gabaergic synchronization in the entorhinal cortex in the absence of ionotropic glutamatergic receptor signalling. Neuropharmacology 2020; 167:107982. [PMID: 32014449 DOI: 10.1016/j.neuropharm.2020.107982] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 01/17/2020] [Accepted: 01/28/2020] [Indexed: 12/17/2022]
Abstract
γ-Aminobutyric acid (GABA), which is released by interneurons, plays an active role in generating interictal epileptiform spikes during blockade of ionotropic glutamatergic signalling, but it remains unclear whether and how the K+-Cl- cotransporter 2 (KCC2) influences these paroxysmal events. Therefore, we employed tetrode recordings in the in vitro rat entorhinal cortex (EC) to analyze the effects of the KCC2 antagonist VU0463271 on 4-aminopyridine (4AP)-induced interictal spikes that were pharmacologically isolated by applying ionotropic glutamatergic receptor antagonists. After the addition of VU0463271, these interictal spikes continued to occur at similar rates as in control (i.e., during application of 4AP with ionotropic glutamatergic receptor antagonists) but were smaller and shorter. Despite the absence of ionotropic glutamatergic receptor signalling, both interneurons and principal cells increased their firing during interictal spikes. Moreover, we found that KCC2 antagonism increased interneuron firing but decreased principal cell firing during the interictal spike rising phase; in contrast, during the falling phase, interneuron firing decreased in the presence of VU0463271 while no change was observed in principal cell firing. Overall, our results show that KCC2 antagonism enhances interneuron excitability at the onset of interictal spikes generated by the EC neuronal networks during blockade of ionotropic glutamatergic transmission but disrupts later neuronal recruitment.
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Affiliation(s)
- Li-Yuan Chen
- Montreal Neurological Institute and Hospital, Departments of Neurology & Neurosurgery and of Physiology, McGill University, 3801 University Street, Montreal, H3A 2B4, QC, Canada
| | - Maxime Lévesque
- Montreal Neurological Institute and Hospital, Departments of Neurology & Neurosurgery and of Physiology, McGill University, 3801 University Street, Montreal, H3A 2B4, QC, Canada
| | - Massimo Avoli
- Montreal Neurological Institute and Hospital, Departments of Neurology & Neurosurgery and of Physiology, McGill University, 3801 University Street, Montreal, H3A 2B4, QC, Canada.
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9
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Lévesque M, Ragsdale D, Avoli M. Evolving Mechanistic Concepts of Epileptiform Synchronization and their Relevance in Curing Focal Epileptic Disorders. Curr Neuropharmacol 2020; 17:830-842. [PMID: 30479217 PMCID: PMC7052840 DOI: 10.2174/1570159x17666181127124803] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2018] [Revised: 10/26/2018] [Accepted: 11/17/2018] [Indexed: 01/01/2023] Open
Abstract
The synchronized activity of neuronal networks under physiological conditions is mirrored by specific oscillatory patterns of the EEG that are associated with different behavioral states and cognitive functions. Excessive synchronization can, however, lead to focal epileptiform activity characterized by interictal and ictal discharges in epileptic patients and animal models. This review focusses on studies that have addressed epileptiform synchronization in temporal lobe regions by employing in vitro and in vivo recording techniques. First, we consider the role of ionotropic and metabotropic excitatory glutamatergic transmission in seizure generation as well as the paradoxical role of GABAA signaling in initiating and perhaps maintaining focal seizure activity. Second, we address non-synaptic mechanisms (which include voltage-gated ionic currents and gap junctions) in the generation of epileptiform synchronization. For each mechanism, we discuss the actions of antiepileptic drugs that are presumably modulating excitatory or inhibitory signaling and voltage-gated currents to prevent seizures in epileptic patients. These findings provide insights into the mechanisms of seizure initiation and maintenance, thus leading to the development of specific pharmacological treatments for focal epileptic disorders.
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Affiliation(s)
- Maxime Lévesque
- Montreal Neurological Institute, McGill University, Montreal, H3A 2B4 Quebec, Canada
| | - David Ragsdale
- Montreal Neurological Institute, McGill University, Montreal, H3A 2B4 Quebec, Canada
| | - Massimo Avoli
- Montreal Neurological Institute, McGill University, Montreal, H3A 2B4 Quebec, Canada.,Departments of Neurology & Neurosurgery, and of Physiology, McGill University, Montréal, H3A 2B4 Québec, Canada.,Department of Experimental Medicine, Facoltà di Medicina e Odontoiatria, Sapienza University of Rome, 00185 Roma, Italy
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10
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Burman RJ, Raimondo JV, Jefferys JG, Sen A, Akerman CJ. The transition to status epilepticus: how the brain meets the demands of perpetual seizure activity. Seizure 2020; 75:137-144. [DOI: 10.1016/j.seizure.2019.09.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Accepted: 09/23/2019] [Indexed: 02/08/2023] Open
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11
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Li J, Grinenko O, Mosher JC, Gonzalez-Martinez J, Leahy RM, Chauvel P. Learning to define an electrical biomarker of the epileptogenic zone. Hum Brain Mapp 2019; 41:429-441. [PMID: 31609058 PMCID: PMC7268034 DOI: 10.1002/hbm.24813] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Revised: 09/17/2019] [Accepted: 09/19/2019] [Indexed: 01/07/2023] Open
Abstract
The role of fast activity as a potential biomarker in localization of the epileptogenic zone (EZ) remains controversial due to recently reported unsatisfactory performance. We recently identified a “fingerprint” of the EZ as a time‐frequency pattern that is defined by a combination of preictal spike(s), fast oscillatory activity, and concurrent suppression of lower frequencies. Here we examine the generalizability of the fingerprint in application to an independent series of patients (11 seizure‐free and 13 non‐seizure‐free after surgery) and show that the fingerprint can also be identified in seizures with lower frequency (such as beta) oscillatory activity. In the seizure‐free group, only 5 of 47 identified EZ contacts were outside the resection. In contrast, in the non‐seizure‐free group, 104 of 142 identified EZ contacts were outside the resection. We integrated the fingerprint prediction with the subject's MR images, thus providing individualized anatomical estimates of the EZ. We show that these fingerprint‐based estimates in seizure‐free patients are almost always inside the resection. On the other hand, for a large fraction of the nonseizure‐free patients the estimated EZ was not well localized and was partially or completely outside the resection, which may explain surgical failure in such cases. We also show that when mapping fast activity alone onto MR images, the EZ was often over‐estimated, indicating a reduced discriminative ability for fast activity relative to the full fingerprint for localization of the EZ.
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Affiliation(s)
- Jian Li
- Signal and Image Processing Institute, University of Southern California, Los Angeles, California
| | - Olesya Grinenko
- Epilepsy Center, Cleveland Clinic Neurological Institute, Cleveland, Ohio
| | - John C Mosher
- Department of Neurology, University of Texas Health Science Center at Houston, Houston, Texas
| | | | - Richard M Leahy
- Signal and Image Processing Institute, University of Southern California, Los Angeles, California
| | - Patrick Chauvel
- Epilepsy Center, Cleveland Clinic Neurological Institute, Cleveland, Ohio
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12
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Codadu NK, Graham RT, Burman RJ, Jackson‐Taylor RT, Raimondo JV, Trevelyan AJ, Parrish RR. Divergent paths to seizure-like events. Physiol Rep 2019; 7:e14226. [PMID: 31587522 PMCID: PMC6778598 DOI: 10.14814/phy2.14226] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Revised: 07/29/2019] [Accepted: 07/31/2019] [Indexed: 12/19/2022] Open
Abstract
Much debate exists about how the brain transitions into an epileptic seizure. One source of confusion is that there are likely to be critical differences between experimental seizure models. To address this, we have compared the evolving activity patterns in two widely used in vitro models of epileptic discharges. Brain slices from young adult mice were prepared in the same way and bathed either in 0 Mg2+ or 100 µmol/L 4AP artificial cerebrospinal fluid. We have found that while local field potential recordings of epileptiform discharges in the two models appear broadly similar, patch-clamp analysis reveals an important difference in the relative degree of glutamatergic involvement. 4AP affects parvalbumin-expressing interneurons more than other cortical populations, destabilizing their resting state and inducing spontaneous bursting behavior. Consequently, the most prominent pattern of transient discharge ("interictal event") in this model is almost purely GABAergic, although the transition to seizure-like events (SLEs) involves pyramidal recruitment. In contrast, interictal discharges in 0 Mg2+ are only maintained by a very large glutamatergic component that also involves transient discharges of the interneurons. Seizure-like events in 0 Mg2+ have significantly higher power in the high gamma frequency band (60-120Hz) than these events do in 4AP, and are greatly delayed in onset by diazepam, unlike 4AP events. We, therefore, conclude that the 0 Mg2+ and 4AP models display fundamentally different levels of glutamatergic drive, demonstrating how ostensibly similar pathological discharges can arise from different sources. We contend that similar interpretative issues will also be relevant to clinical practice.
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Affiliation(s)
- Neela K. Codadu
- Institute of NeuroscienceMedical SchoolNewcastle UniversityNewcastle upon TyneUnited Kingdom
| | - Robert T. Graham
- Institute of NeuroscienceMedical SchoolNewcastle UniversityNewcastle upon TyneUnited Kingdom
| | - Richard J. Burman
- Division of Cell BiologyDepartment of Human Biology, Neuroscience Institute and Institute of Infectious Disease and Molecular MedicineFaculty of Health SciencesUniversity of Cape TownCape TownSouth Africa
| | | | - Joseph V. Raimondo
- Division of Cell BiologyDepartment of Human Biology, Neuroscience Institute and Institute of Infectious Disease and Molecular MedicineFaculty of Health SciencesUniversity of Cape TownCape TownSouth Africa
| | - Andrew J. Trevelyan
- Institute of NeuroscienceMedical SchoolNewcastle UniversityNewcastle upon TyneUnited Kingdom
| | - R. Ryley Parrish
- Institute of NeuroscienceMedical SchoolNewcastle UniversityNewcastle upon TyneUnited Kingdom
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13
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de Curtis M, Librizzi L, Uva L, Gnatkovsky V. GABAA receptor-mediated networks during focal seizure onset and progression in vitro. Neurobiol Dis 2019; 125:190-197. [DOI: 10.1016/j.nbd.2019.02.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 01/08/2019] [Accepted: 02/07/2019] [Indexed: 02/02/2023] Open
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14
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Magloire V, Cornford J, Lieb A, Kullmann DM, Pavlov I. KCC2 overexpression prevents the paradoxical seizure-promoting action of somatic inhibition. Nat Commun 2019; 10:1225. [PMID: 30874549 PMCID: PMC6420604 DOI: 10.1038/s41467-019-08933-4] [Citation(s) in RCA: 58] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2018] [Accepted: 02/01/2019] [Indexed: 11/09/2022] Open
Abstract
Although cortical interneurons are apparently well-placed to suppress seizures, several recent reports have highlighted a paradoxical role of perisomatic-targeting parvalbumin-positive (PV+) interneurons in ictogenesis. Here, we use an acute in vivo model of focal cortical seizures in awake behaving mice, together with closed-loop optogenetic manipulation of PV+ interneurons, to investigate their function during seizures. We show that photo-depolarization of PV+ interneurons rapidly switches from an anti-ictal to a pro-ictal effect within a few seconds of seizure initiation. The pro-ictal effect of delayed photostimulation of PV+ interneurons was not shared with dendrite-targeting somatostatin-positive (SOM+) interneurons. We also show that this switch can be prevented by overexpression of the neuronal potassium-chloride co-transporter KCC2 in principal cortical neurons. These results suggest that strategies aimed at improving the ability of principal neurons to maintain a trans-membrane chloride gradient in the face of excessive network activity can prevent interneurons from contributing to seizure perpetuation.
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Affiliation(s)
- Vincent Magloire
- Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, University College London, London, WC1N 3BG, UK.
| | - Jonathan Cornford
- Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, University College London, London, WC1N 3BG, UK
| | - Andreas Lieb
- Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, University College London, London, WC1N 3BG, UK
| | - Dimitri M Kullmann
- Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, University College London, London, WC1N 3BG, UK
| | - Ivan Pavlov
- Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, University College London, London, WC1N 3BG, UK.
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15
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Moxon KA, Shahlaie K, Girgis F, Saez I, Kennedy J, Gurkoff GG. From adagio to allegretto: The changing tempo of theta frequencies in epilepsy and its relation to interneuron function. Neurobiol Dis 2019; 129:169-181. [PMID: 30798003 DOI: 10.1016/j.nbd.2019.02.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 02/06/2019] [Accepted: 02/20/2019] [Indexed: 12/29/2022] Open
Abstract
Despite decades of research, our understanding of epilepsy, including how seizures are generated and propagate, is incomplete. However, there is growing recognition that epilepsy is more than just the occurrence of seizures, with patients often experiencing comorbid deficits in cognition that are poorly understood. In addition, the available therapies for treatment of epilepsy, from pharmaceutical treatment to surgical resection and seizure prevention devices, often exacerbate deficits in cognitive function. In this review, we discuss the hypothesis that seizure generation and cognitive deficits have a similar pathological source characterized by, but not limited to, deficits in theta oscillations and their influence on interneurons. We present a new framework that describes oscillatory states in epilepsy as alternating between hyper- and hypo-synchrony rather than solely the spontaneous transition to hyper-excitability characterized by the seizures. This framework suggests that as neural oscillations, specifically in the theta range, vary their tempo from a slowed almost adagio tempo during interictal periods to faster, more rhythmic allegretto tempo preictally, they impact the function of interneurons, modulating their ability to control seizures and their role in cognitive processing. This slow wave oscillatory framework may help explain why current therapies that work to reduce hyper-excitability do not completely eliminate seizures and often lead to exacerbated cognitive deficits.
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Affiliation(s)
- Karen A Moxon
- Department of Biomedical Engineering, University of California Davis, Davis, CA 95616, United States of America.
| | - Kiarash Shahlaie
- Department of Neurological Surgery, University of California Davis, Sacramento, CA 95817, United States of America; Center for Neuroscience, University of California Davis, Davis, CA 95618, United States of America
| | - Fady Girgis
- Department of Neurological Surgery, University of California Davis, Sacramento, CA 95817, United States of America
| | - Ignacio Saez
- Department of Neurological Surgery, University of California Davis, Sacramento, CA 95817, United States of America; Center for Neuroscience, University of California Davis, Davis, CA 95618, United States of America
| | - Jeffrey Kennedy
- Department of Neurology, University of California Davis, Sacramento, CA 95817, United States of America
| | - Gene G Gurkoff
- Department of Neurological Surgery, University of California Davis, Sacramento, CA 95817, United States of America; Center for Neuroscience, University of California Davis, Davis, CA 95618, United States of America
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16
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Wang Y, Wang Y, Chen Z. Double-edged GABAergic synaptic transmission in seizures: The importance of chloride plasticity. Brain Res 2018; 1701:126-136. [PMID: 30201259 DOI: 10.1016/j.brainres.2018.09.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Revised: 09/04/2018] [Accepted: 09/06/2018] [Indexed: 12/18/2022]
Abstract
GABAergic synaptic inhibition, which is a critical regulator of neuronal excitability, is closely involved in epilepsy. Interestingly, fast GABAergic transmission mediated by Cl- permeable GABAA receptors can bi-directionally exert both seizure-suppressing and seizure-promoting actions. Accumulating evidence suggests that chloride plasticity, the driving force of GABAA receptor-mediated synaptic transmission, contributes to the double-edged role of GABAergic synapses in seizures. Large amounts of Cl- influx can overwhelm Cl- extrusion during seizures not only in healthy tissue in a short-term "activity-dependent" manner, but also in chronic epilepsy in a long-term, irreversible "pathology-dependent" manner related to the dysfunction of two chloride transporters: the chloride importer NKCC1 and the chloride exporter KCC2. In this review, we address the importance of chloride plasticity for the "activity-dependent" and "pathology-dependent" mechanisms underlying epileptic events and provide possible directions for further research, which may be clinically important for the design of GABAergic synapse-targeted precise therapeutic interventions for epilepsy.
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Affiliation(s)
- Ying Wang
- Institute of Pharmacology & Toxicology, Key Laboratory of Medical Neurobiology of the Ministry of Health of China, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, China
| | - Yi Wang
- Institute of Pharmacology & Toxicology, Key Laboratory of Medical Neurobiology of the Ministry of Health of China, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, China
| | - Zhong Chen
- Institute of Pharmacology & Toxicology, Key Laboratory of Medical Neurobiology of the Ministry of Health of China, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, China; Epilepsy Center, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
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17
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Wenzel M, Hamm JP, Peterka DS, Yuste R. Reliable and Elastic Propagation of Cortical Seizures In Vivo. Cell Rep 2018; 19:2681-2693. [PMID: 28658617 DOI: 10.1016/j.celrep.2017.05.090] [Citation(s) in RCA: 75] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2016] [Revised: 05/15/2017] [Accepted: 05/28/2017] [Indexed: 12/27/2022] Open
Abstract
Mapping the fine-scale neural activity that underlies epilepsy is key to identifying potential control targets of this frequently intractable disease. Yet, the detailed in vivo dynamics of seizure progression in cortical microcircuits remain poorly understood. We combine fast (30-Hz) two-photon calcium imaging with local field potential (LFP) recordings to map, cell by cell, the spread of locally induced (4-AP or picrotoxin) seizures in anesthetized and awake mice. Using single-layer and microprism-assisted multilayer imaging in different cortical areas, we uncover reliable recruitment of local neural populations within and across cortical layers, and we find layer-specific temporal delays, suggesting an initial supra-granular invasion followed by deep-layer recruitment during lateral seizure spread. Intriguingly, despite consistent progression pathways, successive seizures show pronounced temporal variability that critically depends on GABAergic inhibition. We propose an epilepsy circuit model resembling an elastic meshwork, wherein ictal progression faithfully follows preexistent pathways but varies flexibly in time, depending on the local inhibitory restraint.
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Affiliation(s)
- Michael Wenzel
- Neurotechnology Center, Department of Biological Sciences, Columbia University, New York, NY 10027, USA.
| | - Jordan P Hamm
- Neurotechnology Center, Department of Biological Sciences, Columbia University, New York, NY 10027, USA
| | - Darcy S Peterka
- Neurotechnology Center, Department of Biological Sciences, Columbia University, New York, NY 10027, USA
| | - Rafael Yuste
- Neurotechnology Center, Department of Biological Sciences, Columbia University, New York, NY 10027, USA
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18
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Pelkey KA, Chittajallu R, Craig MT, Tricoire L, Wester JC, McBain CJ. Hippocampal GABAergic Inhibitory Interneurons. Physiol Rev 2017; 97:1619-1747. [PMID: 28954853 DOI: 10.1152/physrev.00007.2017] [Citation(s) in RCA: 495] [Impact Index Per Article: 70.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Revised: 05/16/2017] [Accepted: 05/26/2017] [Indexed: 12/11/2022] Open
Abstract
In the hippocampus GABAergic local circuit inhibitory interneurons represent only ~10-15% of the total neuronal population; however, their remarkable anatomical and physiological diversity allows them to regulate virtually all aspects of cellular and circuit function. Here we provide an overview of the current state of the field of interneuron research, focusing largely on the hippocampus. We discuss recent advances related to the various cell types, including their development and maturation, expression of subtype-specific voltage- and ligand-gated channels, and their roles in network oscillations. We also discuss recent technological advances and approaches that have permitted high-resolution, subtype-specific examination of their roles in numerous neural circuit disorders and the emerging therapeutic strategies to ameliorate such pathophysiological conditions. The ultimate goal of this review is not only to provide a touchstone for the current state of the field, but to help pave the way for future research by highlighting where gaps in our knowledge exist and how a complete appreciation of their roles will aid in future therapeutic strategies.
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Affiliation(s)
- Kenneth A Pelkey
- Porter Neuroscience Center, Eunice Kennedy-Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland; Institute of Biomedical and Clinical Sciences, University of Exeter Medical School, Hatherly Laboratories, University of Exeter, Exeter, United Kingdom; and Sorbonne Universités, UPMC University of Paris, INSERM, CNRS, Neurosciences Paris Seine-Institut de Biologie Paris Seine, Paris, France
| | - Ramesh Chittajallu
- Porter Neuroscience Center, Eunice Kennedy-Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland; Institute of Biomedical and Clinical Sciences, University of Exeter Medical School, Hatherly Laboratories, University of Exeter, Exeter, United Kingdom; and Sorbonne Universités, UPMC University of Paris, INSERM, CNRS, Neurosciences Paris Seine-Institut de Biologie Paris Seine, Paris, France
| | - Michael T Craig
- Porter Neuroscience Center, Eunice Kennedy-Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland; Institute of Biomedical and Clinical Sciences, University of Exeter Medical School, Hatherly Laboratories, University of Exeter, Exeter, United Kingdom; and Sorbonne Universités, UPMC University of Paris, INSERM, CNRS, Neurosciences Paris Seine-Institut de Biologie Paris Seine, Paris, France
| | - Ludovic Tricoire
- Porter Neuroscience Center, Eunice Kennedy-Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland; Institute of Biomedical and Clinical Sciences, University of Exeter Medical School, Hatherly Laboratories, University of Exeter, Exeter, United Kingdom; and Sorbonne Universités, UPMC University of Paris, INSERM, CNRS, Neurosciences Paris Seine-Institut de Biologie Paris Seine, Paris, France
| | - Jason C Wester
- Porter Neuroscience Center, Eunice Kennedy-Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland; Institute of Biomedical and Clinical Sciences, University of Exeter Medical School, Hatherly Laboratories, University of Exeter, Exeter, United Kingdom; and Sorbonne Universités, UPMC University of Paris, INSERM, CNRS, Neurosciences Paris Seine-Institut de Biologie Paris Seine, Paris, France
| | - Chris J McBain
- Porter Neuroscience Center, Eunice Kennedy-Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland; Institute of Biomedical and Clinical Sciences, University of Exeter Medical School, Hatherly Laboratories, University of Exeter, Exeter, United Kingdom; and Sorbonne Universités, UPMC University of Paris, INSERM, CNRS, Neurosciences Paris Seine-Institut de Biologie Paris Seine, Paris, France
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19
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Interneuronal Network Activity at the Onset of Seizure-Like Events in Entorhinal Cortex Slices. J Neurosci 2017; 37:10398-10407. [PMID: 28947576 DOI: 10.1523/jneurosci.3906-16.2017] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Revised: 07/05/2017] [Accepted: 07/08/2017] [Indexed: 12/19/2022] Open
Abstract
The onset of focal seizures in humans and in different animal models of focal epilepsy correlates with reduction of neuronal firing and enhanced interneuronal network activity. Whether this phenomenon contributes to seizure generation is still unclear. We used the in vitro entorhinal cortex slices bathed in 4-aminopirydine (4-AP) as an experimental paradigm model to evaluate the correlation between interneuronal GABAergic network activity and seizure-like events. Epileptiform discharges were recorded in layer V-VI pyramidal neurons and fast-spiking interneurons in slices from male and female mice and in the isolated female guinea pig brain preparation during perfusion with 4-AP. We observed that 90% of seizure-like events recorded in principal cells were preceded by outward currents coupled with extracellular potassium shifts, abolished by pharmacological blockade of GABAA receptors. Potassium elevations associated to GABAA receptor-mediated population events were confirmed in the entorhinal cortex of the in vitro isolated whole guinea pig brain. Fast-rising and sustained extracellular potassium increases associated to interneuronal network activity consistently preceded the initiation of seizure-like events. We conclude that in the 4-AP seizure model, interneuronal network activity occurs before 4-AP-induced seizures and therefore supports a role of interneuron activity in focal seizure generation.SIGNIFICANCE STATEMENT The paper focuses on the mechanisms of ictogenesis, a topic that requires a step beyond the simplistic view that seizures, and epilepsy, are due to an increase of excitatory network activity. Focal temporal lobe seizures in humans and in several experimental epilepsies likely correlate with a prevalent activation of interneurons. The potassium channel blocker 4-aminopyridine reliably induces seizure-like events in temporal lobe structures. Herein, we show that a majority of seizures in the entorhinal cortex starts with interneuronal network activity accompanied by a fast and sustained increase in extracellular potassium. Our new findings reinforce and add a new piece of evidence to the proposal that limbic seizures can be supported by GABAergic hyperactivity.
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20
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Moore YE, Kelley MR, Brandon NJ, Deeb TZ, Moss SJ. Seizing Control of KCC2: A New Therapeutic Target for Epilepsy. Trends Neurosci 2017; 40:555-571. [PMID: 28803659 DOI: 10.1016/j.tins.2017.06.008] [Citation(s) in RCA: 92] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Revised: 06/20/2017] [Accepted: 06/22/2017] [Indexed: 11/17/2022]
Abstract
Deficits in GABAergic inhibition result in the abnormal neuronal activation and synchronization that underlies seizures. However, the molecular mechanisms responsible for transforming a normal brain into an epileptic one remain largely unknown. Hyperpolarizing inhibition mediated by type A GABA (GABAA) receptors is dependent on chloride extrusion by the neuron-specific type 2K+-Cl- cotransporter (KCC2). Loss-of-function mutations in KCC2 are a known cause of infantile epilepsy in humans and KCC2 dysfunction is present in patients with both idiopathic and acquired epilepsy. Here we discuss the growing evidence that KCC2 dysfunction has a central role in the development and severity of the epilepsies.
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Affiliation(s)
- Yvonne E Moore
- Department of Neuroscience, Physiology and Pharmacology, University College London, London WC1E 6BT, UK; Department of Neuroscience, Tufts University School of Medicine, Boston, MA 02111, USA
| | - Matt R Kelley
- Department of Neuroscience, Tufts University School of Medicine, Boston, MA 02111, USA
| | - Nicholas J Brandon
- AstraZeneca Tufts Laboratory for Basic and Translational Neuroscience, Boston, MA 02111, USA; AstraZeneca Neuroscience, Innovative Medicines and Early Development Biotech Unit, R&D Boston, Waltham, MA 024515, USA
| | - Tarek Z Deeb
- Department of Neuroscience, Tufts University School of Medicine, Boston, MA 02111, USA; AstraZeneca Tufts Laboratory for Basic and Translational Neuroscience, Boston, MA 02111, USA
| | - Stephen J Moss
- Department of Neuroscience, Physiology and Pharmacology, University College London, London WC1E 6BT, UK; Department of Neuroscience, Tufts University School of Medicine, Boston, MA 02111, USA; AstraZeneca Tufts Laboratory for Basic and Translational Neuroscience, Boston, MA 02111, USA.
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21
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Neumann AR, Raedt R, Steenland HW, Sprengers M, Bzymek K, Navratilova Z, Mesina L, Xie J, Lapointe V, Kloosterman F, Vonck K, Boon PAJM, Soltesz I, McNaughton BL, Luczak A. Involvement of fast-spiking cells in ictal sequences during spontaneous seizures in rats with chronic temporal lobe epilepsy. Brain 2017; 140:2355-2369. [PMID: 29050390 PMCID: PMC6248724 DOI: 10.1093/brain/awx179] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Revised: 05/25/2017] [Accepted: 06/08/2017] [Indexed: 11/14/2022] Open
Abstract
See Lenck-Santini (doi:10.1093/awx205) for a scientific commentary on this article. Epileptic seizures represent altered neuronal network dynamics, but the temporal evolution and cellular substrates of the neuronal activity patterns associated with spontaneous seizures are not fully understood. We used simultaneous recordings from multiple neurons in the hippocampus and neocortex of rats with chronic temporal lobe epilepsy to demonstrate that subsets of cells discharge in a highly stereotypical sequential pattern during ictal events, and that these stereotypical patterns were reproducible across consecutive seizures. In contrast to the canonical view that principal cell discharges dominate ictal events, the ictal sequences were predominantly composed of fast-spiking, putative inhibitory neurons, which displayed unusually strong coupling to local field potential even before seizures. The temporal evolution of activity was characterized by unique dynamics where the most correlated neuronal pairs before seizure onset displayed the largest increases in correlation strength during the seizures. These results demonstrate the selective involvement of fast spiking interneurons in structured temporal sequences during spontaneous ictal events in hippocampal and neocortical circuits in experimental models of chronic temporal lobe epilepsy.
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Affiliation(s)
- Adam R Neumann
- Department of Neuroscience, Canadian Centre for Behavioural
Neuroscience, University of Lethbridge, 4401 University Dr W, Lethbridge, AB, T1K 3M4,
Canada
| | - Robrecht Raedt
- Department of Neurology, Ghent University, Gent, Belgium
| | - Hendrik W Steenland
- Department of Neuroscience, Canadian Centre for Behavioural
Neuroscience, University of Lethbridge, 4401 University Dr W, Lethbridge, AB, T1K 3M4,
Canada
| | | | - Katarzyna Bzymek
- Department of Neuroscience, Canadian Centre for Behavioural
Neuroscience, University of Lethbridge, 4401 University Dr W, Lethbridge, AB, T1K 3M4,
Canada
| | - Zaneta Navratilova
- Department of Neuroscience, Canadian Centre for Behavioural
Neuroscience, University of Lethbridge, 4401 University Dr W, Lethbridge, AB, T1K 3M4,
Canada
- Neuro-Electronics Research Flanders, Leuven, Belgium
| | - Lilia Mesina
- Department of Neuroscience, Canadian Centre for Behavioural
Neuroscience, University of Lethbridge, 4401 University Dr W, Lethbridge, AB, T1K 3M4,
Canada
| | - Jeanne Xie
- Department of Neuroscience, Canadian Centre for Behavioural
Neuroscience, University of Lethbridge, 4401 University Dr W, Lethbridge, AB, T1K 3M4,
Canada
| | - Valerie Lapointe
- Department of Neuroscience, Canadian Centre for Behavioural
Neuroscience, University of Lethbridge, 4401 University Dr W, Lethbridge, AB, T1K 3M4,
Canada
| | - Fabian Kloosterman
- Neuro-Electronics Research Flanders, Leuven, Belgium
- VIB, Leuven, Belgium
- Brain and Cognition Research unit, KU Leuven, Leuven, Belgium
| | - Kristl Vonck
- Department of Neurology, Ghent University, Gent, Belgium
| | | | - Ivan Soltesz
- Department of Neurosurgery, and Stanford Neurosciences Institute,
Stanford University, Stanford, CA, USA
| | - Bruce L McNaughton
- Department of Neuroscience, Canadian Centre for Behavioural
Neuroscience, University of Lethbridge, 4401 University Dr W, Lethbridge, AB, T1K 3M4,
Canada
- Department of Neurobiology and Behavior, University of California at
Irvine, Center for the Neurobiology of Learning and Memory, Irvine, CA, USA
| | - Artur Luczak
- Department of Neuroscience, Canadian Centre for Behavioural
Neuroscience, University of Lethbridge, 4401 University Dr W, Lethbridge, AB, T1K 3M4,
Canada
- Department of Neurosurgery, and Stanford Neurosciences Institute,
Stanford University, Stanford, CA, USA
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22
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Nonomura S, Fujiwara-Tsukamoto Y, Kajihara T, Fujiyama F, Isomura Y. Continuous membrane potential fluctuations in motor cortex and striatum neurons during voluntary forelimb movements and pauses. Neurosci Res 2017; 120:53-59. [DOI: 10.1016/j.neures.2017.03.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Revised: 02/23/2017] [Accepted: 03/01/2017] [Indexed: 01/26/2023]
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Kim CM, Nykamp DQ. The influence of depolarization block on seizure-like activity in networks of excitatory and inhibitory neurons. J Comput Neurosci 2017; 43:65-79. [PMID: 28528529 DOI: 10.1007/s10827-017-0647-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Revised: 03/11/2017] [Accepted: 04/26/2017] [Indexed: 11/29/2022]
Abstract
The inhibitory restraint necessary to suppress aberrant activity can fail when inhibitory neurons cease to generate action potentials as they enter depolarization block. We investigate possible bifurcation structures that arise at the onset of seizure-like activity resulting from depolarization block in inhibitory neurons. Networks of conductance-based excitatory and inhibitory neurons are simulated to characterize different types of transitions to the seizure state, and a mean field model is developed to verify the generality of the observed phenomena of excitatory-inhibitory dynamics. Specifically, the inhibitory population's activation function in the Wilson-Cowan model is modified to be non-monotonic to reflect that inhibitory neurons enter depolarization block given strong input. We find that a physiological state and a seizure state can coexist, where the seizure state is characterized by high excitatory and low inhibitory firing rate. Bifurcation analysis of the mean field model reveals that a transition to the seizure state may occur via a saddle-node bifurcation or a homoclinic bifurcation. We explain the hysteresis observed in network simulations using these two bifurcation types. We also demonstrate that extracellular potassium concentration affects the depolarization block threshold; the consequent changes in bifurcation structure enable the network to produce the tonic to clonic phase transition observed in biological epileptic networks.
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Affiliation(s)
- Christopher M Kim
- School of Mathematics, University of Minnesota, Minneapolis, MN, USA. .,Laboratory of Biological Modeling, NIDDK, National Institute of Health, Bethesda, MD, USA.
| | - Duane Q Nykamp
- School of Mathematics, University of Minnesota, Minneapolis, MN, USA
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24
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Raimondo JV, Richards BA, Woodin MA. Neuronal chloride and excitability - the big impact of small changes. Curr Opin Neurobiol 2016; 43:35-42. [PMID: 27992777 DOI: 10.1016/j.conb.2016.11.012] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Revised: 10/19/2016] [Accepted: 11/09/2016] [Indexed: 12/18/2022]
Abstract
Synaptic inhibition is a critical regulator of neuronal excitability, and in the mature brain the majority of synaptic inhibition is mediated by Cl--permeable GABAA receptors. Unlike other physiologically relevant ions, Cl- is dynamically regulated, and alterations in the Cl- gradient can have significant impact on neuronal excitability. Due to changes in the neuronal Cl- concentration, GABAergic transmission can bidirectionally regulate the induction of excitatory synaptic plasticity and gate the closing of the critical period for monocular deprivation in visual cortex. GABAergic circuitry can also provide a powerful restraining mechanism for the spread of excitation, however Cl- extrusion mechanisms can become overwhelmed and GABA can paradoxically contribute to pathological excitation such as the propagation of seizure activity.
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Affiliation(s)
- Joseph V Raimondo
- Division of Physiology, Department of Human Biology and Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Anzio Road Observatory, 7925 Cape Town, South Africa
| | - Blake A Richards
- Department of Biological Sciences, University of Toronto Scarborough, 1265 Military Trail, Toronto, Ontario M1C 1A4, Canada; Department of Cell and Systems Biology, University of Toronto, 25 Harbord Street, Toronto, Ontario M5S 3G5, Canada
| | - Melanie A Woodin
- Department of Cell and Systems Biology, University of Toronto, 25 Harbord Street, Toronto, Ontario M5S 3G5, Canada.
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25
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Schönherr M, Stefan H, Hamer HM, Rössler K, Buchfelder M, Rampp S. The delta between postoperative seizure freedom and persistence: Automatically detected focal slow waves after epilepsy surgery. Neuroimage Clin 2016; 13:256-263. [PMID: 28018852 PMCID: PMC5167245 DOI: 10.1016/j.nicl.2016.12.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Revised: 11/03/2016] [Accepted: 12/01/2016] [Indexed: 11/09/2022]
Abstract
OBJECTIVE In this study, we use a novel automated method for localization and quantitative comparison of magnetoencephalographic (MEG) delta activity in patients with and without recurrent seizures after epilepsy surgery as well as healthy controls. METHODS We identified the generators of delta activity by source location in frequency domain between 1 and 4 Hz in spontaneous MEG data. Comparison with healthy control subjects by z-transform emphasized relative changes of activation in patients. The individual results were compared to spike localizations and statistical group analysis was performed. Additionally, MEG results were compared to 1-4 Hz activity in invasive EEG (iEEG) in two patients, in whom this data was available. RESULTS Patients with recurrent seizures exhibited significantly increased focal MEG delta activity both in comparison to healthy controls and seizure free patients. This slow activity showed a correlation to interictal epileptic activity and was not explained by consequences of the resection alone. In two patients with iEEG, iEEG analysis was concordant with the MEG findings. SIGNIFICANCE The quantity of delta activity could be used as a diagnostic marker for recurrent seizures. The close relation to epileptic spike localizations and the resection volume of patients with successful second surgery imply involvement in seizure recurrence. This initial evidence suggests a potential application in the planning of second epilepsy surgery.
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Affiliation(s)
- Margit Schönherr
- Epilepsy Center, Department of Neurology, University Hospital Erlangen, Schwabachanlage 6, 91054 Erlangen, Germany
| | - Hermann Stefan
- Epilepsy Center, Department of Neurology, University Hospital Erlangen, Schwabachanlage 6, 91054 Erlangen, Germany
| | - Hajo M. Hamer
- Epilepsy Center, Department of Neurology, University Hospital Erlangen, Schwabachanlage 6, 91054 Erlangen, Germany
| | - Karl Rössler
- Department of Neurosurgery, University Hospital Erlangen, Schwabachanlage 6, 91054 Erlangen, Germany
| | - Michael Buchfelder
- Department of Neurosurgery, University Hospital Erlangen, Schwabachanlage 6, 91054 Erlangen, Germany
| | - Stefan Rampp
- Department of Neurosurgery, University Hospital Erlangen, Schwabachanlage 6, 91054 Erlangen, Germany
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Buchin A, Chizhov A, Huberfeld G, Miles R, Gutkin BS. Reduced Efficacy of the KCC2 Cotransporter Promotes Epileptic Oscillations in a Subiculum Network Model. J Neurosci 2016; 36:11619-11633. [PMID: 27852771 PMCID: PMC6231544 DOI: 10.1523/jneurosci.4228-15.2016] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Revised: 08/04/2016] [Accepted: 08/07/2016] [Indexed: 12/17/2022] Open
Abstract
Pharmacoresistant epilepsy is a chronic neurological condition in which a basal brain hyperexcitability results in paroxysmal hypersynchronous neuronal discharges. Human temporal lobe epilepsy has been associated with dysfunction or loss of the potassium-chloride cotransporter KCC2 in a subset of pyramidal cells in the subiculum, a key structure generating epileptic activities. KCC2 regulates intraneuronal chloride and extracellular potassium levels by extruding both ions. Absence of effective KCC2 may alter the dynamics of chloride and potassium levels during repeated activation of GABAergic synapses due to interneuron activity. In turn, such GABAergic stress may itself affect Cl- regulation. Such changes in ionic homeostasis may switch GABAergic signaling from inhibitory to excitatory in affected pyramidal cells and also increase neuronal excitability. Possibly these changes contribute to periodic bursting in pyramidal cells, an essential component in the onset of ictal epileptic events. We tested this hypothesis with a computational model of a subicular network with realistic connectivity. The pyramidal cell model explicitly incorporated the cotransporter KCC2 and its effects on the internal/external chloride and potassium levels. Our network model suggested the loss of KCC2 in a critical number of pyramidal cells increased external potassium and intracellular chloride concentrations leading to seizure-like field potential oscillations. These oscillations included transient discharges leading to ictal-like field events with frequency spectra as in vitro Restoration of KCC2 function suppressed seizure activity and thus may present a useful therapeutic option. These simulations therefore suggest that reduced KCC2 cotransporter activity alone may underlie the generation of ictal discharges. SIGNIFICANCE STATEMENT Ion regulation in the brain is a major determinant of neural excitability. Intracellular chloride in neurons, a partial determinant of the resting potential and the inhibitory reversal potentials, is regulated together with extracellular potassium via kation chloride cotransporters. During temporal lobe epilepsy, the homeostatic regulation of intracellular chloride is impaired in pyramidal cells, yet how this dysregulation may lead to seizures has not been explored. Using a realistic neural network model describing ion mechanisms, we show that chloride homeostasis pathology provokes seizure activity analogous to recordings from epileptogenic brain tissue. We show that there is a critical percentage of pathological cells required for seizure initiation. Our model predicts that restoration of the chloride homeostasis in pyramidal cells could be a viable antiepileptic strategy.
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Affiliation(s)
- Anatoly Buchin
- École normale supérieure, Paris Sciences et Lettres University, Laboratoire de Neurosciences Cognitives, Institute national de la santé et de la recherche médicale U960, Group for Neural Theory, 75005 Paris, France,
- Peter the Great St. Petersburg Polytechnic University, St. Petersburg 195251, Russia
- National Research University Higher School of Economics, Center for Cognition and Decision Making, Moscow 109316, Russia
| | - Anton Chizhov
- Ioffe Institute, Computational Physics Laboratory, St. Petersburg 194021, Russia
- Sechenov Institute of Evolutionary Physiology and Biochemistry of the Russian Academy of Sciences, St. Petersburg 194223, Russia
| | - Gilles Huberfeld
- Université Pierre et Marie Curie, Pitié-Salpêtrière Hôpital, Assistance Publique-Hôpitaux de Paris, Neurophysiology Department, 75013 Paris, France
- Institute national de la santé et de la recherche médicale U1129 "Infantile Epilepsies and Brain Plasticity," Paris Descartes University, Pôle de recherche et d'enseignement supérieur Sorbonne Paris Cité, 75015 Paris, France, and
| | - Richard Miles
- Institut du Cerveau et de la Moelle Epinière, Cortex et Epilepsie Group, 75013 Paris, France
| | - Boris S Gutkin
- École normale supérieure, Paris Sciences et Lettres University, Laboratoire de Neurosciences Cognitives, Institute national de la santé et de la recherche médicale U960, Group for Neural Theory, 75005 Paris, France
- National Research University Higher School of Economics, Center for Cognition and Decision Making, Moscow 109316, Russia
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Tung JK, Berglund K, Gross RE. Optogenetic Approaches for Controlling Seizure Activity. Brain Stimul 2016; 9:801-810. [PMID: 27496002 PMCID: PMC5143193 DOI: 10.1016/j.brs.2016.06.055] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2016] [Revised: 06/21/2016] [Accepted: 06/28/2016] [Indexed: 01/01/2023] Open
Abstract
Optogenetics, a technique that utilizes light-sensitive ion channels or pumps to activate or inhibit neurons, has allowed scientists unprecedented precision and control for manipulating neuronal activity. With the clinical need to develop more precise and effective therapies for patients with drug-resistant epilepsy, these tools have recently been explored as a novel treatment for halting seizure activity in various animal models. In this review, we provide a detailed and current summary of these optogenetic approaches and provide a perspective on their future clinical application as a potential neuromodulatory therapy.
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Affiliation(s)
- Jack K Tung
- Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA; Department of Neurosurgery, Emory University, Atlanta, GA
| | - Ken Berglund
- Department of Neurosurgery, Emory University, Atlanta, GA
| | - Robert E Gross
- Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA; Department of Neurosurgery, Emory University, Atlanta, GA.
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28
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Amakhin DV, Ergina JL, Chizhov AV, Zaitsev AV. Synaptic Conductances during Interictal Discharges in Pyramidal Neurons of Rat Entorhinal Cortex. Front Cell Neurosci 2016; 10:233. [PMID: 27790093 PMCID: PMC5061778 DOI: 10.3389/fncel.2016.00233] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Accepted: 09/26/2016] [Indexed: 11/13/2022] Open
Abstract
In epilepsy, the balance of excitation and inhibition underlying the basis of neural network activity shifts, resulting in neuronal network hyperexcitability and recurrent seizure-associated discharges. Mechanisms involved in ictal and interictal events are not fully understood, in particular, because of controversial data regarding the dynamics of excitatory and inhibitory synaptic conductances. In the present study, we estimated AMPAR-, NMDAR-, and GABAA R-mediated conductances during two distinct types of interictal discharge (IID) in pyramidal neurons of rat entorhinal cortex in cortico-hippocampal slices. Repetitively emerging seizure-like events and IIDs were recorded in high extracellular potassium, 4-aminopyridine, and reduced magnesium-containing solution. An original procedure for estimating synaptic conductance during IIDs was based on the differences among the current-voltage characteristics of the synaptic components. The synaptic conductance dynamics obtained revealed that the first type of IID is determined by activity of GABAA R channels with depolarized reversal potential. The second type of IID is determined by the interplay between excitation and inhibition, with early AMPAR and prolonged depolarized GABAA R and NMDAR-mediated components. The study then validated the contribution of these components to IIDs by intracellular pharmacological isolation. These data provide new insights into the mechanisms of seizures generation, development, and cessation.
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Affiliation(s)
- Dmitry V Amakhin
- Laboratory of Molecular Mechanisms of Neural Interactions, Sechenov Institute of Evolutionary Physiology and Biochemistry of the Russian Academy of Sciences Saint Petersburg, Russia
| | - Julia L Ergina
- Laboratory of Molecular Mechanisms of Neural Interactions, Sechenov Institute of Evolutionary Physiology and Biochemistry of the Russian Academy of Sciences Saint Petersburg, Russia
| | - Anton V Chizhov
- Laboratory of Molecular Mechanisms of Neural Interactions, Sechenov Institute of Evolutionary Physiology and Biochemistry of the Russian Academy of SciencesSaint Petersburg, Russia; Computational Physics Laboratory, Division of Plasma Physics, Atomic Physics and Astrophysics, Ioffe InstituteSaint Petersburg, Russia
| | - Aleksey V Zaitsev
- Laboratory of Molecular Mechanisms of Neural Interactions, Sechenov Institute of Evolutionary Physiology and Biochemistry of the Russian Academy of Sciences Saint Petersburg, Russia
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Kelley MR, Deeb TZ, Brandon NJ, Dunlop J, Davies PA, Moss SJ. Compromising KCC2 transporter activity enhances the development of continuous seizure activity. Neuropharmacology 2016; 108:103-10. [PMID: 27108931 PMCID: PMC5337122 DOI: 10.1016/j.neuropharm.2016.04.029] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2015] [Revised: 04/05/2016] [Accepted: 04/20/2016] [Indexed: 11/17/2022]
Abstract
Impaired neuronal inhibition has long been associated with the increased probability of seizure occurrence and heightened seizure severity. Fast synaptic inhibition in the brain is primarily mediated by the type A γ-aminobutyric acid receptors (GABAARs), ligand-gated ion channels that can mediate Cl(-) influx resulting in membrane hyperpolarization and the restriction of neuronal firing. In most adult brain neurons, the K(+)/Cl(-) co-transporter-2 (KCC2) establishes hyperpolarizing GABAergic inhibition by maintaining low [Cl(-)]i. In this study, we sought to understand how decreased KCC2 transport function affects seizure event severity. We impaired KCC2 transport in the 0-Mg(2+) ACSF and 4-aminopyridine in vitro models of epileptiform activity in acute mouse brain slices. Experiments with the selective KCC2 inhibitor VU0463271 demonstrated that reduced KCC2 transport increased the duration of SLEs, resulting in non-terminating discharges of clonic-like activity. We also investigated slices obtained from the KCC2-Ser940Ala (S940A) point-mutant mouse, which has a mutation at a known functional phosphorylation site causing behavioral and cellular deficits under hyperexcitable conditions. We recorded from the entorhinal cortex of S940A mouse brain slices in both 0-Mg(2+) ACSF and 4-aminopyridine, and demonstrated that loss of the S940 residue increased the susceptibility of continuous clonic-like discharges, an in vitro form of status epilepticus. Our experiments revealed KCC2 transport activity is a critical factor in seizure event duration and mechanisms of termination. Our results highlight the need for therapeutic strategies that potentiate KCC2 transport function in order to decrease seizure event severity and prevent the development of status epilepticus.
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Affiliation(s)
- Matthew R Kelley
- Department of Neuroscience, Tufts University School of Medicine, Boston, MA 02111, USA
| | - Tarek Z Deeb
- AstraZeneca Tufts Laboratory for Basic and Translational Neuroscience, Boston, MA 02111, USA
| | - Nicholas J Brandon
- AstraZeneca Neuroscience, Innovative Medicines and Early Development Biotech Unit, 141, Portland St, Cambridge, MA, USA
| | - John Dunlop
- AstraZeneca Neuroscience, Innovative Medicines and Early Development Biotech Unit, 141, Portland St, Cambridge, MA, USA
| | - Paul A Davies
- Department of Neuroscience, Tufts University School of Medicine, Boston, MA 02111, USA
| | - Stephen J Moss
- Department of Neuroscience, Tufts University School of Medicine, Boston, MA 02111, USA; AstraZeneca Tufts Laboratory for Basic and Translational Neuroscience, Boston, MA 02111, USA; Department of Neuroscience, Physiology and Pharmacology, University College, London, WC1E 6BT, UK.
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30
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Botterill JJ, Nogovitsyn N, Caruncho HJ, Kalynchuk LE. Selective plasticity of hippocampal GABAergic interneuron populations following kindling of different brain regions. J Comp Neurol 2016; 525:389-406. [PMID: 27362579 DOI: 10.1002/cne.24071] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Revised: 06/06/2016] [Accepted: 06/28/2016] [Indexed: 12/20/2022]
Abstract
The vulnerability and plasticity of hippocampal GABAergic interneurons is a topic of broad interest and debate in the field of epilepsy. In this experiment, we used the electrical kindling model of epilepsy to determine whether seizures that originate in different brain regions have differential effects on hippocampal interneuron subpopulations. Long-Evans rats received 99 electrical stimulations of the hippocampus, amygdala, or caudate nucleus, followed by sacrifice and immunohistochemical or western blot analyses. We analyzed markers of dendritic (somatostatin), perisomatic (parvalbumin), and interneuron-selective (calretinin) inhibition, as well as an overall indicator (GAD67) of interneuron distribution across all major hippocampal subfields. Our results indicate that kindling produces selective effects on the number and morphology of different functional classes of GABAergic interneurons. In particular, limbic kindling appears to enhance dendritic inhibition, indicated by a greater number of somatostatin-immunoreactive (-ir) cells in the CA1 pyramidal layer and robust morphological sprouting in the dentate gyrus. We also found a reduction in the number of interneuron-selective calretinin-ir cells in the dentate gyrus of hippocampal-kindled rats, which suggests a possible reduction of synchronized dendritic inhibition. In contrast, perisomatic inhibition indicated by parvalbumin immunoreactivity appears to be largely resilient to the effects of kindling. Finally, we found a significant induction in the number of GAD67-cells in caudate-kindled rats in the dentate gyrus and CA3 hippocampal subfields. Taken together, our results demonstrate that kindling has subfield-selective effects on the different functional classes of hippocampal GABAergic interneurons. J. Comp. Neurol. 525:389-406, 2017. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- J J Botterill
- Department of Psychology, University of Saskatchewan, Saskatoon, SK, Canada
| | - N Nogovitsyn
- Department of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - H J Caruncho
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK, Canada
| | - L E Kalynchuk
- Department of Medicine, University of Saskatchewan, Saskatoon, SK, Canada
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31
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Trevelyan AJ. Do Cortical Circuits Need Protecting from Themselves? Trends Neurosci 2016; 39:502-511. [PMID: 27378547 DOI: 10.1016/j.tins.2016.06.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Revised: 05/09/2016] [Accepted: 06/09/2016] [Indexed: 01/27/2023]
Abstract
All hippocampal and neocortical networks can be driven to seize quite easily. This can be done using drugs, by altering the ionic constituency of the bathing medium [cerebrospinal fluid (CSF)], or by electrical stimulation (both experimentally and clinically, as in electroconvulsive therapy). It is worth asking why this is so, because this will both tell us more about potentially devastating neurological disorders and extend our understanding of cortical function and architecture. Here I review work examining the features of cortical networks that bias activity towards and away from hyperexcitability. I suggest that several cellular- and circuit-level features of rapidly responsive interneuron networks tip the balance away from seizure in the healthy brain.
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Affiliation(s)
- Andrew J Trevelyan
- Institute of Neuroscience, Medical School, Framlington Place, Newcastle upon Tyne NE2 4HH, UK.
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32
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de Curtis M, Avoli M. GABAergic networks jump-start focal seizures. Epilepsia 2016; 57:679-87. [PMID: 27061793 DOI: 10.1111/epi.13370] [Citation(s) in RCA: 89] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/19/2016] [Indexed: 01/20/2023]
Abstract
Abnormally enhanced glutamatergic excitation is commonly believed to mark the onset of a focal seizure. This notion, however, is not supported by firm evidence, and it will be challenged here. A general reduction of unit firing has been indeed observed in association with low-voltage fast activity at the onset of seizures recorded during presurgical intracranial monitoring in patients with focal, drug-resistant epilepsies. Moreover, focal seizures in animal models start with increased γ-aminobutyric acid (GABA)ergic interneuronal activity that silences principal cells. In vitro studies have shown that synchronous activation of GABAA receptors occurs at seizure onset and causes sizeable elevations in extracellular potassium, thus facilitating neuronal recruitment and seizure progression. A paradoxical involvement of GABAergic networks is required for the initiation of focal seizures characterized by low-voltage fast activity, which represents the most common seizure-onset pattern in focal epilepsies.
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Affiliation(s)
| | - Massimo Avoli
- Montreal Neurological Institute, McGill University, Montréal, Quebec, Canada.,Faculty of Medicine and Dentistry, La Sapienza University, Rome, Italy
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33
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Abstract
This review centers on the discoveries made during more than six decades of neuroscience research on the role of gamma-amino-butyric acid (GABA) as neurotransmitter. In doing so, special emphasis is directed to the significant involvement of Canadian scientists in these advances. Starting with the early studies that established GABA as an inhibitory neurotransmitter at central synapses, we summarize the results pointing at the GABA receptor as a drug target as well as more recent evidence showing that GABAA receptor signaling plays a surprisingly active role in neuronal network synchronization, both during development and in the adult brain. Finally, we briefly address the involvement of GABA in neurological conditions that encompass epileptic disorders and mental retardation.
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34
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Abstract
γ-Aminobutyric acid (GABA) is the main inhibitory neurotransmitter in the cerebral cortex. GABAergic inhibition enables synchronization of activity in cortical networks, and contributes to generation of variety of brain activity patterns. In relation to epilepsy, GABAergic inhibition has been traditionally viewed as the main mechanism counterbalancing glutamatergic excitation and preventing hypersynchronous neuronal discharges. Indeed, deficits in GABAergic functions most commonly result in a hyperexcitable epileptic state, and many of the currently used antiepileptic drugs act through enhancement of GABAergic functions. However, a number of observations show that some epileptiform activity patterns involve synchronization by GABAergic mechanisms. These include two main categories that will be reviewed here: (1) synchronization of epileptiform oscillations based on GABAergic inhibition, and (2) epileptiform events driven by depolarizing and excitatory GABA. The conclusion is reached that GABAergic control of spike timing, either through inhibition or excitation under certain conditions, may work as a powerful synchronizing mechanism during epilepsy.
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Affiliation(s)
- Roustem Khazipov
- INMED-INSERM U901, 13273 Marseille Cedex 09, France Aix-Marseille University, 13273 Marseille Cedex 09, France Laboratory of Neurobiology, Kazan Federal University, 420008 Kazan, Russia
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35
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Raimondo JV, Burman RJ, Katz AA, Akerman CJ. Ion dynamics during seizures. Front Cell Neurosci 2015; 9:419. [PMID: 26539081 PMCID: PMC4612498 DOI: 10.3389/fncel.2015.00419] [Citation(s) in RCA: 101] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Accepted: 10/04/2015] [Indexed: 12/14/2022] Open
Abstract
Changes in membrane voltage brought about by ion fluxes through voltage and transmitter-gated channels represent the basis of neural activity. As such, electrochemical gradients across the membrane determine the direction and driving force for the flow of ions and are therefore crucial in setting the properties of synaptic transmission and signal propagation. Ion concentration gradients are established by a variety of mechanisms, including specialized transporter proteins. However, transmembrane gradients can be affected by ionic fluxes through channels during periods of elevated neural activity, which in turn are predicted to influence the properties of on-going synaptic transmission. Such activity-induced changes to ion concentration gradients are a feature of both physiological and pathological neural processes. An epileptic seizure is an example of severely perturbed neural activity, which is accompanied by pronounced changes in intracellular and extracellular ion concentrations. Appreciating the factors that contribute to these ion dynamics is critical if we are to understand how a seizure event evolves and is sustained and terminated by neural tissue. Indeed, this issue is of significant clinical importance as status epilepticus—a type of seizure that does not stop of its own accord—is a life-threatening medical emergency. In this review we explore how the transmembrane concentration gradient of the six major ions (K+, Na+, Cl−, Ca2+, H+and HCO3−) is altered during an epileptic seizure. We will first examine each ion individually, before describing how multiple interacting mechanisms between ions might contribute to concentration changes and whether these act to prolong or terminate epileptic activity. In doing so, we will consider how the availability of experimental techniques has both advanced and restricted our ability to study these phenomena.
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Affiliation(s)
- Joseph V Raimondo
- Department of Human Biology, Faculty of Health Sciences, University of Cape Town Cape Town, South Africa ; UCT/MRC Receptor Biology Unit, Department of Integrative Biomedical Sciences and Institute of Infectious Disease and Molecular Medicine, Faculty of Health Sciences, University of Cape Town Cape Town, South Africa
| | - Richard J Burman
- UCT/MRC Receptor Biology Unit, Department of Integrative Biomedical Sciences and Institute of Infectious Disease and Molecular Medicine, Faculty of Health Sciences, University of Cape Town Cape Town, South Africa
| | - Arieh A Katz
- UCT/MRC Receptor Biology Unit, Department of Integrative Biomedical Sciences and Institute of Infectious Disease and Molecular Medicine, Faculty of Health Sciences, University of Cape Town Cape Town, South Africa
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Saitsu H, Akita T, Tohyama J, Goldberg-Stern H, Kobayashi Y, Cohen R, Kato M, Ohba C, Miyatake S, Tsurusaki Y, Nakashima M, Miyake N, Fukuda A, Matsumoto N. De novo KCNB1 mutations in infantile epilepsy inhibit repetitive neuronal firing. Sci Rep 2015; 5:15199. [PMID: 26477325 PMCID: PMC4609934 DOI: 10.1038/srep15199] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Accepted: 09/21/2015] [Indexed: 11/09/2022] Open
Abstract
The voltage-gated Kv2.1 potassium channel encoded by KCNB1 produces the major delayed rectifier potassium current in pyramidal neurons. Recently, de novo heterozygous missense KCNB1 mutations have been identified in three patients with epileptic encephalopathy and a patient with neurodevelopmental disorder. However, the frequency of KCNB1 mutations in infantile epileptic patients and their effects on neuronal activity are yet unknown. We searched whole exome sequencing data of a total of 437 patients with infantile epilepsy, and found novel de novo heterozygous missense KCNB1 mutations in two patients showing psychomotor developmental delay and severe infantile generalized seizures with high-amplitude spike-and-wave electroencephalogram discharges. The mutation located in the channel voltage sensor (p.R306C) disrupted sensitivity and cooperativity of the sensor, while the mutation in the channel pore domain (p.G401R) selectively abolished endogenous Kv2 currents in transfected pyramidal neurons, indicating a dominant-negative effect. Both mutants inhibited repetitive neuronal firing through preventing production of deep interspike voltages. Thus KCNB1 mutations can be a rare genetic cause of infantile epilepsy, and insufficient firing of pyramidal neurons would disturb both development and stability of neuronal circuits, leading to the disease phenotypes.
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Affiliation(s)
- Hirotomo Saitsu
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Tenpei Akita
- Department of Neurophysiology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Jun Tohyama
- Department of Pediatrics, Epilepsy Center, Nishi-Niigata Chuo National Hospital, Niigata, Japan
| | | | - Yu Kobayashi
- Department of Pediatrics, Epilepsy Center, Nishi-Niigata Chuo National Hospital, Niigata, Japan
| | - Roni Cohen
- Epilepsy Center, Schneider's Children Medical Center, Petah Tiqwa, Israel
| | - Mitsuhiro Kato
- Department of Pediatrics, Yamagata University Faculty of Medicine, Yamagata, Japan
| | - Chihiro Ohba
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Satoko Miyatake
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Yoshinori Tsurusaki
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Mitsuko Nakashima
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Noriko Miyake
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Atsuo Fukuda
- Department of Neurophysiology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Naomichi Matsumoto
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan
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Unit Activity of Hippocampal Interneurons before Spontaneous Seizures in an Animal Model of Temporal Lobe Epilepsy. J Neurosci 2015; 35:6600-18. [PMID: 25904809 DOI: 10.1523/jneurosci.4786-14.2015] [Citation(s) in RCA: 83] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Mechanisms of seizure initiation are unclear. To evaluate the possible roles of inhibitory neurons, unit recordings were obtained in the dentate gyrus, CA3, CA1, and subiculum of epileptic pilocarpine-treated rats as they experienced spontaneous seizures. Most interneurons in the dentate gyrus, CA1, and subiculum increased their firing rate before seizures, and did so with significant consistency from seizure to seizure. Identification of CA1 interneuron subtypes based on firing characteristics during theta and sharp waves suggested that a parvalbumin-positive basket cell and putative bistratified cells, but not oriens lacunosum moleculare cells, were activated preictally. Preictal changes occurred much earlier than those described by most previous in vitro studies. Preictal activation of interneurons began earliest (>4 min before seizure onset), increased most, was most prevalent in the subiculum, and was minimal in CA3. Preictal inactivation of interneurons was most common in CA1 (27% of interneurons) and included a putative ivy cell and parvalbumin-positive basket cell. Increased or decreased preictal activity correlated with whether interneurons fired faster or slower, respectively, during theta activity. Theta waves were more likely to occur before seizure onset, and increased preictal firing of subicular interneurons correlated with theta activity. Preictal changes by other hippocampal interneurons were largely independent of theta waves. Within seconds of seizure onset, many interneurons displayed a brief pause in firing and a later, longer drop that was associated with reduced action potential amplitude. These findings suggest that many interneurons inactivate during seizures, most increase their activity preictally, but some fail to do so at the critical time before seizure onset.
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de Curtis M, Avoli M. Initiation, Propagation, and Termination of Partial (Focal) Seizures. Cold Spring Harb Perspect Med 2015; 5:a022368. [PMID: 26134843 PMCID: PMC4484951 DOI: 10.1101/cshperspect.a022368] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
The neurophysiological patterns that correlate with partial (focal) seizures are well defined in humans by standard electroencephalogram (EEG) and presurgical depth electrode recordings. Seizure patterns with similar features are reproduced in animal models of partial seizures and epilepsy. However, the network determinants that support interictal spikes, as well as the initiation, progression, and termination of seizures, are still elusive. Recent findings show that inhibitory networks are prominently involved at the onset of these seizures, and that extracellular changes in potassium contribute to initiate and sustain seizure progression. The end of a partial seizure correlates with an increase in network synchronization, which possibly involves both excitatory and inhibitory mechanisms.
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Affiliation(s)
- Marco de Curtis
- Unit of Epileptology and Experimental Neurophysiology and Fondazione Istituto Neurologico Carlo Besta, 20133 Milano, Italy
| | - Massimo Avoli
- Montreal Neurological Institute and Departments of Neurology and Neurosurgery and Physiology, McGill University, Montréal, H3A 2B4 Québec, Canada Department of Experimental Medicine, Facoltà di Medicina e Odontoiatria, Sapienza Università di Roma, 00185 Roma, Italy
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39
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Sivakumaran S, Cardarelli RA, Maguire J, Kelley MR, Silayeva L, Morrow DH, Mukherjee J, Moore YE, Mather RJ, Duggan ME, Brandon NJ, Dunlop J, Zicha S, Moss SJ, Deeb TZ. Selective inhibition of KCC2 leads to hyperexcitability and epileptiform discharges in hippocampal slices and in vivo. J Neurosci 2015; 35:8291-6. [PMID: 26019342 PMCID: PMC4444547 DOI: 10.1523/jneurosci.5205-14.2015] [Citation(s) in RCA: 75] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Revised: 04/07/2015] [Accepted: 04/20/2015] [Indexed: 11/21/2022] Open
Abstract
GABA(A) receptors form Cl(-) permeable channels that mediate the majority of fast synaptic inhibition in the brain. The K(+)/Cl(-) cotransporter KCC2 is the main mechanism by which neurons establish low intracellular Cl(-) levels, which is thought to enable GABAergic inhibitory control of neuronal activity. However, the widely used KCC2 inhibitor furosemide is nonselective with antiseizure efficacy in slices and in vivo, leading to a conflicting scheme of how KCC2 influences GABAergic control of neuronal synchronization. Here we used the selective KCC2 inhibitor VU0463271 [N-cyclopropyl-N-(4-methyl-2-thiazolyl)-2-[(6-phenyl-3-pyridazinyl)thio]acetamide] to investigate the influence of KCC2 function. Application of VU0463271 caused a reversible depolarizing shift in E(GABA) values and increased spiking of cultured hippocampal neurons. Application of VU0463271 to mouse hippocampal slices under low-Mg(2+) conditions induced unremitting recurrent epileptiform discharges. Finally, microinfusion of VU0463271 alone directly into the mouse dorsal hippocampus rapidly caused epileptiform discharges. Our findings indicated that KCC2 function was a critical inhibitory factor ex vivo and in vivo.
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Affiliation(s)
- Sudhir Sivakumaran
- Department of Neuroscience, Tufts University School of Medicine, Boston, Massachusetts 02111, Department of Biosciences, University of Helsinki, 00014 Helsinki, Finland
| | - Ross A Cardarelli
- AstraZeneca Tufts Laboratory for Basic and Translational Neuroscience, Boston, Massachusetts 02111
| | - Jamie Maguire
- Department of Neuroscience, Tufts University School of Medicine, Boston, Massachusetts 02111
| | - Matt R Kelley
- Department of Neuroscience, Tufts University School of Medicine, Boston, Massachusetts 02111
| | - Liliya Silayeva
- AstraZeneca Tufts Laboratory for Basic and Translational Neuroscience, Boston, Massachusetts 02111
| | - Danielle H Morrow
- Department of Neuroscience, Tufts University School of Medicine, Boston, Massachusetts 02111
| | - Jayanta Mukherjee
- AstraZeneca Tufts Laboratory for Basic and Translational Neuroscience, Boston, Massachusetts 02111
| | - Yvonne E Moore
- Department of Neuroscience, Tufts University School of Medicine, Boston, Massachusetts 02111
| | - Robert J Mather
- AstraZeneca Tufts Laboratory for Basic and Translational Neuroscience, Boston, Massachusetts 02111, AstraZeneca Neuroscience iMED, Cambridge, Massachusetts 02139, and
| | - Mark E Duggan
- AstraZeneca Tufts Laboratory for Basic and Translational Neuroscience, Boston, Massachusetts 02111, AstraZeneca Neuroscience iMED, Cambridge, Massachusetts 02139, and
| | - Nicholas J Brandon
- AstraZeneca Tufts Laboratory for Basic and Translational Neuroscience, Boston, Massachusetts 02111, AstraZeneca Neuroscience iMED, Cambridge, Massachusetts 02139, and
| | - John Dunlop
- AstraZeneca Tufts Laboratory for Basic and Translational Neuroscience, Boston, Massachusetts 02111, AstraZeneca Neuroscience iMED, Cambridge, Massachusetts 02139, and
| | - Stephen Zicha
- AstraZeneca Tufts Laboratory for Basic and Translational Neuroscience, Boston, Massachusetts 02111, AstraZeneca Neuroscience iMED, Cambridge, Massachusetts 02139, and
| | - Stephen J Moss
- Department of Neuroscience, Tufts University School of Medicine, Boston, Massachusetts 02111, AstraZeneca Tufts Laboratory for Basic and Translational Neuroscience, Boston, Massachusetts 02111, Department of Neuroscience, Physiology and Pharmacology, University College, London, WC1E 6BT, United Kingdom
| | - Tarek Z Deeb
- AstraZeneca Tufts Laboratory for Basic and Translational Neuroscience, Boston, Massachusetts 02111,
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Synchronous inhibitory potentials precede seizure-like events in acute models of focal limbic seizures. J Neurosci 2015; 35:3048-55. [PMID: 25698742 DOI: 10.1523/jneurosci.3692-14.2015] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Interictal spikes in models of focal seizures and epilepsies are sustained by the synchronous activation of glutamatergic and GABAergic networks. The nature of population spikes associated with seizure initiation (pre-ictal spikes; PSs) is still undetermined. We analyzed the networks involved in the generation of both interictal and PSs in acute models of limbic cortex ictogenesis induced by pharmacological manipulations. Simultaneous extracellular and intracellular recordings from both principal cells and interneurons were performed in the medial entorhinal cortex of the in vitro isolated guinea pig brain during focal interictal and ictal discharges induced in the limbic network by intracortical and brief arterial infusions of either bicuculline methiodide (BMI) or 4-aminopyridine (4AP). Local application of BMI in the entorhinal cortex did not induce seizure-like events (SLEs), but did generate periodic interictal spikes sensitive to the glutamatergic non-NMDA receptor antagonist DNQX. Unlike local applications, arterial perfusion of either BMI or 4AP induced focal limbic SLEs. PSs just ahead of SLE were associated with hyperpolarizing potentials coupled with a complete blockade of firing in principal cells and burst discharges in putative interneurons. Interictal population spikes recorded from principal neurons between two SLEs correlated with a depolarizing potential. We demonstrate in two models of acute limbic SLE that PS events are different from interictal spikes and are sustained by synchronous activation of inhibitory networks. Our findings support a prominent role of synchronous network inhibition in the initiation of a focal seizure.
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Excitatory effects of parvalbumin-expressing interneurons maintain hippocampal epileptiform activity via synchronous afterdischarges. J Neurosci 2015; 34:15208-22. [PMID: 25392490 DOI: 10.1523/jneurosci.1747-14.2014] [Citation(s) in RCA: 126] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Epileptic seizures are characterized by periods of hypersynchronous, hyperexcitability within brain networks. Most seizures involve two stages: an initial tonic phase, followed by a longer clonic phase that is characterized by rhythmic bouts of synchronized network activity called afterdischarges (ADs). Here we investigate the cellular and network mechanisms underlying hippocampal ADs in an effort to understand how they maintain seizure activity. Using in vitro hippocampal slice models from rats and mice, we performed electrophysiological recordings from CA3 pyramidal neurons to monitor network activity and changes in GABAergic signaling during epileptiform activity. First, we show that the highest synchrony occurs during clonic ADs, consistent with the idea that specific circuit dynamics underlie this phase of the epileptiform activity. We then show that ADs require intact GABAergic synaptic transmission, which becomes excitatory as a result of a transient collapse in the chloride (Cl(-)) reversal potential. The depolarizing effects of GABA are strongest at the soma of pyramidal neurons, which implicates somatic-targeting interneurons in AD activity. To test this, we used optogenetic techniques to selectively control the activity of somatic-targeting parvalbumin-expressing (PV(+)) interneurons. Channelrhodopsin-2-mediated activation of PV(+) interneurons during the clonic phase generated excitatory GABAergic responses in pyramidal neurons, which were sufficient to elicit and entrain synchronous AD activity across the network. Finally, archaerhodopsin-mediated selective silencing of PV(+) interneurons reduced the occurrence of ADs during the clonic phase. Therefore, we propose that activity-dependent Cl(-) accumulation subverts the actions of PV(+) interneurons to perpetuate rather than terminate pathological network hyperexcitability during the clonic phase of seizures.
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Yekhlef L, Breschi GL, Lagostena L, Russo G, Taverna S. Selective activation of parvalbumin- or somatostatin-expressing interneurons triggers epileptic seizurelike activity in mouse medial entorhinal cortex. J Neurophysiol 2014; 113:1616-30. [PMID: 25505119 DOI: 10.1152/jn.00841.2014] [Citation(s) in RCA: 104] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
GABAergic interneurons are thought to play a critical role in eliciting interictal spikes (IICs) and triggering ictal discharges in temporal lobe epilepsy, yet the contribution of different interneuronal subtypes to seizure initiation is still largely unknown. Here we took advantage of optogenetic techniques combined with patch-clamp and field recordings to selectively stimulate parvalbumin (PV)- or somatostatin (SOM)-positive interneurons expressing channelrhodopsin-2 (CHR-2) in layers II-III of adult mouse medial entorhinal cortical slices during extracellular perfusion with the proconvulsive compound 4-aminopyridine (4-AP, 100-200 μM). In control conditions, blue laser photostimulation selectively activated action potential firing in either PV or SOM interneurons and, in both cases, caused a robust GABAA-receptor-mediated inhibition in pyramidal cells (PCs). During perfusion with 4-AP, brief photostimuli (300 ms) activating either PV or SOM interneurons induced patterns of epileptiform activity that closely replicated spontaneously occurring IICs and tonic-clonic ictal discharges. Laser-induced synchronous firing in both interneuronal types elicited large compound GABAergic inhibitory postsynaptic currents (IPSCs) correlating with IICs and preictal spikes. In addition, spontaneous and laser-induced epileptic events were similarly initiated in concurrence with a large increase in extracellular potassium concentration. Finally, interneuron activation was unable to stop or significantly shorten the progression of seizurelike episodes. These results suggest that entorhinal PV and SOM interneurons are nearly equally effective in triggering interictal and ictal discharges that closely resemble human temporal lobe epileptic activity.
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Affiliation(s)
- Latefa Yekhlef
- Department of Neuroscience and Brain Technologies, Istituto Italiano di Tecnologia, Genoa, Italy
| | - Gian Luca Breschi
- Department of Neuroscience and Brain Technologies, Istituto Italiano di Tecnologia, Genoa, Italy
| | - Laura Lagostena
- Department of Neuroscience and Brain Technologies, Istituto Italiano di Tecnologia, Genoa, Italy
| | - Giovanni Russo
- Department of Neuroscience and Brain Technologies, Istituto Italiano di Tecnologia, Genoa, Italy
| | - Stefano Taverna
- Department of Neuroscience and Brain Technologies, Istituto Italiano di Tecnologia, Genoa, Italy
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43
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Khazipov R, Valeeva G, Khalilov I. Depolarizing GABA and developmental epilepsies. CNS Neurosci Ther 2014; 21:83-91. [PMID: 25438879 DOI: 10.1111/cns.12353] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2014] [Revised: 10/14/2014] [Accepted: 10/20/2014] [Indexed: 12/22/2022] Open
Abstract
Early in development, GABA, which is the main inhibitory neurotransmitter in adult brain, depolarizes immature neurons and exerts dual--excitatory and shunting/inhibitory--effects in the developing neuronal networks. The present review discusses some general questions, including the properties of excitation at depolarizing GABAergic synapse and shunting inhibition by depolarizing GABA; technical issues in exploration of depolarizing GABA using various techniques and preparations, including the developmental aspects of traumatic injury and what is known (or rather unknown) on the actions of GABA in vivo; complex roles of depolarizing GABA in developmental epilepsies, including a contribution of depolarizing GABA to enhanced excitability in the immature networks, caused by repetitive seizures accumulation of intracellular chloride concentration that increases excitatory GABA power and its synchronizing proconvulsive effects, and correction of chloride homeostasis as a potential strategy to treat neonatal seizures.
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Affiliation(s)
- Roustem Khazipov
- INMED-INSERM U901, Marseille, France; Aix-Marseille University, Marseille, France; Laboratory of Neurobiology, Kazan Federal University, Kazan, Russia
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Szilágyi T, Száva I, Metz EJ, Mihály I, Orbán-Kis K. Untangling the pathomechanisms of temporal lobe epilepsy—The promise of epileptic biomarkers and novel therapeutic approaches. Brain Res Bull 2014; 109:1-12. [DOI: 10.1016/j.brainresbull.2014.08.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2014] [Revised: 08/11/2014] [Accepted: 08/14/2014] [Indexed: 12/30/2022]
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45
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Boido D, Gnatkovsky V, Uva L, Francione S, de Curtis M. Simultaneous enhancement of excitation and postburst inhibition at the end of focal seizures. Ann Neurol 2014; 76:826-36. [PMID: 24916758 DOI: 10.1002/ana.24193] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2014] [Revised: 06/04/2014] [Accepted: 06/04/2014] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Comprehension of the events that lead to seizure termination contributes to the development of strategies to confine propagation of ictal discharges. It is commonly assumed that the inhibitory control fails during seizures and recovers after the end of the ictal event. We examine the possibility that a progressive increase of inhibition that counters an increase in the strength of excitation contributes to terminating a focal seizure. METHODS We analyzed seizures acutely induced by pharmacological manipulations (bicuculline and 4-aminopyridine) in the entorhinal cortex and in the hippocampus of the in vitro isolated guinea pig brain. RESULTS As seizures ended, extracellular and intracellular recordings showed periodic bursting that progressively decreased in frequency. During the late bursting phase, the duration, number, and rate of occurrence of spikes within single bursts remained constant, whereas cumulative spike amplitude (index of excitation during a burst) and interburst interval (index of inhibition between bursts) progressively increased. The increment of average/cumulative burst excitation and interburst interval toward seizure end was confirmed in human focal seizures recorded with intracerebral electrodes in patients with drug-resistant partial epilepsies. A postburst refractory period of circa 2 seconds that increases with time toward the end of the seizure was confirmed in the experimental model by probing interburst epochs in the CA1 region with local dentate gyrus stimulation just suprathreshold for burst generation. INTERPRETATION Our findings support the concept that focal seizures are terminated by the simultaneous and opposing enhancement of excitation (burst activity) in addition to postburst inhibition. We hypothesize that a seizure stops when postburst inhibition becomes large enough to prevent reactivation of excitation.
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Affiliation(s)
- Davide Boido
- Unit of Epileptology and Experimental Neurophysiology, Carlo Besta Neurological Institute Foundation, Milan, Italy
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Świąder MJ, Kotowski J, Łuszczki JJ. Modulation of adenosinergic system and its application for the treatment of epilepsy. Pharmacol Rep 2014; 66:335-42. [DOI: 10.1016/j.pharep.2013.10.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2013] [Revised: 10/15/2013] [Accepted: 10/31/2013] [Indexed: 11/25/2022]
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How can we identify ictal and interictal abnormal activity? ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2014; 813:3-23. [PMID: 25012363 DOI: 10.1007/978-94-017-8914-1_1] [Citation(s) in RCA: 96] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
The International League Against Epilepsy (ILAE) defined a seizure as "a transient occurrence of signs and/or symptoms due to abnormal excessive or synchronous neuronal activity in the brain." This definition has been used since the era of Hughlings Jackson, and does not take into account subsequent advances made in epilepsy and neuroscience research. The clinical diagnosis of a seizure is empirical, based upon constellations of certain signs and symptoms, while simultaneously ruling out a list of potential imitators of seizures. Seizures should be delimited in time, but the borders of ictal (during a seizure), interictal (between seizures) and postictal (after a seizure) often are indistinct. EEG recording is potentially very helpful for confirmation, classification and localization. About a half-dozen common EEG patterns are encountered during seizures. Clinicians rely on researchers to answer such questions as why seizures start, spread and stop, whether seizures involve increased synchrony, the extent to which extra-cortical structures are involved, and how to identify the seizure network and at what points interventions are likely to be helpful. Basic scientists have different challenges in use of the word 'seizure,' such as distinguishing seizures from normal behavior, which would seem easy but can be very difficult because some rodents have EEG activity during normal behavior that resembles spike-wave discharge or bursts of rhythmic spiking. It is also important to define when a seizure begins and stops so that seizures can be quantified accurately for pre-clinical studies. When asking what causes seizures, the transition to a seizure and differentiating the pre-ictal, ictal and post-ictal state is also important because what occurs before a seizure could be causal and may warrant further investigation for that reason. These and other issues are discussed by three epilepsy researchers with clinical and basic science expertise.
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Blauwblomme T, Jiruska P, Huberfeld G. Mechanisms of ictogenesis. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2014; 114:155-85. [PMID: 25078502 DOI: 10.1016/b978-0-12-418693-4.00007-8] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Epilepsy is a paroxysmal condition characterized by repeated transient seizures separated by longer interictal periods. Ictogenesis describes the processes of transition from the interictal state to a seizure. The processes include a preictal state, with specific clinical signs and a distinct electrophysiology which may provide opportunities to anticipate, or even prevent, seizures. Biological mechanisms of ictogenesis remain poorly understood and may vary between conditions/syndromes. We review here ictogenic processes including the involvement of pyramidal cells, interneurons and astrocytes, GABAergic and glutamatergic signaling, and ionic perturbations. Our review suggests that specific excitatory influences at the transition to an ictal event include (1) GABA receptor activation with a neuronal Cl(-) load and (2) a transient increase in external K(+).
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Affiliation(s)
- Thomas Blauwblomme
- Neurosurgery Unit, Hopital Necker-Enfants Malades, APHP, Paris, France; Université Paris Descartes, Paris, France; INSERM U1129-Infantile Epilepsies and Brain Plasticity, Paris, France; University Paris Descartes, PRES Sorbonne Paris Cité, Paris, France; CEA, Gif sur Yvette, France
| | - Premysl Jiruska
- Department of Developmental Epileptology, Institute of Physiology, Academy of Sciences of Czech Republic, Prague, Czech Republic; Department of Neurology, 2nd Faculty of Medicine, Charles University in Prague, Motol University Hospital, Prague, Czech Republic
| | - Gilles Huberfeld
- INSERM U1129-Infantile Epilepsies and Brain Plasticity, Paris, France; University Paris Descartes, PRES Sorbonne Paris Cité, Paris, France; CEA, Gif sur Yvette, France; Clinical Neurophysiology Department, CHU Pitié-Salpêtrière, APHP, Paris, France; Université Pierre et Marie Curie, Paris, France.
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Cossart R. Operational hub cells: a morpho-physiologically diverse class of GABAergic neurons united by a common function. Curr Opin Neurobiol 2013; 26:51-6. [PMID: 24650504 DOI: 10.1016/j.conb.2013.12.002] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2013] [Revised: 11/06/2013] [Accepted: 12/03/2013] [Indexed: 11/30/2022]
Abstract
GABAergic microcircuits structure the activation of neuronal ensembles that support most cortical computations. Because of the heterogeneous nature of the GABAergic cell community, a full understanding of structure-function relationships in these microcircuits may be hampered by a reductionist approach that consists of classifying them according to an exhaustive collection of parameters. It therefore could be beneficial to our understanding of these complex cells to also consider other approaches. Thus, graph theory has recently taught us that biological networks often include hub nodes that are essential for information flow, and ensuing experimental evidence has demonstrated the existence of 'operational' hub neurons. So far, only GABAergic neurons have been identified as 'operational hubs', further emphasizing their critical function in controlling cortical network dynamics.
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Affiliation(s)
- Rosa Cossart
- INMED, INSERM U901, Aix-Marseille Université, Parc Scientifique de Luminy, BP.13, 13273 Marseille cedex 9, France.
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50
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Grasse DW, Karunakaran S, Moxon KA. Neuronal synchrony and the transition to spontaneous seizures. Exp Neurol 2013; 248:72-84. [DOI: 10.1016/j.expneurol.2013.05.004] [Citation(s) in RCA: 88] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2013] [Revised: 04/30/2013] [Accepted: 05/07/2013] [Indexed: 11/28/2022]
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