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Uva L, Bruno G, de Curtis M. Activity-dependent extracellular potassium changes in unmyelinated versus myelinated areas in olfactory regions of the isolated female guinea-pig brain. Exp Neurol 2024; 379:114884. [PMID: 38992824 DOI: 10.1016/j.expneurol.2024.114884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Revised: 06/26/2024] [Accepted: 07/08/2024] [Indexed: 07/13/2024]
Abstract
The potassium released in the extracellular space during neuronal activity is rapidly removed by glia and neurons to maintain tissue homeostasis. Oligodendrocyte-derived myelin axonal coating contributes to potassium buffering and is therefore crucial to control brain excitability. We studied activity-dependent extracellular potassium ([K+]o) changes in the piriform cortex (PC), a region that features highly segregated bundles of myelinated and unmyelinated fibers. Four-aminopyridine (4AP; 50 μM) treatment or patterned high-frequency stimulations (hfST) were utilized to generate [K+]o changes measured with potassium-sensitive electrodes in the myelinated lateral olfactory tract (LOT), in the unmyelinated PC layer I and in the myelinated deep PC layers in the ex vivo isolated guinea-pig brain. Seizure-like events induced by 4AP are initiated by the abrupt [K+]o rise in the layer I formed by unmyelinated fibers (Uva et al., 2017). Larger [K+]o shifts occurred in unmyelinated layers compared to the myelinated LOT. LOT hfST that mimicks pre-seizure discharges also generated higher [K+]o changes in unmyelinated PC layer I than in LOT and deep PC layers. The treatment with the Kir4.1 potassium channel blocker BaCl2 (100 μM) enhanced the [K+]o changes generated by hfST in myelinated structures. Our data show that activity-dependent [K+]o changes are intrinsically different in myelinated vs unmyelinated cortical regions. The larger [K+]o shifts generated in unmyelinated structures may represent a vehicle for seizure generation.
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Affiliation(s)
- Laura Uva
- Epilepsy Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, via Celoria 11/via Amadeo 42, Milano, Italy..
| | - Gaia Bruno
- Epilepsy Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, via Celoria 11/via Amadeo 42, Milano, Italy.; Dipartimento di Biologia e Biotecnologia, via Forlanini, 6, Università di Pavia, 27100, Pavia, Italy..
| | - Marco de Curtis
- Epilepsy Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, via Celoria 11/via Amadeo 42, Milano, Italy..
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2
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Scalmani P, Paterra R, Mantegazza M, Avoli M, de Curtis M. Involvement of GABAergic Interneuron Subtypes in 4-Aminopyridine-Induced Seizure-Like Events in Mouse Entorhinal Cortex in Vitro. J Neurosci 2023; 43:1987-2001. [PMID: 36810229 PMCID: PMC10027059 DOI: 10.1523/jneurosci.1190-22.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 12/30/2022] [Accepted: 01/05/2023] [Indexed: 02/23/2023] Open
Abstract
Single-unit recordings performed in temporal lobe epilepsy patients and in models of temporal lobe seizures have shown that interneurons are active at focal seizure onset. We performed simultaneous patch-clamp and field potential recordings in entorhinal cortex slices of GAD65 and GAD67 C57BL/6J male mice that express green fluorescent protein in GABAergic neurons to analyze the activity of specific interneuron (IN) subpopulations during acute seizure-like events (SLEs) induced by 4-aminopyridine (4-AP; 100 μm). IN subtypes were identified as parvalbuminergic (INPV, n = 17), cholecystokinergic (INCCK), n = 13], and somatostatinergic (INSOM, n = 15), according to neurophysiological features and single-cell digital PCR. INPV and INCCK discharged at the start of 4-AP-induced SLEs characterized by either low-voltage fast or hyper-synchronous onset pattern. In both SLE onset types, INSOM fired earliest before SLEs, followed by INPV and INCCK discharges. Pyramidal neurons became active with variable delays after SLE onset. Depolarizing block was observed in ∼50% of cells in each INs subgroup, and it was longer in IN (∼4 s) than in pyramidal neurons (<1 s). As SLE evolved, all IN subtypes generated action potential bursts synchronous with the field potential events leading to SLE termination. High-frequency firing throughout the SLE occurred in one-third of INPV and INSOM We conclude that entorhinal cortex INs are very active at the onset and during the progression of SLEs induced by 4-AP. These results support earlier in vivo and in vivo evidence and suggest that INs have a preferential role in focal seizure initiation and development.SIGNIFICANCE STATEMENT Focal seizures are believed to result from enhanced excitation. Nevertheless, we and others demonstrated that cortical GABAergic networks may initiate focal seizures. Here, we analyzed for the first time the role of different IN subtypes in seizures generated by 4-aminopyridine in the mouse entorhinal cortex slices. We found that in this in vitro focal seizure model, all IN types contribute to seizure initiation and that INs precede firing of principal cells. This evidence is in agreement with the active role of GABAergic networks in seizure generation.
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Affiliation(s)
| | - Rosina Paterra
- Neuro-Oncology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano 20133, Italy
| | - Massimo Mantegazza
- Université Côte d'Azur, 06560 Valbonne-Sophia Antipolis, France
- Institute of Molecular and Cellular Pharmacology, Centre National de la Recherche Scientifique, Unité Mixte de Recherche 7275, Laboratoire d'Excellence/Canaux Ioniques d'Intérêt Thérapeutique, 06650 Valbonne-Sophia Antipolis, France
- Institut National de la Santé et de la Recherche Médicale, 06650 Valbonne-Sophia Antipolis, France
| | - Massimo Avoli
- Montreal Neurological Institute-Hospital, McGill University, Montreal, Quebec H3A 2B4, Canada
- Departments of Neurology and Neurosurgery and Physiology, McGill University, Montreal, Quebec H3A 2B4, Canada
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3
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Limbic and olfactory cortical circuits in focal seizures. Neurobiol Dis 2023; 178:106007. [PMID: 36682502 DOI: 10.1016/j.nbd.2023.106007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 01/17/2023] [Accepted: 01/18/2023] [Indexed: 01/22/2023] Open
Abstract
Epilepsies affecting the limbic regions are common and generate seizures often resistant to pharmacological treatment. Clinical evidence demonstrates that diverse regions of the mesial portion of the temporal lobe participate in limbic seizures; these include the hippocampus, the entorhinal, perirhinal and parahippocampal regions and the piriform cortex. The network mechanisms involved in the generation of olfactory-limbic epileptiform patterns will be here examined, with particular emphasis on acute interictal and ictal epileptiform discharges obtained by treatment with pro-convulsive drugs and by high-frequency stimulations on in vitro preparations, such as brain slices and the isolated guinea pig brain. The interactions within olfactory-limbic circuits can be summarized as follows: independent, region-specific seizure-like events (SLE) are generated in the olfactory and in the limbic cortex; SLEs generated in the hippocampal-parahippocampal regions tend to remain within these areas; the perirhinal region controls the neocortical propagation and the generalization of limbic seizures; interictal spiking in the olfactory regions prevents the invasion by SLEs generated in limbic regions. The potential relevance of these observations for human focal epilepsy is discussed.
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4
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Kinboshi M. [Studying abroad for epilepsy basic research during the COVID-19 pandemic]. Rinsho Shinkeigaku 2023; 63:105-107. [PMID: 36843023 DOI: 10.5692/clinicalneurol.63_2_studyabroad1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2023]
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5
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Koike-Kumagai M, Fujimoto M, Wataya-Kaneda M. Sirolimus relieves seizures and neuropsychiatric symptoms via changes of microglial polarity in tuberous sclerosis complex model mice. Neuropharmacology 2022; 218:109203. [PMID: 35931213 DOI: 10.1016/j.neuropharm.2022.109203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 07/21/2022] [Accepted: 07/23/2022] [Indexed: 10/31/2022]
Abstract
Tuberous sclerosis complex (TSC) is a genetic disorder involving a variety of physical manifestations, and is associated with epilepsy and multiple serious neuropsychiatric symptoms. These symptoms are collectively known as TSC-associated neuropsychiatric disorders (TAND), which is a severe burden for patients and their families. Overactivation of the mechanistic target of rapamycin complex 1 (mTORC1) by mutations in TSC1 or TSC2 is thought to cause TSC, and mTORC1 inhibitors such as sirolimus and everolimus are reported to be effective against various tumor types of TSC. However, there are various reports on the effect of mTORC1 inhibitor therapy on TAND in patients with TSC, which may or may not be effective. In our previous investigations, we generated TSC2 conditional knockout mice (Mitf-Cre, Tsc2 KO; Tsc2 cKO). These mice developed spontaneous epileptic activity. In the current study, we further analyzed the detailed behaviors of Tsc2 cKO mice and confirmed that they exhibited phenotypes of TAND as well as epileptic seizures, indicating that Tsc2 cKO mice are a useful model for TAND. Furthermore, the olfactory bulb and piriform cortex caused epilepsy and TAND in Tsc2 cKO mice, and neurodegeneration was observed. Immunohistology and immunophenotypic analysis of cells, and quantitative RT-PCR suggested that changes in microglial polarity were involved in the onset of TSC epilepsy and neuropsychiatric symptoms. Although the effect of mTORC1 inhibitors on TAND has not been established, the results of this study might help elucidate the mechanism of TAND pathogenesis and suggest that sirolimus may be a valuable therapeutic tool for TAND.
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Affiliation(s)
- Makiko Koike-Kumagai
- Department of Neurocutaneous Medicine, Division of Health Sciences, Graduate School of Medicine, Osaka University, 2-1 Yamada-oka, Suita, Osaka, 565-0871, Japan.
| | - Manabu Fujimoto
- Department of Dermatology, Graduate School of Medicine, Osaka University, 2-2 Yamada-oka, Suita, Osaka, 565-0871, Japan.
| | - Mari Wataya-Kaneda
- Department of Neurocutaneous Medicine, Division of Health Sciences, Graduate School of Medicine, Osaka University, 2-1 Yamada-oka, Suita, Osaka, 565-0871, Japan.
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6
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Traub RD, Tu Y, Whittington MA. Cell assembly formation and structure in a piriform cortex model. Rev Neurosci 2021; 33:111-132. [PMID: 34271607 DOI: 10.1515/revneuro-2021-0056] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Accepted: 06/19/2021] [Indexed: 11/15/2022]
Abstract
The piriform cortex is rich in recurrent excitatory synaptic connections between pyramidal neurons. We asked how such connections could shape cortical responses to olfactory lateral olfactory tract (LOT) inputs. For this, we constructed a computational network model of anterior piriform cortex with 2000 multicompartment, multiconductance neurons (500 semilunar, 1000 layer 2 and 500 layer 3 pyramids; 200 superficial interneurons of two types; 500 deep interneurons of three types; 500 LOT afferents), incorporating published and unpublished data. With a given distribution of LOT firing patterns, and increasing the strength of recurrent excitation, a small number of firing patterns were observed in pyramidal cell networks: first, sparse firings; then temporally and spatially concentrated epochs of action potentials, wherein each neuron fires one or two spikes; then more synchronized events, associated with bursts of action potentials in some pyramidal neurons. We suggest that one function of anterior piriform cortex is to transform ongoing streams of input spikes into temporally focused spike patterns, called here "cell assemblies", that are salient for downstream projection areas.
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Affiliation(s)
- Roger D Traub
- AI Foundations, IBM T.J. Watson Research Center, Yorktown Heights, NY10598, USA
| | - Yuhai Tu
- AI Foundations, IBM T.J. Watson Research Center, Yorktown Heights, NY10598, USA
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7
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Uva L, Aracri P, Forcaia G, de Curtis M. Mapping region-specific seizure-like patterns in the in vitro isolated guinea pig brain. Exp Neurol 2021; 342:113727. [PMID: 33930392 DOI: 10.1016/j.expneurol.2021.113727] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 04/09/2021] [Accepted: 04/22/2021] [Indexed: 10/21/2022]
Abstract
Specific neurophysiological seizure patterns in patients with focal epilepsy depend on cerebral location and the underlying neuropathology. Location-specific patterns have been also reported in experimental models. Two focal seizure patterns, named p-type and l-type, typical of neocortical and mesial temporal regions were identified in both patients explored with intracerebral EEG and in animal models. These two patterns were recorded in the olfactory regions and in the entorhinal cortex after either 4AP or BMI administration. Here we mapped epileptiform activities in other cortices to verify the existence of specific epileptiform patterns. Field potentials were simultaneously recorded at multiple locations in olfactory, limbic and neocortical regions of the isolated guinea pig brain after arterial administration of either 4AP or BMI. Most neocortical areas did not generate new distinctive focal seizure-like event (SLE), beside the p-type and l-type patterns. Spiking activity was typically recorded after BMI in all new analyzed regions, whereas SLEs were commonly observed during 4AP perfusion. We confirmed the presence of reproducible region-specific epileptiform patterns in all explored cortical areas and demonstrated that strongly inter-connected areas generate similar SLEs. Our study suggests that p- and l-type SLE represent the most common focal seizure patterns during acute manipulations with pro-epileptic compounds.
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Affiliation(s)
- Laura Uva
- Epilepsy Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, via Amadeo 42, 20133 Milano, Italy.
| | - Patrizia Aracri
- Epilepsy Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, via Amadeo 42, 20133 Milano, Italy
| | - Greta Forcaia
- School of Medicine and Surgery, University of Milano-Bicocca, via Cadore 48, 20900 Monza, MB, Italy.
| | - Marco de Curtis
- Epilepsy Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, via Amadeo 42, 20133 Milano, Italy.
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de Curtis M, Garbelli R, Uva L. A hypothesis for the role of axon demyelination in seizure generation. Epilepsia 2021; 62:583-595. [PMID: 33493363 DOI: 10.1111/epi.16824] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 01/04/2021] [Accepted: 01/05/2021] [Indexed: 01/06/2023]
Abstract
Loss of myelin and altered oligodendrocyte distribution in the cerebral cortex are commonly observed both in postsurgical tissue derived from different focal epilepsies (such as focal cortical dysplasias and tuberous sclerosis) and in animal models of focal epilepsy. Moreover, seizures are a frequent symptom in demyelinating diseases, such as multiple sclerosis, and in animal models of demyelination and oligodendrocyte dysfunction. Finally, the excessive activity reported in demyelinated axons may promote hyperexcitability. We hypothesize that the extracellular potassium rise generated during epileptiform activity may be amplified by the presence of axons without appropriate myelin coating and by alterations in oligodendrocyte function. This process could facilitate the triggering of recurrent spontaneous seizures in areas of altered myelination and could result in further demyelination, thus promoting epileptogenesis.
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Affiliation(s)
- Marco de Curtis
- Epilepsy Unit, IRCCS Foundation Carlo Besta Neurological Institute, Milan, Italy
| | - Rita Garbelli
- Epilepsy Unit, IRCCS Foundation Carlo Besta Neurological Institute, Milan, Italy
| | - Laura Uva
- Epilepsy Unit, IRCCS Foundation Carlo Besta Neurological Institute, Milan, Italy
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9
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Martin-Lopez E, Ishiguro K, Greer CA. The Laminar Organization of Piriform Cortex Follows a Selective Developmental and Migratory Program Established by Cell Lineage. Cereb Cortex 2020; 29:1-16. [PMID: 29136113 DOI: 10.1093/cercor/bhx291] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Indexed: 12/12/2022] Open
Abstract
Piriform cortex (PC) is a 3-layer paleocortex receiving primary afferent input from the olfactory bulb. The past decade has seen significant progress in understanding the synaptic, cellular and functional organization of PC, but PC embryogenesis continues to be enigmatic. Here, using birthdating strategies and clonal analyses, we probed the early development and laminar specificity of neurogenesis/gliogenesis as it relates to the organization of the PC. Our data demonstrate a temporal sequence of laminar-specific neurogenesis following the canonical "inside-out" pattern, with the notable exception of PC Layer II which exhibited an inverse "outside-in" temporal neurogenic pattern. Of interest, we found no evidence of a neurogenic gradient along the anterior to posterior axis, although the timing of neuronal migration and laminar development was delayed rostrally by approximately 24 h. To begin probing if lineage affected cell fate in the PC, we labeled PC neuroblasts using a multicolor technique and analyzed their laminar organization. Our results suggested that PC progenitors were phenotypically committed to reach specific layers early in the development. Collectively, these studies shed new light on the determinants of the laminar specificity of neuronal/glial organization in PC and the likely role of subpopulations of committed progenitors in regulating PC embryogenesis.
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Affiliation(s)
- Eduardo Martin-Lopez
- Department of Neurosurgery, Yale University School of Medicine, 333 Cedar Street, New Haven, CT, USA
| | - Kimiko Ishiguro
- Department of Neurosurgery, Yale University School of Medicine, 333 Cedar Street, New Haven, CT, USA
| | - Charles A Greer
- Department of Neurosurgery, Yale University School of Medicine, 333 Cedar Street, New Haven, CT, USA.,Department of Neuroscience, Yale University School of Medicine, 333 Cedar Street, New Haven, CT, USA.,The Interdepartmental Neuroscience Graduate Program, Yale University School of Medicine, 333 Cedar Street, New Haven, CT, USA
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10
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de Curtis M, Uva L, Lévesque M, Biella G, Avoli M. Piriform cortex ictogenicity in vitro. Exp Neurol 2019; 321:113014. [DOI: 10.1016/j.expneurol.2019.113014] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 05/07/2019] [Accepted: 07/15/2019] [Indexed: 02/05/2023]
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11
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Gnatkovsky V, Pelliccia V, de Curtis M, Tassi L. Two main focal seizure patterns revealed by intracerebral electroencephalographic biomarker analysis. Epilepsia 2018; 60:96-106. [DOI: 10.1111/epi.14610] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Revised: 10/08/2018] [Accepted: 10/29/2018] [Indexed: 02/06/2023]
Affiliation(s)
- Vadym Gnatkovsky
- Epilepsy Unit; Institute of Cure, Recovery, and Scientific Research (IRCCS) Foundation Carlo Besta Neurological Institute; Milan Italy
| | | | - Marco de Curtis
- Epilepsy Unit; Institute of Cure, Recovery, and Scientific Research (IRCCS) Foundation Carlo Besta Neurological Institute; Milan Italy
| | - Laura Tassi
- Claudio Munari Epilepsy Surgery Center; Niguarda Hospital; Milan Italy
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12
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Dulla CG, Janigro D, Jiruska P, Raimondo JV, Ikeda A, Lin CCK, Goodkin HP, Galanopoulou AS, Bernard C, de Curtis M. How do we use in vitro models to understand epileptiform and ictal activity? A report of the TASK1-WG4 group of the ILAE/AES Joint Translational Task Force. Epilepsia Open 2018; 3:460-473. [PMID: 30525115 PMCID: PMC6276782 DOI: 10.1002/epi4.12277] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/27/2018] [Indexed: 02/06/2023] Open
Abstract
In vitro brain tissue preparations allow the convenient and affordable study of brain networks and have allowed us to garner molecular, cellular, and electrophysiologic insights into brain function with a detail not achievable in vivo. Preparations from both rodent and human postsurgical tissue have been utilized to generate in vitro electrical activity similar to electrographic activity seen in patients with epilepsy. A great deal of knowledge about how brain networks generate various forms of epileptiform activity has been gained, but due to the multiple in vitro models and manipulations used, there is a need for a standardization across studies. Here, we describe epileptiform patterns generated using in vitro brain preparations, focusing on issues and best practices pertaining to recording, reporting, and interpretation of the electrophysiologic patterns observed. We also discuss criteria for defining in vitro seizure‐like patterns (i.e., ictal) and interictal discharges. Unifying terminologies and definitions are proposed. We suggest a set of best practices for reporting in vitro studies to favor both efficient across‐lab comparisons and translation to in vivo models and human studies.
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Affiliation(s)
- Chris G Dulla
- Department of Neuroscience Tufts University School of Medicine Boston Massachusetts U.S.A
| | - Damir Janigro
- Flocel Inc. and Case Western Reserve University Cleveland Ohio U.S.A
| | - Premysl Jiruska
- Department of Developmental Epileptology Institute of Physiology of the Czech Academy of Sciences Prague Czechia
| | - Joseph V Raimondo
- Division of Cell Biology and Neuroscience Institute Department of Human Biology Faculty of Health Sciences University of Cape Town Cape Town South Africa
| | - Akio Ikeda
- Department of Epilepsy, Movement Disorders and Physiology Kyoto University Graduate School of Medicine Kyoto Japan
| | - Chou-Ching K Lin
- Department of Neurology National Cheng Kung University Hospital College of Medicine National Cheng Kung University Tainan Taiwan
| | - Howard P Goodkin
- The Departments of Neurology and Pediatrics University of Virginia Charlottesville Virginia U.S.A
| | - Aristea S Galanopoulou
- Laboratory of Developmental Epilepsy Saul R. Korey Department of Neurology Isabelle Rapin Division of Child Neurology Dominick P. Purpura Department of Neuroscience Albert Einstein College of Medicine, and Einstein/Montefiore Epilepsy Center Montefiore Medical Center Bronx New York U.S.A
| | | | - Marco de Curtis
- Epilepsy Unit Fondazione IRCCS Istituto Neurologico Carlo Besta Milano Italy
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13
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Potassium dynamics and seizures: Why is potassium ictogenic? Epilepsy Res 2018; 143:50-59. [DOI: 10.1016/j.eplepsyres.2018.04.005] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Revised: 03/26/2018] [Accepted: 04/07/2018] [Indexed: 01/01/2023]
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14
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Abstract
Epilepsy affects all age groups and is one of the most common and most disabling neurological disorders. The accurate diagnosis of seizures is essential as some patients will be misdiagnosed with epilepsy, whereas others will receive an incorrect diagnosis. Indeed, errors in diagnosis are common, and many patients fail to receive the correct treatment, which often has severe consequences. Although many patients have seizure control using a single medication, others require multiple medications, resective surgery, neuromodulation devices or dietary therapies. In addition, one-third of patients will continue to have uncontrolled seizures. Epilepsy can substantially impair quality of life owing to seizures, comorbid mood and psychiatric disorders, cognitive deficits and adverse effects of medications. In addition, seizures can be fatal owing to direct effects on autonomic and arousal functions or owing to indirect effects such as drowning and other accidents. Deciphering the pathophysiology of epilepsy has advanced the understanding of the cellular and molecular events initiated by pathogenetic insults that transform normal circuits into epileptic circuits (epileptogenesis) and the mechanisms that generate seizures (ictogenesis). The discovery of >500 genes associated with epilepsy has led to new animal models, more precise diagnoses and, in some cases, targeted therapies.
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Affiliation(s)
- Orrin Devinsky
- Departments of Neurology, Neuroscience, Neurosurgery and Psychiatry, NYU School of Medicine, New York, NY, USA
| | - Annamaria Vezzani
- Laboratory of Experimental Neurology, Department of Neuroscience, IRCCS 'Mario Negri' Institute for Pharmacological Research, Milan, Italy
| | - Terence J O'Brien
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Victoria, Australia.,Department of Neurology, Alfred Health, Melbourne, Victoria, Australia.,Departments of Neurology and Medicine, The Royal Melbourne Hospital, The University of Melbourne, Melbourne, Victoria, Australia
| | - Nathalie Jette
- Department of Neurology and Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Ingrid E Scheffer
- Epilepsy Research Centre, Department of Medicine, Austin Health, The University of Melbourne, Melbourne, Victoria, Australia.,The Florey Institute of Neuroscience and Mental Health, Melbourne, Victoria, Australia.,Department of Paediatrics, The University of Melbourne, and Department of Neurology, The Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Marco de Curtis
- Epilepsy Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Piero Perucca
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Victoria, Australia.,Department of Neurology, Alfred Health, Melbourne, Victoria, Australia.,Departments of Neurology and Medicine, The Royal Melbourne Hospital, The University of Melbourne, Melbourne, Victoria, Australia
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15
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Proix T, Jirsa VK, Bartolomei F, Guye M, Truccolo W. Predicting the spatiotemporal diversity of seizure propagation and termination in human focal epilepsy. Nat Commun 2018. [PMID: 29540685 PMCID: PMC5852068 DOI: 10.1038/s41467-018-02973-y] [Citation(s) in RCA: 69] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Recent studies have shown that seizures can spread and terminate across brain areas via a rich diversity of spatiotemporal patterns. In particular, while the location of the seizure onset area is usually invariant across seizures in an individual patient, the source of traveling (2–3 Hz) spike-and-wave discharges during seizures can either move with the slower propagating ictal wavefront or remain stationary at the seizure onset area. Furthermore, although many focal seizures terminate synchronously across brain areas, some evolve into distinct ictal clusters and terminate asynchronously. Here, we introduce a unifying perspective based on a new neural field model of epileptic seizure dynamics. Two main mechanisms, the co-existence of wave propagation in excitable media and coupled-oscillator dynamics, together with the interaction of multiple time scales, account for the reported diversity. We confirm our predictions in seizures and tractography data obtained from patients with pharmacologically resistant epilepsy. Our results contribute toward patient-specific seizure modeling. A major goal of epilepsy research is understanding the spatiotemporal dynamics of seizure. Here, the authors extend the Epileptor neural mass model into a neural field model, in order to provide a unified and patient-specific model of seizure initiation, propagation, and termination.
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Affiliation(s)
- Timothée Proix
- Department of Neuroscience, Brown University, Providence, RI, 02912, USA.,Institute for Brain Science, Brown University, Providence, RI, 02912, USA.,Center for Neurorestoration & Neurotechnology, U.S. Department of Veterans Affairs, Providence, RI, 02912, USA
| | - Viktor K Jirsa
- Institut de Neurosciences des Systèmes (INS), Inserm, Aix Marseille Univ, Marseille, 13005, France
| | - Fabrice Bartolomei
- Institut de Neurosciences des Systèmes (INS), Inserm, Aix Marseille Univ, Marseille, 13005, France
| | - Maxime Guye
- CNRS, CRMBM UMR 7339, Aix Marseille Univ, Marseille, 13005, France
| | - Wilson Truccolo
- Department of Neuroscience, Brown University, Providence, RI, 02912, USA. .,Institute for Brain Science, Brown University, Providence, RI, 02912, USA. .,Center for Neurorestoration & Neurotechnology, U.S. Department of Veterans Affairs, Providence, RI, 02912, USA.
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16
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Let's Be Superficial About Ictal Activity. Epilepsy Curr 2017; 17:299-300. [PMID: 29225545 DOI: 10.5698/1535-7597.17.5.299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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