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Ali NH, Al-Kuraishy HM, Al-Gareeb AI, Alnaaim SA, Hetta HF, Saad HM, Batiha GES. A Mutual Nexus Between Epilepsy and α-Synuclein: A Puzzle Pathway. Mol Neurobiol 2024:10.1007/s12035-024-04204-6. [PMID: 38703341 DOI: 10.1007/s12035-024-04204-6] [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: 07/01/2023] [Accepted: 04/12/2024] [Indexed: 05/06/2024]
Abstract
Alpha-synuclein (α-Syn) is a specific neuronal protein that regulates neurotransmitter release and trafficking of synaptic vesicles. Exosome-associated α-Syn which is specific to the central nervous system (CNS) is involved in the pathogenesis of epilepsy. Therefore, this review aimed to elucidate the possible link between α-Syn and epilepsy, and how it affects the pathophysiology of epilepsy. A neurodegenerative protein such as α-Syn is implicated in the pathogenesis of epilepsy. Evidence from preclinical and clinical studies revealed that upregulation of α-Syn induces progressive neuronal dysfunctions through induction of oxidative stress, neuroinflammation, and inhibition of autophagy in a vicious cycle with subsequent development of severe epilepsy. In addition, accumulation of α-Syn in epilepsy could be secondary to the different cellular alterations including oxidative stress, neuroinflammation, reduction of brain-derived neurotrophic factor (BDNF) and progranulin (PGN), and failure of the autophagy pathway. However, the mechanism of α-Syn-induced-epileptogenesis is not well elucidated. Therefore, α-Syn could be a secondary consequence of epilepsy. Preclinical and clinical studies are warranted to confirm this causal relationship.
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Affiliation(s)
- Naif H Ali
- Department of Internal Medicine, Medical College, Najran University, Najran, Kingdom of Saudi Arabia
| | - Hayder M Al-Kuraishy
- Department of Clinical Pharmacology and Medicine, College of Medicine, Mustansiriyah University, M.B.Ch.B, FRCP, P.O. Box 14132, Baghdad, Iraq
| | - Ali I Al-Gareeb
- Jabir Ibn Hayyan Medical University, Al-Ameer Qu, P.O. Box 13, Kufa, Najaf, Iraq
| | - Saud A Alnaaim
- Clinical Neurosciences Department, College of Medicine, King Faisal University, Hofuf, Saudi Arabia
| | - Helal F Hetta
- Department of Medical Microbiology and Immunology, Faculty of Medicine, Assiut University, Assiut, 71515, Egypt
| | - Hebatallah M Saad
- Department of Pathology, Faculty of Veterinary Medicine, Matrouh University, Matrouh, 51744, Egypt.
| | - Gaber El-Saber Batiha
- Department of Pharmacology and Therapeutics, Faculty of Veterinary Medicine, Damanhour University, Damanhour, 22511, AlBeheira, Egypt.
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Khan J, Yadav S. Nanotechnology-based Nose-to-brain Delivery in Epilepsy: A NovelApproach to Diagnosis and Treatment. Pharm Nanotechnol 2024; 12:314-328. [PMID: 37818558 DOI: 10.2174/0122117385265554230919070402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Revised: 08/09/2023] [Accepted: 08/13/2023] [Indexed: 10/12/2023]
Abstract
Epilepsy is a serious neurological disease, and scientists have a significant challenge in developing a noninvasive treatment for the treatment of epilepsy. The goal is to provide novel ideas for improving existing and future anti-epileptic medications. The injection of nano treatment via the nose to the brain is being considered as a possible seizure control method. Various nasal medicine nanoformulations have the potential to cure epilepsy. Investigations with a variety of nose-to-brain dosing methods for epilepsy treatment have yielded promising results. After examining global literature on nanotechnology and studies, the authors propose nasal administration with nanoformulations as a means to successfully treat epilepsy. The goal of this review is to look at the innovative application of nanomedicine for epilepsy treatment via nose-to-brain transfer, with a focus on the use of nanoparticles for load medicines. When nanotechnology is combined with the nose to brain approach, treatment efficacy can be improved through site specific delivery. Furthermore, this technique of administration decreases adverse effects and patient noncompliance encountered with more traditional procedures.
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Affiliation(s)
- Javed Khan
- Department of Pharmacy, School of Medical and Allied Sciences, Galgotias University, Greater Noida, Uttar Pradesh, India
| | - Shikha Yadav
- Department of Pharmacy, School of Medical and Allied Sciences, Galgotias University, Greater Noida, Uttar Pradesh, India
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Alnaaim SA, Al‐kuraishy HM, Al‐Gareeb AI, Ali NH, Alexiou A, Papadakis M, Saad HM, Batiha GE. New insights on the potential anti-epileptic effect of metformin: Mechanistic pathway. J Cell Mol Med 2023; 27:3953-3965. [PMID: 37737447 PMCID: PMC10747420 DOI: 10.1111/jcmm.17965] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 09/06/2023] [Accepted: 09/09/2023] [Indexed: 09/23/2023] Open
Abstract
Epilepsy is a chronic neurological disease characterized by recurrent seizures. Epilepsy is observed as a well-controlled disease by anti-epileptic agents (AEAs) in about 69%. However, 30%-40% of epileptic patients fail to respond to conventional AEAs leading to an increase in the risk of brain structural injury and mortality. Therefore, adding some FDA-approved drugs that have an anti-seizure activity to the anti-epileptic regimen is logical. The anti-diabetic agent metformin has anti-seizure activity. Nevertheless, the underlying mechanism of the anti-seizure activity of metformin was not entirely clarified. Henceforward, the objective of this review was to exemplify the mechanistic role of metformin in epilepsy. Metformin has anti-seizure activity by triggering adenosine monophosphate-activated protein kinase (AMPK) signalling and inhibiting the mechanistic target of rapamycin (mTOR) pathways which are dysregulated in epilepsy. In addition, metformin improves the expression of brain-derived neurotrophic factor (BDNF) which has a neuroprotective effect. Hence, metformin via induction of BDNF can reduce seizure progression and severity. Consequently, increasing neuronal progranulin by metformin may explain the anti-seizure mechanism of metformin. Also, metformin reduces α-synuclein and increases protein phosphatase 2A (PPA2) with modulation of neuroinflammation. In conclusion, metformin might be an adjuvant with AEAs in the management of refractory epilepsy. Preclinical and clinical studies are warranted in this regard.
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Affiliation(s)
- Saud A. Alnaaim
- Clinical Neurosciences Department, College of MedicineKing Faisal UniversityHofufSaudi Arabia
| | - Hayder M. Al‐kuraishy
- Department of Clinical Pharmacology and Medicine, College of MedicineALmustansiriyia UniversityBaghdadIraq
| | - Ali I. Al‐Gareeb
- Department of Clinical Pharmacology and Medicine, College of MedicineALmustansiriyia UniversityBaghdadIraq
| | - Naif H. Ali
- Department of Internal Medicine, Medical CollegeNajran UniversityNajranSaudi Arabia
| | - Athanasios Alexiou
- Department of Science and EngineeringNovel Global Community Educational FoundationHebershamNew South WalesAustralia
- AFNP MedWienAustria
| | - Marios Papadakis
- Department of Surgery IIUniversity Hospital Witten‐Herdecke, University of Witten‐HerdeckeWuppertalGermany
| | - Hebatallah M. Saad
- Department of Pathology, Faculty of Veterinary MedicineMatrouh UniversityMatrouhEgypt
| | - Gaber El‐Saber Batiha
- Department of Pharmacology and Therapeutics, Faculty of Veterinary MedicineDamanhour UniversityDamanhourEgypt
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Engineering of an ene-reductase for producing the key intermediate of antiepileptic drug Brivaracetam. Appl Microbiol Biotechnol 2023; 107:1649-1661. [PMID: 36710288 DOI: 10.1007/s00253-023-12389-4] [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: 10/27/2022] [Revised: 01/12/2023] [Accepted: 01/15/2023] [Indexed: 01/31/2023]
Abstract
(R)-4-Propyldihydrofuran-2(3H)-one (R-PDFO) is the key chiral intermediate for the antiepileptic drug Brivaracetam. Lacking a simple and economical method to approaching R-PDFO, the production of R-PDFO also remains environmentally unfriendly. Here, we developed a straightforward bioreduction way from easily synthesized 4-propylfuran-2(5H)-one (PFO) using ene-reductases. After screened with 27 ene-reductases, E116 stood out with 25.7% yield and 97% ee (R) as the starting enzyme. To improve the catalytic efficiency of E116, several rounds of directed evolution were first carried out. Through rational design, alanine scanning and random mutagenesis, engineered ene-reductase E116-M3 was obtained, with a 2.63-fold improvement in yields over WT, a 12.6-fold improvement in kcat/Km over WT, and stereoselectivity increased to 99% (R). To further improve the yield of R-PDFO, the reaction conditions were then optimized. The catalytic activity of the optimized reaction system was increased again by 2.3 times and the turnover number (TON) of E116-M3 reached 705. Subsequently, whole cells harboring E116-M3 were also shown to have similar capabilities of synthesizing R-PDFO. Finally, E116-M3 was employed in the 50-mL-scale synthesis of R-PDFO under 20 mM of PFO loading to achieve 81% isolated yield and 99% ee. In conclusion, this new approach of engineered ene-reductase catalyzing the asymmetric reduction of PFO could be a green alternative for the efficient synthesis of R-PDFO. KEY POINTS: • An ene-reductase library was first used to screen the bioreduction of PFO. • Rational design contributed to the enhanced R-stereoselectivity of PFO reduction. • E116-M3 was obtained with high activity and stereoselectivity for R-PDFO.
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Pal R, Singh K, Paul J, Khan SA, Naim MJ, Akhtar MJ. Overview of Chemistry and Therapeutic Potential of Non-Nitrogen Heterocyclics as Anticonvulsant Agents. Curr Neuropharmacol 2022; 20:1519-1553. [PMID: 34344289 PMCID: PMC9881093 DOI: 10.2174/1570159x19666210803144815] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 06/14/2021] [Accepted: 07/20/2021] [Indexed: 11/22/2022] Open
Abstract
Epilepsy is a chronic neurological disorder, characterized by the predisposition of unprovoked seizures affecting the neurobiological, psychological, cognitive, economic, and social wellbeing of the patient. As per the 2019 report by World Health Organization, it affects nearly 80% of the population, which comes from middle to low-income countries. It has been suggested that 70% of such cases can be treated effectively if properly diagnosed. It is one of the most common neurological diseases affecting 50 million people globally. Most of the antiepileptic drugs used in clinical practice are only 60-80% effective in controlling the disease. These drugs suffer from serious drawbacks of non-selectivity and toxicity that limit their clinical usefulness. Hence, there is a need to search for safe, potent, and effective anti-epileptic drugs. One of the emerging strategies to discover and develop selective and non-toxic anticonvulsant molecules focuses on the design of non-nitrogen heterocyclic compounds (NNHC). Drugs such as valproic acid, gabapentin, viagabatrin, fluorofelbamate, tiagabine, progabide, pregabalin, gamma amino butyric acid (GABA), etc. do not contain a nitrogen heterocyclic ring but are as effective anticonvulsants as conventional heterocyclic nitrogen compounds. This review covers the various classes of NNHC which have been developed in the recent past as anticonvulsants along with their chemistry, percentage yield, structure-activity relationship and biological activity. The most potent compound in each series has been identified for comparative studies, for further structural modification and to improve the pharmacokinetic profile. Various optimized synthetic pathways and diverse functionalities other than nitrogen-containing rings discussed in the article may help medicinal chemists to design safe and effective anticonvulsant drugs in near future.
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Affiliation(s)
- Rohit Pal
- Department of Pharmaceutical Chemistry, ISF College of Pharmacy, Ghal Kalan, Ferozpur, Punjab, India;,These authors contributed equally to the review
| | - Karanvir Singh
- Department of Pharmaceutical Chemistry, ISF College of Pharmacy, Ghal Kalan, Ferozpur, Punjab, India;,These authors contributed equally to the review
| | - Joyson Paul
- Department of Pharmaceutical Chemistry, ISF College of Pharmacy, Ghal Kalan, Ferozpur, Punjab, India
| | - Shah Alam Khan
- Department of Pharmaceutical Chemistry, College of Pharmacy, National University of Science and Technology, PO 620, PC 130, Azaiba, Bousher, Muscat, Sultanate of Oman
| | - Mohd. Javed Naim
- Department of Pharmaceutical Chemistry, Bhagwant University, Ajmer Rajasthan, India
| | - Md. Jawaid Akhtar
- Department of Pharmaceutical Chemistry, College of Pharmacy, National University of Science and Technology, PO 620, PC 130, Azaiba, Bousher, Muscat, Sultanate of Oman;,Address correspondence to this author at the Department of Pharmaceutical Chemistry, College of Pharmacy, National University of Science and Technology, PO 620, PC 130, Azaiba, Bousher, Muscat, Sultanate of Oman; E-mails: ,
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Lian J, Xu F. Spatial Enhanced Pattern Through Graph Convolutional Neural Network for Epileptic EEG Identification. Int J Neural Syst 2022; 32:2250033. [DOI: 10.1142/s0129065722500332] [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]
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Abstract
Temporal lobe epilepsy is considered to be one of the most common and severe forms of focal epilepsies. Patients frequently develop cognitive deficits and emotional blunting along progression of the disease. The high incidence of refractoriness to antiepileptic drugs and a frequent lack of admissibility to surgery pose an unmet medical challenge. In the urgent quest for novel treatment strategies, neuropeptides and their receptors are interesting candidates. However, their therapeutic potential has not yet been fully exploited. This chapter focuses on the functional role of the dynorphins (Dyns) and the kappa opioid receptor (KOR) system in temporal lobe epilepsy and the hippocampus.Genetic polymorphisms in the prepro-dynorphin (pDyn) gene causing lower levels of Dyns in humans and pDyn gene knockout in mice increase the risk to develop epilepsy. This suggests a role of Dyns and KOR as modulators of neuronal excitability. Indeed, KOR agonists induce inhibition of presynaptic neurotransmitter release, as well as postsynaptic hyperpolarization in glutamatergic neurons, both producing anticonvulsant effects.The development of new approaches to modulate the complex KOR signalling cascade (e.g. biased agonism and gene therapy) opens up new exciting therapeutic opportunities with regard to seizure control and epilepsy. Potential adverse side effects of KOR agonists may be minimized through functional selectivity or locally restricted treatment. Preclinical data suggest a high potential of such approaches to control seizures.
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Affiliation(s)
- Luca Zangrandi
- Institute of Virology, Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, Berlin, Germany
- Freie Universität Berlin, Berlin, Germany
- Humboldt-Universität zu Berlin, Berlin, Germany
- Berlin Institute of Health, Berlin, Germany
| | - Christoph Schwarzer
- Department of Pharmacology, Medical University of Innsbruck, Innsbruck, Austria.
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Yuan J, Ran X, Liu K, Yao C, Yao Y, Wu H, Liu Q. Machine learning applications on neuroimaging for diagnosis and prognosis of epilepsy: A review. J Neurosci Methods 2021; 368:109441. [PMID: 34942271 DOI: 10.1016/j.jneumeth.2021.109441] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 10/23/2021] [Accepted: 12/11/2021] [Indexed: 02/07/2023]
Abstract
Machine learning is playing an increasingly important role in medical image analysis, spawning new advances in the clinical application of neuroimaging. There have been some reviews on machine learning and epilepsy before, and they mainly focused on electrophysiological signals such as electroencephalography (EEG) and stereo electroencephalography (SEEG), while neglecting the potential of neuroimaging in epilepsy research. Neuroimaging has its important advantages in confirming the range of the epileptic region, which is essential in presurgical evaluation and assessment after surgery. However, it is difficult for EEG to locate the accurate epilepsy lesion region in the brain. In this review, we emphasize the interaction between neuroimaging and machine learning in the context of epilepsy diagnosis and prognosis. We start with an overview of epilepsy and typical neuroimaging modalities used in epilepsy clinics, MRI, DWI, fMRI, and PET. Then, we elaborate two approaches in applying machine learning methods to neuroimaging data: (i) the conventional machine learning approach combining manual feature engineering and classifiers, (ii) the deep learning approach, such as the convolutional neural networks and autoencoders. Subsequently, the application of machine learning on epilepsy neuroimaging, such as segmentation, localization, and lateralization tasks, as well as tasks directly related to diagnosis and prognosis are looked into in detail. Finally, we discuss the current achievements, challenges, and potential future directions in this field, hoping to pave the way for computer-aided diagnosis and prognosis of epilepsy.
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Affiliation(s)
- Jie Yuan
- Shenzhen Key Laboratory of Smart Healthcare Engineering, Department of Biomedical Engineering, Southern University of Science and Technology, Shenzhen 518055, PR China
| | - Xuming Ran
- Shenzhen Key Laboratory of Smart Healthcare Engineering, Department of Biomedical Engineering, Southern University of Science and Technology, Shenzhen 518055, PR China
| | - Keyin Liu
- Shenzhen Key Laboratory of Smart Healthcare Engineering, Department of Biomedical Engineering, Southern University of Science and Technology, Shenzhen 518055, PR China
| | - Chen Yao
- Shenzhen Second People's Hospital, Shenzhen 518035, PR China
| | - Yi Yao
- Shenzhen Children's Hospital, Shenzhen 518017, PR China
| | - Haiyan Wu
- Centre for Cognitive and Brain Sciences and Department of Psychology, University of Macau, Taipa, Macau
| | - Quanying Liu
- Shenzhen Key Laboratory of Smart Healthcare Engineering, Department of Biomedical Engineering, Southern University of Science and Technology, Shenzhen 518055, PR China.
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Walker MJ, Nielsen J, Goddard E, Harris A, Hutchison K. Induced Pluripotent Stem Cell-Based Systems for Personalising Epilepsy Treatment: Research Ethics Challenges and New Insights for the Ethics of Personalised Medicine. AJOB Neurosci 2021; 13:120-131. [PMID: 34324412 DOI: 10.1080/21507740.2021.1949404] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
ABSTRACTThis paper examines potential ethical and legal issues arising during the research, development and clinical use of a proposed strategy in personalized medicine (PM): using human induced pluripotent stem cell (iPSC)-derived tissue cultures as predictive models of individual patients to inform treatment decisions. We focus on epilepsy treatment as a likely early application of this strategy, for which early-stage stage research is underway. In relation to the research process, we examine issues associated with biological samples; data; health; vulnerable populations; neural organoids; and what level of accuracy justifies using the iPSC-derived neural tissue system. In relation to clinical use, we examine potential uses in pre-natal screening, and effects on clinical decision-making. Although our focus is providing recommendations for researchers developing work in this area, we identify the novel issue of deciding on an acceptable accuracy level for the system. We also emphasize an issue thus far neglected in the ethics of PM: PM tends to represent treatment decisions as though they should be directed solely by biomedical information, but this in itself could be detrimental to best personalizing treatment decisions in the clinic.
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Affiliation(s)
- Mary Jean Walker
- La Trobe University.,ARC Centre of Excellence for Electromaterials Science, University of Wollongong
| | - Jane Nielsen
- ARC Centre of Excellence for Electromaterials Science, University of Wollongong.,University of Tasmania
| | - Eliza Goddard
- La Trobe University.,ARC Centre of Excellence for Electromaterials Science, University of Wollongong
| | - Alex Harris
- ARC Centre of Excellence for Electromaterials Science, University of Wollongong.,University of Melbourne
| | - Katrina Hutchison
- ARC Centre of Excellence for Electromaterials Science, University of Wollongong.,Macquarie University
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Weng N, Sun J, Kuang S, Lan H, He Q, Yang H, Zhang L, Xue H. MicroRNA-451 Aggravates Kainic Acid-induced Seizure and Neuronal Apoptosis by Targeting GDNF. Curr Neurovasc Res 2021; 17:50-57. [PMID: 31870266 DOI: 10.2174/1567202617666191223150510] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 11/12/2019] [Accepted: 11/24/2019] [Indexed: 11/22/2022]
Abstract
AIM Epilepsy is a common and serious neurological disease that causes recurrent episodes, but its molecular mechanism remains unclear. Abnormal miRNA expression is associated with epilepsy, including miR-451. This research investigated the role of miR-451 in seizure and its detailed mechanism. METHODS The seizure mice model was induced by kainic acid (KA) injection to the right lateral cerebral ventricle. Behavioral changes in mice were observed and evaluated by the Racine Scale. The miR-451 knockout mice were established by adenovirus infection. The in vitro model was performed by miR-451 mimics transfected HEK-293 cells. The amount of neuronal death and morphological changes were evaluated by Nissl staining and H&E staining. RESULTS The results showed that miR-451 is up regulated in KA-induced seizure models and miR- 451 knockout decreased the behavior score and improved the pathological changes of the hippocampus. Besides, MiR-451 knockout inhibited the apoptosis of hippocampal neurons. Bioinformatics studies have shown that glial cell line-derived neurotrophic factor (GDNF) is a target gene of miR-451. MiR-451 could negatively regulate the expression of GDNF. GDNF overexpression could reverse the effect of miR-451 on KA induced brain injury and neuronal apoptosis. CONCLUSION This research demonstrates that miR-451 can affect the behavior of KA-induced epilepsy mice and hippocampal neuronal damage by regulating GDNF expression. The results would provide an experimental foundation for further research about the potential contribution of mi- RNAs to epilepsy pathophysiology.
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Affiliation(s)
- Ning Weng
- The Second Clinical College of Guangzhou, University of Chinese Medicine, Guangzhou City, Guangdong Province, 510120, China.,Department of Neurology, The Second Affiliated Hospital of Guizhou, Guizhou University of Traditional Chinese Medicine, Guiyang City, Guizhou Province, 550003, China
| | - Jingbo Sun
- The Second Clinical College of Guangzhou, University of Chinese Medicine, Guangzhou City, Guangdong Province, 510120, China
| | - Shixiang Kuang
- Department of Neurology, The Second Affiliated Hospital of Guizhou, Guizhou University of Traditional Chinese Medicine, Guiyang City, Guizhou Province, 550003, China
| | - Hai Lan
- Department of Hematology, No.1 Affiliated Hospital of Guangzhou, Guangzhou University of Chinese Medicine, Guangzhou City, Guangdong Province, 510405, China
| | - Qiansong He
- Department of Neurology, The Second Clinical College of Guizhou, Guizhou University of Traditional Chinese Medicine, Guiyang City, Guizhou Province, 550003, China
| | - Hui Yang
- Department of Neurology, The Second Clinical College of Guizhou, Guizhou University of Traditional Chinese Medicine, Guiyang City, Guizhou Province, 550003, China
| | - Lin Zhang
- Department of Neurology, The Second Affiliated Hospital of Guizhou, Guizhou University of Traditional Chinese Medicine, Guiyang City, Guizhou Province, 550003, China
| | - Hong Xue
- Department of Neurology, The Second Affiliated Hospital of Guizhou, Guizhou University of Traditional Chinese Medicine, Guiyang City, Guizhou Province, 550003, China.,Department of Neurology, The Second Clinical College of Guizhou, Guizhou University of Traditional Chinese Medicine, Guiyang City, Guizhou Province, 550003, China
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Adamczyk B, Węgrzyn K, Wilczyński T, Maciarz J, Morawiec N, Adamczyk-Sowa M. The Most Common Lesions Detected by Neuroimaging as Causes of Epilepsy. ACTA ACUST UNITED AC 2021; 57:medicina57030294. [PMID: 33809843 PMCID: PMC8004256 DOI: 10.3390/medicina57030294] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 03/12/2021] [Accepted: 03/16/2021] [Indexed: 11/24/2022]
Abstract
Epilepsy is a common neurological disorder characterized by chronic, unprovoked and recurrent seizures, which are the result of rapid and excessive bioelectric discharges in nerve cells. Neuroimaging is used to detect underlying structural abnormalities which may be associated with epilepsy. This paper reviews the most common abnormalities, such as hippocampal sclerosis, malformations of cortical development and vascular malformation, detected by neuroimaging in patients with epilepsy to help understand the correlation between these changes and the course, treatment and prognosis of epilepsy. Magnetic resonance imaging (MRI) reveals structural changes in the brain which are described in this review. Recent studies indicate the usefulness of additional imaging techniques. The use of fluorodeoxyglucose positron emission tomography (FDG-PET) improves surgical outcomes in MRI-negative cases of focal cortical dysplasia. Some techniques, such as quantitative image analysis, magnetic resonance spectroscopy (MRS), functional MRI (fMRI), diffusion tensor imaging (DTI) and fibre tract reconstruction, can detect small malformations—which means that some of the epilepsies can be treated surgically. Quantitative susceptibility mapping may become the method of choice in vascular malformations. Neuroimaging determines appropriate diagnosis and treatment and helps to predict prognosis.
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Hao J, Liu H, Ma J, Liu G, Dong G, Liu P, Xiao F. SCN1A IVS5N+5 G>A Polymorphism and Risk of Febrile Seizure and Epilepsy: A Systematic Review and Meta-Analysis. Front Neurol 2021; 11:581539. [PMID: 33391151 PMCID: PMC7773848 DOI: 10.3389/fneur.2020.581539] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 10/30/2020] [Indexed: 01/11/2023] Open
Abstract
Background: Previous studies had investigated the association between polymorphism of IVS5N+5 G>A in SCN1A and the risk of febrile seizure and epilepsy. However, the results were inconsistent. We aimed to conduct a systematic review and meta-analysis to evaluate the association between SCN1A IVS5N+5 G>A polymorphism and risk of febrile seizures and epilepsy. Methods: We searched Embase, Medline, Scopus, and CNKI for studies on the association between SCN1A IVS5N+5 G>A polymorphism and risk of febrile seizures and epilepsy up to 19 February 2020. We pooled odds ratios (ORs) and 95% confidence intervals (CIs) by different genetic models. To explore the source of heterogeneity, we performed the subgroup analysis by ethnicity and source of control. Results: We included a total of 12 studies in the meta-analysis. We found a significant negative association between G allele SCN1A IVS5N+5 G>A polymorphism, febrile seizures [G vs. A: OR (95% CI): 0.690 (0.530-0.897); GG vs. AA: 0.503 (0.279-0.908); AG vs. AA: 0.581 (0.460-0.733); GG + AG vs. AA: 0.543 (0.436-0.677); AA + GG vs. AG: 1.309 (1.061-1.615)], and epilepsy [G vs. A: 0.822 (0.750-0.902); GG vs. AA: 0.655 (0.515-0.832); AG vs. AA: 0.780 (0.705-0.862); GG vs. AG + AA: 0.769 (0.625-0.947); GG + AG vs. AA: 0.743 (0.663-0.833); AA + GG vs. AG: 1.093 (1.001-1.193)]. The subgroup analysis shows the association varied by type of disease, ethnicity, and source of control. Conclusion: The present meta-analysis suggests that G allele in SCN1A IVS5N+5 G>A polymorphism is a protective factor of febrile seizures and epilepsy. It is possible to determine the vulnerability of each individual to develop febrile seizures or epilepsy genotype by these genetic variants. Future studies with better study designs are needed to confirm the results. Study Registration: This study was registered in the International Prospective register of systematic reviews (PROSPERO, CRD42020163318).
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Affiliation(s)
- Jindou Hao
- Department of Paediatrics, The First Affiliated Hospital of Jinan University, Guangzhou, China.,Department of Paediatrics, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China
| | - Haiying Liu
- Department of Paediatrics, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China
| | - Jiying Ma
- Department of Occupational Health Surveillance, Shenzhen Prevention and Treatment Center for Occupational Diseases, Shenzhen, China
| | - Guosheng Liu
- Department of Paediatrics, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Guoqing Dong
- Department of Paediatrics, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China
| | - Peihui Liu
- Department of Paediatrics, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China
| | - Fei Xiao
- Department of Paediatrics, Affiliated Shenzhen Maternity and Child Healthcare Hospital, Southern Medical University, Shenzhen, China
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Abizadeh M, Heysieattalab S, Saeedi N, Hosseinmardi N, Janahmadi M, Salari F, Golpayegani SM, Shojaii A. Ameliorating Effects of Dorema ammoniacum on PTZ-Induced Seizures and Epileptiform Brain Activity in Rats. PLANTA MEDICA 2020; 86:1353-1362. [PMID: 32851611 DOI: 10.1055/a-1229-4436] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The objective of the current study was to investigate the anti-epileptogenic and anticonvulsant effects of Dorema ammoniacum gum, which is used in Iranian traditional medicine for the treatment of seizures. Animals received pentylenetetrazol (IP, 30 mg/kg/48 h) for inducing seizures. Five different seizure stages were evaluated for 20 min and parameters including maximum seizure stage, the latency to the onset of stage 4, stage 4 duration, and seizure duration were measured. D. ammoniacum (50 and 100 mg/kg) or its vehicle was administered 30 min before or after pentylenetetrazol injection in different groups. In addition, the effective dose of D. ammoniacum (100 mg/kg) on different seizure stages was compared with the common antiseizure drug phenobarbital. In another set of experiments, we investigated the effective dose of D. ammoniacum on fully kindled animals in which an interictal electroencephalogram was recorded by superficial electrodes placed on the skull. The results showed that D. ammoniacum administration, before and after pentylenetetrazol injections, significantly decreased seizure stage, seizure duration, stage 4 duration, and 1/stage 4 latency. The anti-epileptogenic effect of D. ammoniacum was about 50 to 60% of phenobarbital. In addition, D. ammoniacum significantly decreased seizure stage, seizure duration, stage 4 duration, and 1/stage 4 latency when administered to fully kindled animals but had no effect on the power of EEG sub-bands. These results indicate that D. ammoniacum has anti-epileptogenic and anticonvulsant effects in a chemical kindling model of seizures.
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Affiliation(s)
- Marzieh Abizadeh
- Department of Physiology, Medical School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Neurophysiology Research Center, Medical School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Negin Saeedi
- Department of Physiology, Medical School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Neurophysiology Research Center, Medical School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Narges Hosseinmardi
- Department of Physiology, Medical School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Neurophysiology Research Center, Medical School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahyar Janahmadi
- Department of Physiology, Medical School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Neurophysiology Research Center, Medical School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farhad Salari
- Department of Physiology, Medical School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Neurophysiology Research Center, Medical School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seyed Mehdi Golpayegani
- Department of Physiology, Medical School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Neurophysiology Research Center, Medical School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Asie Shojaii
- Research Institute for Islamic and Complementary Medicine, Iran University of Medical Sciences, Tehran, Iran
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Liquid Crystalline Nanoparticles for Nasal Delivery of Rosuvastatin: Implications on Therapeutic Efficacy in Management of Epilepsy. Pharmaceuticals (Basel) 2020; 13:ph13110356. [PMID: 33143084 PMCID: PMC7693896 DOI: 10.3390/ph13110356] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Revised: 10/25/2020] [Accepted: 10/28/2020] [Indexed: 12/24/2022] Open
Abstract
In the present study we investigated the protective role of intranasal rosuvastatin liquid crystalline nanoparticles (Ros-LCNPs) against pentylenetetrazole (PTZ) induced seizures, increasing current electroshock (ICES) induced seizures, and PTZ-induced status epilepticus. From the dose titration study, it was evident that intranasal rosuvastatin (ROS), at lower dose, was more effective than oral and intraperitoneal ROS. The Ros-LCNPs equivalent to 5 mg/kg ROS were developed by hydrotrope method using glyceryl monooleate (GMO) as lipid phase. The high resolution TEM revealed that the formed Ros-LCNPs were cubic shaped and multivesicular with mean size of 219.15 ± 8.14 nm. The Ros-LCNPs showed entrapment efficiency of 70.30 ± 1.84% and release was found to be biphasic following Korsmeyer–Peppas kinetics. Intranasal Ros-LCNPs (5 mg/kg) showed significant increase in latency to PTZ-induced seizures and ICES seizure threshold compared to control and intranasal ROS solution. Additionally, intranasal Ros-LCNPs provided effective protection against PTZ-induced status epilepticus. No impairment in cognitive functions was observed following intranasal Ros-LCNPs. The results suggested that Ros-LCNPs could be an effective and promising therapeutics for the epilepsy management.
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15
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Si J, Wang Y, Xu J, Wang J. Antiepileptic effects of exogenous β-hydroxybutyrate on kainic acid-induced epilepsy. Exp Ther Med 2020; 20:177. [PMID: 33101467 PMCID: PMC7579833 DOI: 10.3892/etm.2020.9307] [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: 12/10/2019] [Accepted: 07/10/2020] [Indexed: 01/18/2023] Open
Abstract
The aim of the present study was to explore the potential anticonvulsant effects of β-hydroxybutyrate (BHB) in a kainic acid (KA)-induced rat epilepsy model. The KA-induced rat seizure model was established and BHB was administrated intraperitoneally at a dose of 4 mmol/kg 30 min prior to KA injection. Hippocampal tissues were then obtained 1, 3 and 7 days following KA administration, following which the expression levels of neuron-specific enolase (NSE) and glial fibrillary acidic protein (GFAP) were measured using a double immunofluorescence labeling method. In addition, the contents of glutathione (GSH), γ-aminobutyric acid (GABA) and ATP were measured using ELISA. Pretreatment with BHB markedly increased the expression of NSE after KA injection compared with that in the normal saline (NS) + KA group, suggesting that the application of BHB could alleviate neuronal damage in rats. The protective effect of BHB may be associated with suppressed inflammatory responses, which was indicated by the observed inhibition of GFAP expression in rats in the BHB + KA group compared with that in the NS + KA group. It was also found that GSH and GABA contents were notably increased after the rats were pretreated with BHB compared with those in the NS + KA group. To conclude, the application of exogenous BHB can serve as a novel therapeutic agent for epilepsy.
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Affiliation(s)
- Jianping Si
- Department of Pediatrics, The People's Hospital of Guangrao, Dongying, Shandong 257300, P.R. China
| | - Yingyan Wang
- Department of Neurology, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, P.R. China
| | - Jing Xu
- Department of Neurology, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, P.R. China
| | - Jiwen Wang
- Department of Neurology, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, P.R. China
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16
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Yan Y, Xia H, Hu J, Zhang B. MicroRNA-542-3p Regulates P-glycoprotein Expression in Rat Epilepsy via the Toll-like Receptor 4/Nuclear Factor-kappaB Signaling Pathway. Curr Neurovasc Res 2020; 16:433-440. [PMID: 31702493 DOI: 10.2174/1567202616666191023160201] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 09/19/2019] [Accepted: 09/26/2019] [Indexed: 12/20/2022]
Abstract
BACKGROUND The function of microRNA-542-3p (miR-542-3p) in rat epilepsy is still unclear. METHODS The levels of miR-542-3p and toll-like receptor 4 (TLR4) were determined through quantitative real-time PCR. The protein levels were examined via the western blot analysis. The relationship between miR-542-3p and TLR4 was confirmed through luciferase assay. Pathological changes were analyzed via Hematoxylin-eosin (HE) and Nissl staining. RESULTS The rats and hippocampal cells were treated with kainic acid (KA) in vivo and in vitro. miR-542-3p was low in KA-treated rats, hippocampal cells and cerebrospinal fluid of patients with epilepsy. Further functional analysis showed that miR-542-3p overexpression inhibited KAinduced average seizure frequency, damage of hippocampal neuron and cell apoptosis, leading to the alleviation of the brain injury in epilepsy rats. miR-542-3p was determined to downregulate TLR4 expression. The relationship between miR-542-3p and TLR4 was confirmed. TLR4 knockdown reduced KA-induced nuclear factor-kappa B p65 (NF-κB p65), multidrug resistance 1 (MDR1), P-glycoprotein (P-gp) and apoptosis-associated protein levels. Further, for NF-κB p65, MDR1, P-gp and apoptosis-associated protein levels detection, miR-542-3p mimic showed a suppressive effect on these KA-induced protein levels, whereas TLR4 overexpression ameliorated the miR-542-3p-induced these protein levels in KA-treated epilepsy rats. CONCLUSION We identified that miR-542-3p attenuated seizure-induced brain injury and the expression of P-gp in epilepsy rats through inhibiting TLR4/NF-κB signaling pathway, which might contribute to improved epilepsy therapy.
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Affiliation(s)
- YuKui Yan
- Department of Neurology, Huzhou Central Hospital, Huzhou City, Zhejiang Province, 313000, China
| | - Hongping Xia
- College of Basic Medicine, Nanjing Medical University, Nanjing City, Jiangsu Province, 211166, China
| | - Jianqin Hu
- Department of Neurology, Huzhou Central Hospital, Huzhou City, Zhejiang Province, 313000, China
| | - Bing Zhang
- Department of Neurology, Huzhou Central Hospital, Huzhou City, Zhejiang Province, 313000, China
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Shringarpure M, Gharat S, Momin M, Omri A. Management of epileptic disorders using nanotechnology-based strategies for nose-to-brain drug delivery. Expert Opin Drug Deliv 2020; 18:169-185. [PMID: 32921169 DOI: 10.1080/17425247.2021.1823965] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
INTRODUCTION Epilepsy, a major neurological disorder affects about 1% of the Indian population. The discovery of noninvasive strategies for epilepsy presents a challenge for the scientists. Different types of nose-to-brain dosage-forms have been studied for epilepsy management. It aims to give new perspectives for developing new and existing anti-epileptic drugs. Combining nanotechnology with nose-to-brain approach can help in promoting the treatment efficacy by site-specific delivery. Also, it will minimize the side-effects and patient noncompliance observed in conventional administration routes. Peptide delivery can be an interesting approach for the management of epilepsy. Drug-loaded intranasal nanoformulations exhibit diverse prospective potentials in the management of epilepsy. Considering that, nanotherapy using nose-to-brain delivery as a prospective technique for the efficient management of epilepsy is reviewed. AREAS COVERED The authors have compiled all recently available data pertaining to the nose-to-brain delivery of therapeutics using nanotechnological strategies. The fundamental mechanism of nose-to-brain delivery, claims for intranasal delivery and medical devices for epilepsy are discussed. EXPERT OPINION Drug-loaded intranasal nanoformulations exhibit different prospective potentials in the management of epilepsy. Considering the foregoing research done in the field of nanotechnology, globally, authors propose nose-to-brain delivery of nanoformulations as a potential technique for the efficient management of epilepsy.
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Affiliation(s)
- Mihika Shringarpure
- Department of Pharmaceutics, SVKM's Dr. Bhanuben Nanavati College of Pharmacy, Mumbai, Maharashtra, India
| | - Sankalp Gharat
- Department of Pharmaceutics, SVKM's Dr. Bhanuben Nanavati College of Pharmacy, Mumbai, Maharashtra, India
| | - Munira Momin
- Department of Pharmaceutics, SVKM's Dr. Bhanuben Nanavati College of Pharmacy, Mumbai, Maharashtra, India.,SVKM's Shri C B Patel Research Center for Chemistry and Biological Sciences, Mumbai, Maharashtra, India
| | - Abdelwahab Omri
- The Novel Drug and Vaccine Delivery Systems Facility, Department of Chemistry and Biochemistry, Laurentian University, Sudbury, Canada
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18
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Luria G, Duran D, Visani E, Rossi Sebastiano D, Sorrentino A, Tassi L, Granvillano A, Franceschetti S, Panzica F. Towards the Automatic Localization of the Irritative Zone Through Magnetic Source Imaging. Brain Topogr 2020; 33:651-663. [PMID: 32770321 PMCID: PMC7429532 DOI: 10.1007/s10548-020-00789-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Accepted: 07/24/2020] [Indexed: 10/29/2022]
Abstract
The present work aims at validating a Bayesian multi-dipole modeling algorithm (SESAME) in the clinical scenario consisting of localizing the generators of single interictal epileptiform discharges from resting state magnetoencephalographic recordings. We use the results of Equivalent Current Dipole fitting, performed by an expert user, as a benchmark, and compare the results of SESAME with those of two widely used source localization methods, RAP-MUSIC and wMNE. In addition, we investigate the relation between post-surgical outcome and concordance of the surgical plan with the cerebral lobes singled out by the methods. Unlike dipole fitting, the tested algorithms do not rely on any subjective channel selection and thus contribute towards making source localization more unbiased and automatic. We show that the two dipolar methods, SESAME and RAP-MUSIC, generally agree with dipole fitting in terms of identified cerebral lobes and that the results of the former are closer to the fitted equivalent current dipoles than those of the latter. In addition, for all the tested methods and particularly for SESAME, concordance with surgical plan is a good predictor of seizure freedom while discordance is not a good predictor of poor post-surgical outcome. The results suggest that the dipolar methods, especially SESAME, represent a reliable and more objective alternative to manual dipole fitting for clinical applications in the field of epilepsy surgery.
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Affiliation(s)
- Gianvittorio Luria
- Department of Neurophysiology and Diagnostic Epileptology, IRCCS Foundation Carlo Besta Neurological Institute, Milan, Italy.
- Department of Mathematics, University of Genoa, Genoa, Italy.
| | - Dunja Duran
- Department of Neurophysiology and Diagnostic Epileptology, IRCCS Foundation Carlo Besta Neurological Institute, Milan, Italy
| | - Elisa Visani
- Department of Neurophysiology and Diagnostic Epileptology, IRCCS Foundation Carlo Besta Neurological Institute, Milan, Italy
| | - Davide Rossi Sebastiano
- Department of Neurophysiology and Diagnostic Epileptology, IRCCS Foundation Carlo Besta Neurological Institute, Milan, Italy
| | - Alberto Sorrentino
- Department of Mathematics, University of Genoa, Genoa, Italy
- CNR - SPIN, Genoa, Italy
| | - Laura Tassi
- Epilepsy Surgery Center, Ospedale Niguarda, Milan, Italy
| | - Alice Granvillano
- Department of Neurophysiology and Diagnostic Epileptology, IRCCS Foundation Carlo Besta Neurological Institute, Milan, Italy
| | - Silvana Franceschetti
- Department of Neurophysiology and Diagnostic Epileptology, IRCCS Foundation Carlo Besta Neurological Institute, Milan, Italy
| | - Ferruccio Panzica
- Department of Neurophysiology and Diagnostic Epileptology, IRCCS Foundation Carlo Besta Neurological Institute, Milan, Italy
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Lian J, Shi Y, Zhang Y, Jia W, Fan X, Zheng Y. Revealing False Positive Features in Epileptic EEG Identification. Int J Neural Syst 2020; 30:2050017. [DOI: 10.1142/s0129065720500173] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Feature selection plays a vital role in the detection and discrimination of epileptic seizures in electroencephalogram (EEG) signals. The state-of-the-art EEG classification techniques commonly entail the extraction of the multiple features that would be fed into classifiers. For some techniques, the feature selection strategies have been used to reduce the dimensionality of the entire feature space. However, most of these approaches focus on the performance of classifiers while neglecting the association between the feature and the EEG activity itself. To enhance the inner relationship between the feature subset and the epileptic EEG task with a promising classification accuracy, we propose a machine learning-based pipeline using a novel feature selection algorithm built upon a knockoff filter. First, a number of temporal, spectral, and spatial features are extracted from the raw EEG signals. Second, the proposed feature selection algorithm is exploited to obtain the optimal subgroup of features. Afterwards, three classifiers including [Formula: see text]-nearest neighbor (KNN), random forest (RF) and support vector machine (SVM) are used. The experimental results on the Bonn dataset demonstrate that the proposed approach outperforms the state-of-the-art techniques, with accuracy as high as 99.93% for normal and interictal EEG discrimination and 98.95% for interictal and ictal EEG classification. Meanwhile, it has achieved satisfactory sensitivity (95.67% in average), specificity (98.83% in average), and accuracy (98.89% in average) over the Freiburg dataset.
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Affiliation(s)
- Jian Lian
- School of Information Science and Engineering, Shandong Normal University, Jinan 250358, P. R. China
- Department of Electrical Engineering and Information Technology, Shandong University of Science and Technology, Jinan 250031, P. R. China
| | - Yunfeng Shi
- School of Information Science and Engineering, Shandong Normal University, Jinan 250358, P. R. China
| | - Yan Zhang
- Department of Electrical Engineering and Information Technology, Shandong University of Science and Technology, Jinan 250031, P. R. China
| | - Weikuan Jia
- School of Information Science and Engineering, Shandong Normal University, Jinan 250358, P. R. China
| | - Xiaojun Fan
- Antai College of Economics and Management, Shanghai Jiaotong University, Shanghai 200240, P. R. China
| | - Yuanjie Zheng
- School of Information Science and Engineering, Shandong Normal University, Key Lab of Intelligent Computing and Information Security in Universities of Shandong, Institute of Life Sciences, Shandong Provincial Key Laboratory for Distributed Computer Software and Novel Technologies, and Key Lab of Intelligent Information Processing, Jinan 250358, P. R. China
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20
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Agostinho AS, Mietzsch M, Zangrandi L, Kmiec I, Mutti A, Kraus L, Fidzinski P, Schneider UC, Holtkamp M, Heilbronn R, Schwarzer C. Dynorphin-based "release on demand" gene therapy for drug-resistant temporal lobe epilepsy. EMBO Mol Med 2019; 11:e9963. [PMID: 31486590 PMCID: PMC6783645 DOI: 10.15252/emmm.201809963] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2018] [Revised: 08/01/2019] [Accepted: 08/06/2019] [Indexed: 11/13/2022] Open
Abstract
Focal epilepsy represents one of the most common chronic CNS diseases. The high incidence of drug resistance, devastating comorbidities, and insufficient responsiveness to surgery pose unmet medical challenges. In the quest of novel, disease-modifying treatment strategies of neuropeptides represent promising candidates. Here, we provide the "proof of concept" that gene therapy by adeno-associated virus (AAV) vector transduction of preprodynorphin into the epileptogenic focus of well-accepted mouse and rat models for temporal lobe epilepsy leads to suppression of seizures over months. The debilitating long-term decline of spatial learning and memory is prevented. In human hippocampal slices obtained from epilepsy surgery, dynorphins suppressed seizure-like activity, suggestive of a high potential for clinical translation. AAV-delivered preprodynorphin expression is focally and neuronally restricted and release is dependent on high-frequency stimulation, as it occurs at the onset of seizures. The novel format of "release on demand" dynorphin delivery is viewed as a key to prevent habituation and to minimize the risk of adverse effects, leading to long-term suppression of seizures and of their devastating sequel.
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Affiliation(s)
| | - Mario Mietzsch
- Institute of VirologyCampus Benjamin Franklin, Charité ‐ Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt‐Universität zu Berlin, and Berlin Institute of HealthBerlinGermany
| | - Luca Zangrandi
- Department of PharmacologyMedical University of InnsbruckInnsbruckAustria
| | - Iwona Kmiec
- Department of PharmacologyMedical University of InnsbruckInnsbruckAustria
| | - Anna Mutti
- Department of PharmacologyMedical University of InnsbruckInnsbruckAustria
| | - Larissa Kraus
- Department of NeurologyCharité ‐ Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt‐Universität zu Berlin, and Berlin Institute of Health, Epilepsy‐Center Berlin‐BrandenburgBerlinGermany
- Berlin Institute of Health (BIH)BerlinGermany
| | - Pawel Fidzinski
- Department of NeurologyCharité ‐ Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt‐Universität zu Berlin, and Berlin Institute of Health, Epilepsy‐Center Berlin‐BrandenburgBerlinGermany
| | - Ulf C Schneider
- Department of NeurosurgeryCharité ‐ Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt‐Universität zu Berlin, and Berlin Institute of HealthBerlinGermany
| | - Martin Holtkamp
- Department of NeurologyCharité ‐ Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt‐Universität zu Berlin, and Berlin Institute of Health, Epilepsy‐Center Berlin‐BrandenburgBerlinGermany
- Berlin Institute of Health (BIH)BerlinGermany
| | - Regine Heilbronn
- Institute of VirologyCampus Benjamin Franklin, Charité ‐ Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt‐Universität zu Berlin, and Berlin Institute of HealthBerlinGermany
- Berlin Institute of Health (BIH)BerlinGermany
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21
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Vincze R, Péter M, Szabó Z, Kardos J, Héja L, Kovács Z. Connexin 43 Differentially Regulates Epileptiform Activity in Models of Convulsive and Non-convulsive Epilepsies. Front Cell Neurosci 2019; 13:173. [PMID: 31133805 PMCID: PMC6523398 DOI: 10.3389/fncel.2019.00173] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Accepted: 04/11/2019] [Indexed: 11/13/2022] Open
Abstract
The influence of astrocytic cell networks on neuronal network activity is an emerging issue in epilepsy. Among the various mechanisms by which astrocytes modulate neuronal function, synchronization of astrocytes via gap junction channels is widely considered to be a crucial mechanism in epileptic conditions, contributing to the synchronization of the neuronal cell networks, possibly inducing recurrent epileptiform activity. Here, we explored whether modulation of astrocytic gap junctions could alter epileptic seizures in different types of epilepsy. Opening of gap junctions by trimethylamine intensifies seizure-like events (SLEs) in the low-[Mg2+] in vitro model of temporal lobe epilepsy, while alleviates seizures in the in vivo WAG/Rij rat model of absence epilepsy. In contrast, application of the gap junction blocker carbenoxolone prevents the appearance of SLEs in the low-[Mg2+] epilepsy model, but aggravates seizures in non-convulsive absence epilepsy, in vivo. Pharmacological dissection of neuronal vs. astrocytic connexins shows that astrocytic Cx43 contribute to seizure formation to a significantly higher extent than neuronal Cx36. We conclude that astrocytic gap junctions are key players in the formation of epileptiform activity and we provide a scheme for the different mode of action in the convulsive and non-convulsive epilepsy types.
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Affiliation(s)
- Renáta Vincze
- Functional Pharmacology Research Group, Institute of Organic Chemistry, Research Centre for Natural Sciences, Hungarian Academy of Sciences, Budapest, Hungary
| | - Márton Péter
- Functional Pharmacology Research Group, Institute of Organic Chemistry, Research Centre for Natural Sciences, Hungarian Academy of Sciences, Budapest, Hungary
| | - Zsolt Szabó
- Functional Pharmacology Research Group, Institute of Organic Chemistry, Research Centre for Natural Sciences, Hungarian Academy of Sciences, Budapest, Hungary
| | - Julianna Kardos
- Functional Pharmacology Research Group, Institute of Organic Chemistry, Research Centre for Natural Sciences, Hungarian Academy of Sciences, Budapest, Hungary
| | - László Héja
- Functional Pharmacology Research Group, Institute of Organic Chemistry, Research Centre for Natural Sciences, Hungarian Academy of Sciences, Budapest, Hungary
| | - Zsolt Kovács
- Department of Biology, Eötvös Loránd University, Savaria University Centre, Szombathely, Hungary
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22
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Krasniqi S, Daci A. Role of the Angiotensin Pathway and its Target Therapy in Epilepsy Management. Int J Mol Sci 2019; 20:ijms20030726. [PMID: 30744022 PMCID: PMC6386974 DOI: 10.3390/ijms20030726] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 02/04/2019] [Accepted: 02/05/2019] [Indexed: 02/06/2023] Open
Abstract
Despite extensive research on epileptogenesis, there is still a need to investigate new pathways and targeted therapeutic approaches in this complex process. Inflammation, oxidative stress, neurotoxicity, neural cell death, gliosis, and blood–brain barrier (BBB) dysfunction are the most common causes of epileptogenesis. Moreover, the renin–angiotensin system (RAS) affects the brain’s physiological and pathological conditions, including epilepsy and its consequences. While there are a variety of available pharmacotherapeutic approaches, information on new pathways is in high demand and the achievement of treatment goals is greatly desired. Therefore, targeting the RAS presents an interesting opportunity to better understand this process. This has been supported by preclinical studies, primarily based on RAS enzyme, receptor-inhibition, and selective agonists, which are characterized by pleiotropic properties. Although there are some antiepileptic drugs (AEDs) that interfere with RAS, the main targeted therapy of this pathway contributes in synergy with AEDs. However, the RAS-targeted treatment alone, or in combination with AEDs, requires clinical studies to contribute to, and clarify, the evidence on epilepsy management. There is also a genetic association between RAS and epilepsy, and an involvement of pharmacogenetics in RAS, so there are possibilities for the development of new diagnostic and personalized treatments for epilepsy.
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Affiliation(s)
- Shaip Krasniqi
- Institute of Pharmacology and Toxicology, Faculty of Medicine, University of Prishtina, 10000 Prishtina, Kosovo.
| | - Armond Daci
- Department of Pharmacy, Faculty of Medicine, University of Prishtina, 10000 Prishtina, Kosovo.
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23
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Shah MN, Nguyen RD, Pao LP, Zhu L, CreveCoeur TS, Mitra A, Smyth MD. Role of resting state MRI temporal latency in refractory pediatric extratemporal epilepsy lateralization. J Magn Reson Imaging 2018; 49:1347-1355. [DOI: 10.1002/jmri.26320] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Revised: 08/10/2018] [Accepted: 08/10/2018] [Indexed: 11/12/2022] Open
Affiliation(s)
- Manish N. Shah
- Departments of Pediatric Surgery and Neurosurgery; McGovern Medical School at UTHealth; Houston Texas USA
| | - Ryan D. Nguyen
- Departments of Pediatric Surgery and Neurosurgery; McGovern Medical School at UTHealth; Houston Texas USA
| | - Ludovic P. Pao
- Departments of Pediatric Surgery and Neurosurgery; McGovern Medical School at UTHealth; Houston Texas USA
| | - Liang Zhu
- Department of Internal Medicine, Clinical and Translational Sciences; McGovern Medical School at UTHealth; Houston Texas USA
| | - Travis S. CreveCoeur
- Department of Neurological Surgery; Washington University School of Medicine; Saint Louis Missouri USA
| | - Anish Mitra
- Mallinckrodt Institute of Radiology, Washington University School of Medicine; Saint Louis Missouri USA
| | - Matthew D. Smyth
- Department of Neurological Surgery; Washington University School of Medicine; Saint Louis Missouri USA
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24
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An Ultra-Low Power Smart Headband for Real-Time Epileptic Seizure Detection. IEEE JOURNAL OF TRANSLATIONAL ENGINEERING IN HEALTH AND MEDICINE-JTEHM 2018; 6:2700410. [PMID: 30245945 PMCID: PMC6147694 DOI: 10.1109/jtehm.2018.2861882] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Revised: 06/22/2018] [Accepted: 07/09/2018] [Indexed: 12/03/2022]
Abstract
In this paper, the design of a smart headband for epileptic seizure detection is presented. The proposed headband consists of four key components: 1) an analog front-end circuitry; 2) an epileptic seizure detection tag (ESDT); 3) a Bluetooth low-power chip; and 4) customized electrodes. All the above components are integrated into a fabric headband with only 50.3 g. The smart headband system dissipates 55.89 mW. The epileptic seizure detection algorithm inside ESDT is validated by using Boston Children’s Hospital’s CHB-MIT scalp EEG clinical database with the detection rate of 92.68% and the false alarm of 0.527/h. We develop a service APP connected to the cloud so that the patients’ health condition can be recorded and then referenced by doctors for further diagnosis or research.
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Zhang Y, Xu J, Zhang K, Yang W, Li B. The Anticonvulsant Effects of Ketogenic Diet on Epileptic Seizures and Potential Mechanisms. Curr Neuropharmacol 2018; 16:66-70. [PMID: 28521671 PMCID: PMC5771386 DOI: 10.2174/1570159x15666170517153509] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2017] [Revised: 07/12/2017] [Accepted: 04/27/2017] [Indexed: 12/18/2022] Open
Abstract
Background: Epilepsy is a syndrome of brain dysfunction induced by the aberrant excitability of certain neurons. Despite advances in surgical technique and anti-epileptic drug in recent years, recurrent epileptic seizures remain intractable and lead to a serious morbidity in the world. The ketogenic diet refers to a high-fat, low-carbohydrate and adequate-protein diet.Currently, its beneficial effects on epileptic seizure reduction have been well established. However, the detailed mechanisms underlying the anti-epileptic effects of ketogenic diet are still poorly understood. In this article, the possible roles of ketogenic diet on epilepsy were discussed. Methods: Data was obtained from the websites including Web of Science, Medline, Pubmed,Scopus, based on these keywords: “Ketogenic diet” and “epilepsy”. Results: As shown in both clinical and basic studies, the therapeutic effects of ketogenic diet might involve neuronal metabolism, neurotransmitter function, neuronal membrane potential and neuron protection against ROS. Conclusion: In this review, we systematically reviewed the effects and possible mechanisms of ketogenic diet on epilepsy, which may optimize the therapeutic strategies against epilepsy.
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Affiliation(s)
- Yifan Zhang
- Jilin Provincial Key Laboratory on Molecular and Chemical Genetic, The Second Hospital of Jilin University, 218 Ziqiang Street, Changchun 130041, China
| | - Jingwei Xu
- Jilin Provincial Key Laboratory on Molecular and Chemical Genetic, The Second Hospital of Jilin University, 218 Ziqiang Street, Changchun 130041, China
| | - Kun Zhang
- Jilin Provincial Key Laboratory on Molecular and Chemical Genetic, The Second Hospital of Jilin University, 218 Ziqiang Street, Changchun 130041, China
| | - Wei Yang
- Jilin Provincial Key Laboratory on Molecular and Chemical Genetic, The Second Hospital of Jilin University, 218 Ziqiang Street, Changchun 130041, China
| | - Bingjin Li
- Jilin Provincial Key Laboratory on Molecular and Chemical Genetic, The Second Hospital of Jilin University, 218 Ziqiang Street, Changchun 130041, China
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Šutulović N, Pietro M, Šuvakov S, Hrnčić D. Glial cells, blood brain barrier and cytokines in seizures: Implications for therapeutic modalities. MEDICINSKI PODMLADAK 2018. [DOI: 10.5937/mp69-18143] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
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Burtscher J, Schwarzer C. The Opioid System in Temporal Lobe Epilepsy: Functional Role and Therapeutic Potential. Front Mol Neurosci 2017; 10:245. [PMID: 28824375 PMCID: PMC5545604 DOI: 10.3389/fnmol.2017.00245] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Accepted: 07/24/2017] [Indexed: 12/13/2022] Open
Abstract
Temporal lobe epilepsy is considered to be one of the most common and severe forms of focal epilepsies. Patients often develop cognitive deficits and emotional blunting along the progression of the disease. The high incidence of resistance to antiepileptic drugs and a frequent lack of admissibility to surgery poses an unmet medical challenge. In the urgent quest of novel treatment strategies, neuropeptides are interesting candidates, however, their therapeutic potential has not yet been exploited. This review focuses on the functional role of the endogenous opioid system with respect to temporal lobe epilepsy, specifically in the hippocampus. The role of dynorphins and kappa opioid receptors (KOPr) as modulators of neuronal excitability is well understood: both the reduced release of glutamate as well of postsynaptic hyperpolarization were shown in glutamatergic neurons. In line with this, low levels of dynorphin in humans and mice increase the risk of epilepsy development. The role of enkephalins is not understood so well. On one hand, some agonists of the delta opioid receptors (DOPr) display pro-convulsant properties probably through inhibition of GABAergic interneurons. On the other hand, enkephalins play a neuro-protective role under hypoxic or anoxic conditions, most probably through positive effects on mitochondrial function. Despite the supposed absence of endorphins in the hippocampus, exogenous activation of the mu opioid receptors (MOPr) induces pro-convulsant effects. Recently-expanded knowledge of the complex ways opioid receptors ligands elicit their effects (including biased agonism, mixed binding, and opioid receptor heteromers), opens up exciting new therapeutic potentials with regards to seizures and epilepsy. Potential adverse side effects of KOPr agonists may be minimized through functional selectivity. Preclinical data suggest a high potential of such compounds to control seizures, with a strong predictive validity toward human patients. The discovery of DOPr-agonists without proconvulsant potential stimulates the research on the therapeutic use of neuroprotective potential of the enkephalin/DOPr system.
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Affiliation(s)
| | - Christoph Schwarzer
- Department of Pharmacology, Medical University of InnsbruckInnsbruck, Austria
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Missault S, Peeters L, Amhaoul H, Thomae D, Van Eetveldt A, Favier B, Thakur A, Van Soom J, Pitkänen A, Augustyns K, Joossens J, Staelens S, Dedeurwaerdere S. Decreased levels of active uPA and KLK8 assessed by [111In]MICA-401 binding correlate with the seizure burden in an animal model of temporal lobe epilepsy. Epilepsia 2017; 58:1615-1625. [DOI: 10.1111/epi.13845] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/15/2017] [Indexed: 01/02/2023]
Affiliation(s)
- Stephan Missault
- Experimental Laboratory of Translational Neuroscience and Otolaryngology; Faculty of Medicine and Health Sciences; University of Antwerp; Wilrijk Belgium
| | - Lore Peeters
- Experimental Laboratory of Translational Neuroscience and Otolaryngology; Faculty of Medicine and Health Sciences; University of Antwerp; Wilrijk Belgium
- Bio-Imaging Lab; Faculty of Pharmaceutical, Biomedical and Veterinary Sciences; University of Antwerp; Wilrijk Belgium
| | - Halima Amhaoul
- Experimental Laboratory of Translational Neuroscience and Otolaryngology; Faculty of Medicine and Health Sciences; University of Antwerp; Wilrijk Belgium
| | - David Thomae
- Molecular Imaging Center Antwerp; Faculty of Medicine and Health Sciences; University of Antwerp; Wilrijk Belgium
- Laboratory of Medicinal Chemistry; Faculty of Pharmaceutical, Biomedical and Veterinary Sciences; University of Antwerp; Wilrijk Belgium
| | - Annemie Van Eetveldt
- Experimental Laboratory of Translational Neuroscience and Otolaryngology; Faculty of Medicine and Health Sciences; University of Antwerp; Wilrijk Belgium
| | - Barbara Favier
- Experimental Laboratory of Translational Neuroscience and Otolaryngology; Faculty of Medicine and Health Sciences; University of Antwerp; Wilrijk Belgium
| | - Anagha Thakur
- Experimental Laboratory of Translational Neuroscience and Otolaryngology; Faculty of Medicine and Health Sciences; University of Antwerp; Wilrijk Belgium
| | - Jeroen Van Soom
- Laboratory of Medicinal Chemistry; Faculty of Pharmaceutical, Biomedical and Veterinary Sciences; University of Antwerp; Wilrijk Belgium
| | - Asla Pitkänen
- Department of Neurobiology; A.I. Virtanen Institute for Molecular Sciences; University of Eastern Finland; Kuopio Finland
| | - Koen Augustyns
- Laboratory of Medicinal Chemistry; Faculty of Pharmaceutical, Biomedical and Veterinary Sciences; University of Antwerp; Wilrijk Belgium
| | - Jurgen Joossens
- Laboratory of Medicinal Chemistry; Faculty of Pharmaceutical, Biomedical and Veterinary Sciences; University of Antwerp; Wilrijk Belgium
| | - Steven Staelens
- Molecular Imaging Center Antwerp; Faculty of Medicine and Health Sciences; University of Antwerp; Wilrijk Belgium
| | - Stefanie Dedeurwaerdere
- Experimental Laboratory of Translational Neuroscience and Otolaryngology; Faculty of Medicine and Health Sciences; University of Antwerp; Wilrijk Belgium
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Valproate acid (VPA)-induced dysmetabolic function in clinical and animal studies. Clin Chim Acta 2017; 468:1-4. [DOI: 10.1016/j.cca.2017.01.030] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Revised: 01/17/2017] [Accepted: 01/31/2017] [Indexed: 11/19/2022]
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Investigation of altered microstructure in patients with drug refractory epilepsy using diffusion tensor imaging. Neuroradiology 2017; 59:597-608. [DOI: 10.1007/s00234-017-1835-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Accepted: 04/10/2017] [Indexed: 10/19/2022]
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Anti-Epileptic Drug Combination Efficacy in an In Vitro Seizure Model - Phenytoin and Valproate, Lamotrigine and Valproate. PLoS One 2017; 12:e0169974. [PMID: 28076384 PMCID: PMC5226812 DOI: 10.1371/journal.pone.0169974] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Accepted: 12/24/2016] [Indexed: 11/30/2022] Open
Abstract
In this study, we investigated the relative efficacy of different classes of commonly used anti-epileptic drugs (AEDs) with different mechanisms of action, individually and in combination, to suppress epileptiform discharges in an in vitro model. Extracellular field potential were recorded in 450 μm thick transverse hippocampal slices prepared from juvenile Wistar rats, in which “epileptiform discharges” (ED’s) were produced with a high-K+ (8.5 mM) bicarbonate-buffered saline solution. Single and dual recordings in stratum pyramidale of CA1 and CA3 regions were performed with 3–5 MΩ glass microelectrodes. All drugs—lamotrigine (LTG), phenytoin (PHT) and valproate (VPA)—were applied to the slice by superfusion at a rate of 2 ml/min at 32°C. Effects upon frequency of ED’s were assessed for LTG, PHT and VPA applied at different concentrations, in isolation and in combination. We demonstrated that high-K+ induced ED frequency was reversibly reduced by LTG, PHT and VPA, at concentrations corresponding to human therapeutic blood plasma concentrations. With a protocol using several applications of drugs to the same slice, PHT and VPA in combination displayed additivity of effect with 50μM PHT and 350μM VPA reducing SLD frequency by 44% and 24% individually (n = 19), and together reducing SLD frequency by 66% (n = 19). 20μM LTG reduced SLD frequency by 32% and 350μM VPA by 16% (n = 18). However, in combination there was a supra-linear suppression of ED’s of 64% (n = 18). In another independent set of experiments, similar results of drug combination responses were also found. In conclusion, a combination of conventional AEDs with different mechanisms of action, PHT and VPA, displayed linear additivity of effect on epileptiform activity. More intriguingly, a combination of LTG and VPA considered particularly efficacious clinically showed a supra-additive suppression of ED’s. This approach may be useful as an in vitro platform for assessing drug combination efficacy.
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Wang GB, Long W, Li XD, Xu GY, Lu JX. Dynamic Contrast-Enhanced Magnetic Resonance Imaging (DCE-MRI) Combined with Positron Emission Tomography-Computed Tomography (PET-CT) and Video-Electroencephalography (VEEG) Have Excellent Diagnostic Value in Preoperative Localization of Epileptic Foci in Children with Epilepsy. Med Sci Monit 2017; 23:1-10. [PMID: 28040805 PMCID: PMC5223780 DOI: 10.12659/msm.898316] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background To investigate the effect that dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) has on surgical decision making relative to video-electroencephalography (VEEG) and positron emission tomography-computed tomography (PET-CT), and if the differences in these variables translates to differences in surgical outcomes. Material/Methods A total of 166 children with epilepsy undergoing preoperative DCE-MRI, VEEG, and PET-CT examinations, surgical resection of epileptic foci, and intraoperative electrocorticography (ECoG) monitoring were enrolled. All children were followed up for 12 months and grouped by Engles prognostic classification for epilepsy. Based on intraoperative ECoG as gold standard, the diagnostic values of DCE-MRI, VEEG, PET-CT, DCE-MRI combined with VEEG, DCE-MRI combined with PET-CT, and combined application of DCE-MRI, VEEG, and PET-CT in preoperative localization for epileptic foci were evaluated. Results The sensitivity of DCE-MRI, VEEG, and PET-CT was 59.64%, 76.51%, and 93.98%, respectively; the accuracy of DCE-MRI, VEEG, PET-CT, DCE-MRI combined with VEEG, and DCE-MRI combined with PET-CT was 57.58%, 67.72%, 91.03%, 91.23%, and 96.49%, respectively. Localization accuracy rate of the combination of DCE-MRI, VEEG, and PET-CT was 98.25% (56/57), which was higher than that of DCE-MRI combined with VEEG and of DCE-MRI combined with PET-CT. No statistical difference was found in the accuracy rate of localization between these three combined techniques. During the 12-month follow-up, children were grouped into Engles grade I (n=106), II (n=31), III (n=21), and IV (n=8) according to postoperative conditions. Conclusions All DCE-MRI combined with VEEG, DCE-MRI combined with PET-CT, and DCE-MRI combined with VEEG and PET-CT examinations have excellent accuracy in preoperative localization of epileptic foci and present excellent postoperative efficiency, suggesting that these combined imaging methods are suitable for serving as the reference basis in preoperative localization of epileptic foci in children with epilepsy.
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Affiliation(s)
- Gui-Bin Wang
- Department of Medical Imaging, Linyi People's Hospital, Linyi, Shandong, China (mainland)
| | - Wei Long
- Department of Medical Imaging, Linyi People's Hospital, Linyi, Shandong, China (mainland)
| | - Xiao-Dong Li
- Department of Medical Imaging, Linyi People's Hospital, Linyi, Shandong, China (mainland)
| | - Guang-Yin Xu
- Department of Neurology, Linyi People's Hospital, Linyi, Shandong, China (mainland)
| | - Ji-Xiang Lu
- Department of Medical Imaging, Linyi People's Hospital, Linyi, Shandong, China (mainland)
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Liu X, Liao Y, Wang X, Zou D, Luo C, Jian C, Wu Y. MicroRNA expression profiles in chronic epilepsy rats and neuroprotection from seizures by targeting miR-344a. Neuropsychiatr Dis Treat 2017; 13:2037-2044. [PMID: 28814872 PMCID: PMC5546815 DOI: 10.2147/ndt.s141062] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
MicroRNA (miRNA) is believed to play a crucial role in the cause and treatment of epilepsy by controlling gene expression. However, it is still unclear how miRNA profiles change after multiple prolonged seizures and aggravation of brain injury in chronic epilepsy (CE). To investigate the role of miRNA in epilepsy, we utilized the CE rat models with pentylenetetrazol (PTZ) and miRNA profiles in the hippocampus. miRNA profiles were characterized using miRNA microarray analysis and were compared with the rats in the sham group, which received 0.9% physiological saline treatment at the same dose. Four up-regulated miRNAs (miR-139-3p, -770-5p, -127-5p, -331-3p) and 5 down-regulated miRNAs (miR-802-5p, -380-5p, -183-5p, -547-5p, -344a/-344a-5p) were found in the CE rats (fold change >1.5, P<0.05). Three of the dysregulated miRNAs were validated by quantitative real-time polymerase chain reaction, which revealed an outcome consistent with the initial results of the miRNA microarray analyses. Then, miR-344a agomir was intracerebroventricularly injected and followed by PTZ induction of CE models to investigate the effect of miR-344a in chronic neocortical epileptogenesis. After miRNA-344a agomir and scramble treatment, results showed a restoration of seizure behavior and a reduction in neuron damage in the cortex in miRNA-334a agomir treated rats. These data suggest that miRNA-344a might have a small modulatory effect on seizure-induced apoptosis signaling pathways in the cortex.
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Affiliation(s)
- Xixia Liu
- Department of Neurology, First Affiliated Hospital of Guangxi Medical University.,Department of Rehabilitation, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Yuhan Liao
- Department of Neurology, First Affiliated Hospital of Guangxi Medical University
| | - Xiuxiu Wang
- Department of Neurology, First Affiliated Hospital of Guangxi Medical University
| | - Donghua Zou
- Department of Neurology, First Affiliated Hospital of Guangxi Medical University
| | - Chun Luo
- Department of Neurology, First Affiliated Hospital of Guangxi Medical University
| | - Chongdong Jian
- Department of Neurology, First Affiliated Hospital of Guangxi Medical University
| | - Yuan Wu
- Department of Neurology, First Affiliated Hospital of Guangxi Medical University
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mTOR and MAPK: from localized translation control to epilepsy. BMC Neurosci 2016; 17:73. [PMID: 27855659 PMCID: PMC5114760 DOI: 10.1186/s12868-016-0308-1] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Accepted: 11/09/2016] [Indexed: 01/03/2023] Open
Abstract
Background Epilepsy is one of the most common neurological diseases characterized by excessive hyperexcitability of neurons. Molecular mechanisms of epilepsy are diverse and not really understood. All in common is the misregulation of proteins that determine excitability such as potassium and sodium channels as well as GABA receptors; which are all known as biomarkers for epilepsy. Two recently identified key pathways involve the kinases mechanistic target of rapamycin (mTOR) and mitogen-activated protein kinases (MAPK). Interestingly, mRNAs coding for those biomarkers are found to be localized at or near synapses indicating a local misregulation of synthesis and activity. Results Research in the last decade indicates that RNA-binding proteins (RBPs) responsible for mRNA localization, stability and translation mediate local expression control. Among others, they are affected by mTOR and MAPK to guide expression of epileptic factors. These results suggest that mTOR/MAPK act on RBPs to regulate the fate of mRNAs, indicating a misregulation of protein expression at synapses in epilepsy. Conclusion We propose that mTOR and MAPK regulate RBPs, thereby guiding the local expression of their target-mRNAs encoding for markers of epilepsy. Thus, misregulated mTOR/MAPK-RBP interplay may result in excessive local synthesis of ion channels and receptors thereby leading to hyperexcitability. Continuous stimulation of synapses further activates mTOR/MAPK pathway reinforcing their effect on RBP-mediated expression control establishing the basis for epilepsy. Here, we highlight findings showing the tight interplay between mTOR as well as MAPK with RBPs to control expression for epileptic biomarkers.
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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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Z-Flores E, Trujillo L, Sotelo A, Legrand P, Coria LN. Regularity and Matching Pursuit feature extraction for the detection of epileptic seizures. J Neurosci Methods 2016; 266:107-25. [DOI: 10.1016/j.jneumeth.2016.03.024] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2015] [Revised: 03/30/2016] [Accepted: 03/31/2016] [Indexed: 11/25/2022]
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Herzog AG, Mandle HB, Cahill KE, Fowler KM, Hauser WA, Davis AR. Contraceptive practices of women with epilepsy: Findings of the epilepsy birth control registry. Epilepsia 2016; 57:630-7. [DOI: 10.1111/epi.13320] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/23/2015] [Indexed: 12/01/2022]
Affiliation(s)
- Andrew G. Herzog
- Harvard Neuroendocrine Unit; Beth Israel Deaconess Medical Center; Boston Massachusetts U.S.A
| | - Hannah B. Mandle
- Harvard Neuroendocrine Unit; Beth Israel Deaconess Medical Center; Boston Massachusetts U.S.A
| | - Kaitlyn E. Cahill
- Harvard Neuroendocrine Unit; Beth Israel Deaconess Medical Center; Boston Massachusetts U.S.A
| | - Kristen M. Fowler
- Harvard Neuroendocrine Unit; Beth Israel Deaconess Medical Center; Boston Massachusetts U.S.A
| | - W. Allen Hauser
- Gertrude H. Sergievsky Center; Mailman School of Public Health; Columbia University; New York New York U.S.A
| | - Anne R. Davis
- Department of OBGYN; Columbia University Medical Center; New York New York U.S.A
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Potent KCNQ2/3-specific channel activator suppresses in vivo epileptic activity and prevents the development of tinnitus. J Neurosci 2015; 35:8829-42. [PMID: 26063916 DOI: 10.1523/jneurosci.5176-14.2015] [Citation(s) in RCA: 76] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Voltage-gated Kv7 (KCNQ) channels are voltage-dependent potassium channels that are activated at resting membrane potentials and therefore provide a powerful brake on neuronal excitability. Genetic or experience-dependent reduction of KCNQ2/3 channel activity is linked with disorders that are characterized by neuronal hyperexcitability, such as epilepsy and tinnitus. Retigabine, a small molecule that activates KCNQ2-5 channels by shifting their voltage-dependent opening to more negative voltages, is an US Food and Drug Administration (FDA) approved anti-epileptic drug. However, recently identified side effects have limited its clinical use. As a result, the development of improved KCNQ2/3 channel activators is crucial for the treatment of hyperexcitability-related disorders. By incorporating a fluorine substituent in the 3-position of the tri-aminophenyl ring of retigabine, we synthesized a small-molecule activator (SF0034) with novel properties. Heterologous expression of KCNQ2/3 channels in HEK293T cells showed that SF0034 was five times more potent than retigabine at shifting the voltage dependence of KCNQ2/3 channels to more negative voltages. Moreover, unlike retigabine, SF0034 did not shift the voltage dependence of either KCNQ4 or KCNQ5 homomeric channels. Conditional deletion of Kcnq2 from cerebral cortical pyramidal neurons showed that SF0034 requires the expression of KCNQ2/3 channels for reducing the excitability of CA1 hippocampal neurons. Behavioral studies demonstrated that SF0034 was a more potent and less toxic anticonvulsant than retigabine in rodents. Furthermore, SF0034 prevented the development of tinnitus in mice. We propose that SF0034 provides, not only a powerful tool for investigating ion channel properties, but, most importantly, it provides a clinical candidate for treating epilepsy and preventing tinnitus.
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Ji ZG, Wang H. Optogenetic control of astrocytes: Is it possible to treat astrocyte-related epilepsy? Brain Res Bull 2015; 110:20-5. [DOI: 10.1016/j.brainresbull.2014.10.013] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2014] [Revised: 10/25/2014] [Accepted: 10/28/2014] [Indexed: 11/15/2022]
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Yang Y, Gao X, Xu Y. The dilemma of treatments for epileptic patients with depression. Int J Neurosci 2014; 125:566-77. [PMID: 25271800 DOI: 10.3109/00207454.2014.959122] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Depression is a state of low mood and aversion to activity. It may occur due to existence of other mental or physical diseases or from the medications for those illnesses. It is one of the leading sources of disability. Among these physical diseases, epilepsy is widely recognized as one of the main causes of depression. Patients with epilepsy are at high risk of developing depressive symptoms, and the suicide rates in patients with epilepsy have been reported to be much higher than in the general population. However, due to fears of lowering seizure threshold and adverse drug interactions between antidepressants and antiepileptic drugs, physician are reluctant to place patients with epilepsy on antidepressant medication. As a result, the question has been raised that what the best managements should be used to treat epileptic patients with depression. In this review, the currently used medications for antidepressants and antiepileptic drugs were summarized by their working targets in order to establish appropriate pharmacological management of depression and epilepsy. Despite the complex relationship between epilepsy and depression, coadministration of antidepressants and AEDs can still be done safely and effectively under the conditions of good clinical management. The ideal antidepressants for people with epilepsy should be efficacious but with few adverse effects, which will not antagonize GABAergic mechanisms or interfere with plasma anticonvulsant concentrations.
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Affiliation(s)
- Yang Yang
- 1Department of Clinical Psychology, Subei People Hospital of Jiangsu Province, Yangzhou, 225001, China
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