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Hobson BA, Rowland DJ, Dou Y, Saito N, Harmany ZT, Bruun DA, Harvey DJ, Chaudhari AJ, Garbow JR, Lein PJ. A longitudinal MRI and TSPO PET-based investigation of brain region-specific neuroprotection by diazepam versus midazolam following organophosphate-induced seizures. Neuropharmacology 2024; 251:109918. [PMID: 38527652 DOI: 10.1016/j.neuropharm.2024.109918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 03/01/2024] [Accepted: 03/13/2024] [Indexed: 03/27/2024]
Abstract
Acute poisoning with organophosphorus cholinesterase inhibitors (OPs), such as OP nerve agents and pesticides, can cause life threatening cholinergic crisis and status epilepticus (SE). Survivors often experience significant morbidity, including brain injury, acquired epilepsy, and cognitive deficits. Current medical countermeasures for acute OP poisoning include a benzodiazepine to mitigate seizures. Diazepam was long the benzodiazepine included in autoinjectors used to treat OP-induced seizures, but it is now being replaced in many guidelines by midazolam, which terminates seizures more quickly, particularly when administered intramuscularly. While a direct correlation between seizure duration and the extent of brain injury has been widely reported, there are limited data comparing the neuroprotective efficacy of diazepam versus midazolam following acute OP intoxication. To address this data gap, we used non-invasive imaging techniques to longitudinally quantify neuropathology in a rat model of acute intoxication with the OP diisopropylfluorophosphate (DFP) with and without post-exposure intervention with diazepam or midazolam. Magnetic resonance imaging (MRI) was used to monitor neuropathology and brain atrophy, while positron emission tomography (PET) with a radiotracer targeting translocator protein (TSPO) was utilized to assess neuroinflammation. Animals were scanned at 3, 7, 28, 65, 91, and 168 days post-DFP and imaging metrics were quantitated for the hippocampus, amygdala, piriform cortex, thalamus, cerebral cortex and lateral ventricles. In the DFP-intoxicated rat, neuroinflammation persisted for the duration of the study coincident with progressive atrophy and ongoing tissue remodeling. Benzodiazepines attenuated neuropathology in a region-dependent manner, but neither benzodiazepine was effective in attenuating long-term neuroinflammation as detected by TSPO PET. Diffusion MRI and TSPO PET metrics were highly correlated with seizure severity, and early MRI and PET metrics were positively correlated with long-term brain atrophy. Collectively, these results suggest that anti-seizure therapy alone is insufficient to prevent long-lasting neuroinflammation and tissue remodeling.
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Affiliation(s)
- Brad A Hobson
- Department of Molecular Biosciences, University of California, Davis, School of Veterinary Medicine, Davis, CA 95616, USA; Center for Molecular and Genomic Imaging, University of California, Davis, College of Engineering, Davis, CA 95616, USA.
| | - Douglas J Rowland
- Center for Molecular and Genomic Imaging, University of California, Davis, College of Engineering, Davis, CA 95616, USA.
| | - Yimeng Dou
- Department of Molecular Biosciences, University of California, Davis, School of Veterinary Medicine, Davis, CA 95616, USA.
| | - Naomi Saito
- Department of Public Health Sciences, University of California, Davis, School of Medicine, California 95616, USA.
| | - Zachary T Harmany
- Center for Molecular and Genomic Imaging, University of California, Davis, College of Engineering, Davis, CA 95616, USA.
| | - Donald A Bruun
- Department of Molecular Biosciences, University of California, Davis, School of Veterinary Medicine, Davis, CA 95616, USA.
| | - Danielle J Harvey
- Department of Public Health Sciences, University of California, Davis, School of Medicine, California 95616, USA.
| | - Abhijit J Chaudhari
- Center for Molecular and Genomic Imaging, University of California, Davis, College of Engineering, Davis, CA 95616, USA; Department of Radiology, University of California, Davis, School of Medicine, California 95817, USA.
| | - Joel R Garbow
- Biomedical Magnetic Resonance Center, Mallinckrodt Institute of Radiology, School of Medicine, Washington University in St. Louis, St. Louis, Missouri, 63110, USA.
| | - Pamela J Lein
- Department of Molecular Biosciences, University of California, Davis, School of Veterinary Medicine, Davis, CA 95616, USA.
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Leon-Rojas JE, Iqbal S, Vos SB, Rodionov R, Miserocchi A, McEvoy AW, Vakharia VN, Mancini L, Galovic M, Sparks RE, Ourselin S, Cardoso JM, Koepp MJ, Duncan JS. Resection of the piriform cortex for temporal lobe epilepsy: a Novel approach on imaging segmentation and surgical application. Br J Neurosurg 2024; 38:716-721. [PMID: 34406102 DOI: 10.1080/02688697.2021.1966385] [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: 04/16/2021] [Revised: 07/09/2021] [Accepted: 08/05/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND The piriform cortex (PC) occupies both banks of the endorhinal sulcus and has an important role in the pathophysiology of temporal lobe epilepsy (TLE). A recent study showed that resection of more than 50% of PC increased the odds of becoming seizure free by a factor of 16. OBJECTIVE We report the feasibility of manual segmentation of PC and application of the Geodesic Information Flows (GIF) algorithm to automated segmentation, to guide resection. METHODS Manual segmentation of PC was performed by two blinded independent examiners in 60 patients with TLE (55% Left TLE, 52% female) with a median age of 35 years (IQR, 29-47 years) and 20 controls (60% Women) with a median age of 39.5 years (IQR, 31-49). The GIF algorithm was used to create an automated pipeline for parcellating PC which was used to guide excision as part of temporal lobe resection for TLE. RESULTS Right PC was larger in patients and controls. Parcellation of PC was used to guide anterior temporal lobe resection, with subsequent seizure freedom and no visual field or language deficit. CONCLUSION Reliable segmentation of PC is feasible and can be applied prospectively to guide neurosurgical resection that increases the chances of a good outcome from temporal lobe resection for TLE.
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Affiliation(s)
- Jose E Leon-Rojas
- NeurALL Research Group, Medical School, Universidad Internacional del Ecuador, Quito, Ecuador
- UK National Institute for Health Research University College London Hospitals Biomedical Research Centre, and Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, UK
- Epilepsy Society MRI Unit, Chalfont Centre for Epilepsy, Chalfont St Peter, UK
| | - Sabahat Iqbal
- UK National Institute for Health Research University College London Hospitals Biomedical Research Centre, and Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, UK
- Epilepsy Society MRI Unit, Chalfont Centre for Epilepsy, Chalfont St Peter, UK
| | - Sjoerd B Vos
- UK National Institute for Health Research University College London Hospitals Biomedical Research Centre, and Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, UK
- Centre for Medical Image Computing (CMIC), Department of Computer Science, University College London, London, UK
- Neuroradiological Academic Unit, UCL Queen Square Institute of Neurology, London, UK
| | - Roman Rodionov
- UK National Institute for Health Research University College London Hospitals Biomedical Research Centre, and Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, UK
- Epilepsy Society MRI Unit, Chalfont Centre for Epilepsy, Chalfont St Peter, UK
| | - Anna Miserocchi
- UK National Institute for Health Research University College London Hospitals Biomedical Research Centre, and Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, UK
| | - Andrew W McEvoy
- UK National Institute for Health Research University College London Hospitals Biomedical Research Centre, and Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, UK
| | - Vejay N Vakharia
- UK National Institute for Health Research University College London Hospitals Biomedical Research Centre, and Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, UK
| | - Laura Mancini
- Epilepsy Society MRI Unit, Chalfont Centre for Epilepsy, Chalfont St Peter, UK
| | - Marian Galovic
- UK National Institute for Health Research University College London Hospitals Biomedical Research Centre, and Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, UK
- Epilepsy Society MRI Unit, Chalfont Centre for Epilepsy, Chalfont St Peter, UK
- Department of Neurology, Zurich University Hospital, Zurich, Switzerland
| | - Rachel E Sparks
- School of Biomedical Engineering and Imaging Sciences, Kings College, St Thomas Hospital, London, UK
| | - Sebastien Ourselin
- School of Biomedical Engineering and Imaging Sciences, Kings College, St Thomas Hospital, London, UK
| | - Jorge M Cardoso
- School of Biomedical Engineering and Imaging Sciences, Kings College, St Thomas Hospital, London, UK
| | - Matthias J Koepp
- UK National Institute for Health Research University College London Hospitals Biomedical Research Centre, and Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, UK
- Epilepsy Society MRI Unit, Chalfont Centre for Epilepsy, Chalfont St Peter, UK
| | - John S Duncan
- UK National Institute for Health Research University College London Hospitals Biomedical Research Centre, and Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, UK
- Epilepsy Society MRI Unit, Chalfont Centre for Epilepsy, Chalfont St Peter, UK
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Okumura T, Kida I, Yokoi A, Nakai T, Nishimoto S, Touhara K, Okamoto M. Semantic context-dependent neural representations of odors in the human piriform cortex revealed by 7T MRI. Hum Brain Mapp 2024; 45:e26681. [PMID: 38656060 PMCID: PMC11041378 DOI: 10.1002/hbm.26681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 03/23/2024] [Accepted: 03/28/2024] [Indexed: 04/26/2024] Open
Abstract
Olfactory perception depends not only on olfactory inputs but also on semantic context. Although multi-voxel activity patterns of the piriform cortex, a part of the primary olfactory cortex, have been shown to represent odor perception, it remains unclear whether semantic contexts modulate odor representation in this region. Here, we investigated whether multi-voxel activity patterns in the piriform cortex change when semantic context modulates odor perception and, if so, whether the modulated areas communicate with brain regions involved in semantic and memory processing beyond the piriform cortex. We also explored regional differences within the piriform cortex, which are influenced by olfactory input and semantic context. We used 2 × 2 combinations of word labels and odorants that were perceived as congruent and measured piriform activity with a 1-mm isotropic resolution using 7T MRI. We found that identical odorants labeled with different words were perceived differently. This labeling effect was observed in multi-voxel activity patterns in the piriform cortex, as the searchlight decoding analysis distinguished identical odors with different labels for half of the examined stimulus pairs. Significant functional connectivity was observed between parts of the piriform cortex that were modulated by labels and regions associated with semantic and memory processing. While the piriform multi-voxel patterns evoked by different olfactory inputs were also distinguishable, the decoding accuracy was significant for only one stimulus pair, preventing definitive conclusions regarding the locational differences between areas influenced by word labels and olfactory inputs. These results suggest that multi-voxel patterns of piriform activity can be modulated by semantic context, possibly due to communication between the piriform cortex and the semantic and memory regions.
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Affiliation(s)
- Toshiki Okumura
- Department of Applied Biological Chemistry, Graduate School of Agricultural and Life Sciences, The University of TokyoTokyoJapan
- Center for Information and Neural Networks (CiNet), National Institute of Information and Communications Technology (NICT)OsakaJapan
| | - Ikuhiro Kida
- Center for Information and Neural Networks (CiNet), National Institute of Information and Communications Technology (NICT)OsakaJapan
- Graduate School of Frontier Biosciences, Osaka UniversityOsakaJapan
| | - Atsushi Yokoi
- Center for Information and Neural Networks (CiNet), National Institute of Information and Communications Technology (NICT)OsakaJapan
- Graduate School of Frontier Biosciences, Osaka UniversityOsakaJapan
| | - Tomoya Nakai
- Center for Information and Neural Networks (CiNet), National Institute of Information and Communications Technology (NICT)OsakaJapan
| | - Shinji Nishimoto
- Center for Information and Neural Networks (CiNet), National Institute of Information and Communications Technology (NICT)OsakaJapan
- Graduate School of Frontier Biosciences, Osaka UniversityOsakaJapan
| | - Kazushige Touhara
- Department of Applied Biological Chemistry, Graduate School of Agricultural and Life Sciences, The University of TokyoTokyoJapan
- International Research Center for Neurointelligence (WPI‐IRCN), Institutes for Advanced Study, The University of TokyoTokyoJapan
| | - Masako Okamoto
- Department of Applied Biological Chemistry, Graduate School of Agricultural and Life Sciences, The University of TokyoTokyoJapan
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Shahsavar P, Ghazvineh S, Raoufy MR. From nasal respiration to brain dynamic. Rev Neurosci 2024; 0:revneuro-2023-0152. [PMID: 38579456 DOI: 10.1515/revneuro-2023-0152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 03/25/2024] [Indexed: 04/07/2024]
Abstract
While breathing is a vital, involuntary physiological function, the mode of respiration, particularly nasal breathing, exerts a profound influence on brain activity and cognitive processes. This review synthesizes existing research on the interactions between nasal respiration and the entrainment of oscillations across brain regions involved in cognition. The rhythmic activation of olfactory sensory neurons during nasal respiration is linked to oscillations in widespread brain regions, including the prefrontal cortex, entorhinal cortex, hippocampus, amygdala, and parietal cortex, as well as the piriform cortex. The phase-locking of neural oscillations to the respiratory cycle, through nasal breathing, enhances brain inter-regional communication and is associated with cognitive abilities like memory. Understanding the nasal breathing impact on brain networks offers opportunities to explore novel methods for targeting the olfactory pathway as a means to enhance emotional and cognitive functions.
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Affiliation(s)
- Payam Shahsavar
- Department of Physiology, Faculty of Medical Sciences, 41616 Tarbiat Modares University , Jalal AleAhmad, Nasr, P.O. Box: 14115-111, Tehran, Iran
| | - Sepideh Ghazvineh
- Department of Physiology, Faculty of Medical Sciences, 41616 Tarbiat Modares University , Jalal AleAhmad, Nasr, P.O. Box: 14115-111, Tehran, Iran
| | - Mohammad Reza Raoufy
- Department of Physiology, Faculty of Medical Sciences, 41616 Tarbiat Modares University , Jalal AleAhmad, Nasr, P.O. Box: 14115-111, Tehran, Iran
- Faculty of Medical Sciences, 41616 Institute for Brain Sciences and Cognition, Tarbiat Modares University , Jalal AleAhmad, Nasr, P.O. Box: 14115-111, Tehran, Iran
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Borghei A, Kelly R, Pearce JJ, Stoub TR, Sani S. Structural Connectivity of the Human Piriform Cortex: an Exploratory Study. Neurosurgery 2024; 94:856-863. [PMID: 37955443 DOI: 10.1227/neu.0000000000002756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 09/21/2023] [Indexed: 11/14/2023] Open
Abstract
BACKGROUND AND OBJECTIVES The piriform cortex (PC) is part of the primary olfactory network in humans. Recent findings suggest that it plays a role in pathophysiology of epilepsy. Therefore, studying its connectivity can further our understanding of seizure propagation in epilepsy. We aimed to explore the structural connectivity of PC using high-quality human connectome project data coupled with segmentation of PC on anatomic MRI. METHODS Twenty subjects were randomly selected from the human connectome project database, and PC was traced on each hemisphere. Probabilistic whole-brain tractography was then used to visualize PC connectivity. RESULTS The strongest connectivity was noted between PC and ipsilateral insula in both hemispheres. Specifically, the posterior long gyrus of each insula was predominantly connected to PC. This was followed by connections between PC and basal ganglia as well as orbital frontal cortices. CONCLUSION The PC has the strongest connectivity with the insula bilaterally. Specifically, the posterior long gyri of insula have the strongest connectivity. This finding may provide additional insight for localizing and treating temporo-insular epilepsy.
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Affiliation(s)
- Alireza Borghei
- Department of Neurosurgery, Rush University Medical Center, Chicago , Illinois , USA
| | - Ryan Kelly
- Department of Neurosurgery, Rush University Medical Center, Chicago , Illinois , USA
| | - John J Pearce
- Department of Neurosurgery, Rush University Medical Center, Chicago , Illinois , USA
| | - Travis R Stoub
- Department of Neurological Sciences, Rush University Medical Center, Chicago , Illinois , USA
| | - Sepehr Sani
- Department of Neurosurgery, Rush University Medical Center, Chicago , Illinois , USA
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Liu AA, Barr WB. Overlapping and distinct phenotypic profiles in Alzheimer's disease and late onset epilepsy: a biologically-based approach. Front Neurol 2024; 14:1260523. [PMID: 38545454 PMCID: PMC10965692 DOI: 10.3389/fneur.2023.1260523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 12/18/2023] [Indexed: 04/05/2024] Open
Abstract
Due to shared hippocampal dysfunction, patients with Alzheimer's dementia and late-onset epilepsy (LOE) report memory decline. Multiple studies have described the epidemiological, pathological, neurophysiological, and behavioral overlap between Alzheimer's Disease and LOE, implying a bi-directional relationship. We describe the neurobiological decline occurring at different spatial in AD and LOE patients, which may explain why their phenotypes overlap and differ. We provide suggestions for clinical recognition of dual presentation and novel approaches for behavioral testing that reflect an "inside-out," or biologically-based approach to testing memory. New memory and language assessments could detect-and treat-memory impairment in AD and LOE at an earlier, actionable stage.
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Affiliation(s)
- Anli A. Liu
- Langone Medical Center, New York University, New York, NY, United States
- Department of Neurology, School of Medicine, New York University, New York, NY, United States
- Neuroscience Institute, Langone Medical Center, New York University, New York, NY, United States
| | - William B. Barr
- Department of Neurology, School of Medicine, New York University, New York, NY, United States
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Hines K, Wu C. Epilepsy Networks and Their Surgical Relevance. Brain Sci 2023; 14:31. [PMID: 38248246 PMCID: PMC10813558 DOI: 10.3390/brainsci14010031] [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: 11/09/2023] [Revised: 12/22/2023] [Accepted: 12/24/2023] [Indexed: 01/23/2024] Open
Abstract
Surgical epilepsy is a rapidly evolved field. As the understanding and concepts of epilepsy shift towards a network disorder, surgical outcomes may shed light on numerous components of these systems. This review documents the evolution of the understanding of epilepsy networks and examines the data generated by resective, ablative, neuromodulation, and invasive monitoring surgeries in epilepsy patients. As these network tools are better integrated into epilepsy practice, they may eventually inform surgical decisions and improve clinical outcomes.
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Affiliation(s)
- Kevin Hines
- Department of Neurosurgery, Thomas Jefferson University Hospital, Philadelphia, PA 19107, USA;
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Thompson SA. Kindling in humans: Does secondary epileptogenesis occur? Epilepsy Res 2023; 198:107155. [PMID: 37301727 DOI: 10.1016/j.eplepsyres.2023.107155] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 04/01/2022] [Accepted: 04/25/2023] [Indexed: 06/12/2023]
Abstract
The relevance of secondary epileptogenesis for human epilepsy remains a controversial subject decades after it was first described in animal models. Whether or not a previously normal brain region can become independently epileptogenic through a kindling-like process has not, and cannot, be definitely proven in humans. Rather than reliance on direct experimental evidence, attempts to answering this question must depend on observational data. In this review, observations based largely upon contemporary surgical series will advance the case for secondary epileptogenesis in humans. As will be argued, hypothalamic hamartoma-related epilepsy provides the strongest case for this process; all the stages of secondary epileptogenesis can be observed. Hippocampal sclerosis (HS) is another pathology where the question of secondary epileptogenesis frequently arises, and observations from bitemporal and dual pathology series are explored. The verdict here is far more difficult to reach, in large part because of the scarcity of longitudinal cohorts; moreover, recent experimental data have challenged the claim that HS is acquired consequent to recurrent seizures. Synaptic plasticity more than seizure-induced neuronal injury is the likely mechanism of secondary epileptogenesis. Postoperative running-down phenomenon provides the best evidence that a kindling-like process occurs in some patients, evidenced by its reversal. Finally, a network perspective of secondary epileptogenesis is considered, as well as the possible role for subcortical surgical interventions.
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Affiliation(s)
- Stephen A Thompson
- Department of Medicine (Neurology), McMaster University, Hamilton, ON, Canada.
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Vattoth S, Mariya S. Practical microscopic neuroanatomy of the limbic system and basal forebrain identifiable on clinical 3T MRI. Neuroradiol J 2023; 36:506-514. [PMID: 35996275 PMCID: PMC10569190 DOI: 10.1177/19714009221122250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Microscopic neuroanatomy of limbic system and basal forebrain on MRI is complex and is a terra incognita for many radiologists, clinicians, and neuroscientists. Interestingly, most of the important structures/at least anatomical regions containing these structures demonstrable on cadaveric and surgical dissections can be identified on clinical MRI, with 3T being much better than 1.5T. This article teaches the practical MRI identification of these structures which will greatly help in evaluating complex ailments like temporal lobe epilepsy, Alzheimer dementia, and other neuropsychiatric disorders. This knowledge will also aid in accurate reporting of tumor spread along the white matter fasciculi in the temporal stem/basal forebrain region. Limbic system includes the mesial temporal structures and their connections, piriform cortex including "area tempestas," and the septal area comprising of subcallosal area and paraterminal gyrus. Basal forebrain includes structures like substantia innominata with basal nucleus of Meynert, diagonal gyrus/diagonal band of Broca, and nucleus accumbens lying in between the anterior perforated substance inferiorly and the anterior commissure superiorly.
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Affiliation(s)
- Surjith Vattoth
- Radiology (Neuroradiology), University of Arkansas for Medical Sciences (UAMS), Little Rock, AR, USA
| | - Sheza Mariya
- Malabar Medical College, Kozhikode, Kerala, India
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Soon HR, Gaunt JR, Bansal VA, Lenherr C, Sze SK, Ch’ng TH. Seizure enhances SUMOylation and zinc-finger transcriptional repression in neuronal nuclei. iScience 2023; 26:107707. [PMID: 37694138 PMCID: PMC10483055 DOI: 10.1016/j.isci.2023.107707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 05/29/2023] [Accepted: 08/21/2023] [Indexed: 09/12/2023] Open
Abstract
A single episode of pilocarpine-induced status epilepticus can trigger the development of spontaneous recurrent seizures in a rodent model for epilepsy. The initial seizure-induced events in neuronal nuclei that lead to long-term changes in gene expression and cellular responses likely contribute toward epileptogenesis. Using a transgenic mouse model to specifically isolate excitatory neuronal nuclei, we profiled the seizure-induced nuclear proteome via tandem mass tag mass spectrometry and observed robust enrichment of nuclear proteins associated with the SUMOylation pathway. In parallel with nuclear proteome, we characterized nuclear gene expression by RNA sequencing which provided insights into seizure-driven transcriptional regulation and dynamics. Strikingly, we saw widespread downregulation of zinc-finger transcription factors, specifically proteins that harbor Krüppel-associated box (KRAB) domains. Our results provide a detailed snapshot of nuclear events induced by seizure activity and demonstrate a robust method for cell-type-specific nuclear profiling that can be applied to other cell types and models.
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Affiliation(s)
- Hui Rong Soon
- School of Biological Science, Nanyang Technological University, Singapore 636551, Singapore
| | - Jessica Ruth Gaunt
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore 308232, Singapore
| | - Vibhavari Aysha Bansal
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore 308232, Singapore
| | - Clara Lenherr
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore 308232, Singapore
- Centre for Discovery Brain Science, The University of Edinburgh, Edinburgh, UK
| | - Siu Kwan Sze
- Faculty of Applied Health Sciences, Brock University, St. Catherines, ON, Canada
| | - Toh Hean Ch’ng
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore 308232, Singapore
- School of Biological Science, Nanyang Technological University, Singapore 636551, Singapore
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Piper RJ, Dasgupta D, Eriksson MH, Ripart M, Moosa A, Chari A, Seunarine KK, Clark CA, Duncan JS, Carmichael DW, Tisdall MM, Baldeweg T. Extent of piriform cortex resection in children with temporal lobe epilepsy. Ann Clin Transl Neurol 2023; 10:1613-1622. [PMID: 37475156 PMCID: PMC10502684 DOI: 10.1002/acn3.51852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 05/26/2023] [Accepted: 06/27/2023] [Indexed: 07/22/2023] Open
Abstract
OBJECTIVE A greater extent of resection of the temporal portion of the piriform cortex (PC) has been shown to be associated with higher likelihood of seizure freedom in adults undergoing anterior temporal lobe resection (ATLR) for drug-resistant temporal lobe epilepsy (TLE). There have been no such studies in children, therefore this study aimed to investigate this association in a pediatric cohort. METHODS A retrospective, neuroimaging cohort study of children with TLE who underwent ATLR between 2012 and 2021 was undertaken. The PC, hippocampal and amygdala volumes were measured on the preoperative and postoperative T1-weighted MRI. Using these volumes, the extent of resection per region was compared between the seizure-free and not seizure-free groups. RESULTS In 50 children (median age 9.5 years) there was no significant difference between the extent of resection of the temporal PC in the seizure-free (median = 50%, n = 33/50) versus not seizure-free (median = 40%, n = 17/50) groups (p = 0.26). In a sub-group of 19 with ipsilateral hippocampal atrophy (quantitatively defined by ipsilateral-to-contralateral asymmetry), the median extent of temporal PC resection was greater in children who were seizure-free (53%) versus those not seizure-free (19%) (p = 0.009). INTERPRETATION This is the first study demonstrating that, in children with TLE and hippocampal atrophy, more extensive temporal PC resection is associated with a greater chance of seizure freedom-compatible with an adult series in which 85% of patients had hippocampal sclerosis. In a combined group of children with and without hippocampal atrophy, the extent of PC resection was not associated with seizure outcome, suggesting different epileptogenic networks within this cohort.
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Affiliation(s)
- Rory J. Piper
- Developmental Neurosciences Research and Teaching DepartmentUCL Great Ormond Street Institute of Child HealthLondonUK
- Department of NeurosurgeryGreat Ormond Street HospitalLondonUK
| | - Debayan Dasgupta
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of NeurologyUniversity College LondonLondonUK
- Victor Horsley Department of NeurosurgeryNational Hospital for Neurology and NeurosurgeryLondonUK
| | - Maria H. Eriksson
- Developmental Neurosciences Research and Teaching DepartmentUCL Great Ormond Street Institute of Child HealthLondonUK
- NeuropsychologyGreat Ormond Street Hospital NHS TrustLondonUK
- Department of NeurologyGreat Ormond Street Hospital NHS TrustLondonUK
| | - Mathilde Ripart
- Developmental Neurosciences Research and Teaching DepartmentUCL Great Ormond Street Institute of Child HealthLondonUK
| | - Almira Moosa
- Developmental Neurosciences Research and Teaching DepartmentUCL Great Ormond Street Institute of Child HealthLondonUK
| | - Aswin Chari
- Developmental Neurosciences Research and Teaching DepartmentUCL Great Ormond Street Institute of Child HealthLondonUK
- Department of NeurosurgeryGreat Ormond Street HospitalLondonUK
| | - Kiran K. Seunarine
- Developmental Neurosciences Research and Teaching DepartmentUCL Great Ormond Street Institute of Child HealthLondonUK
| | - Chris A. Clark
- Developmental Neurosciences Research and Teaching DepartmentUCL Great Ormond Street Institute of Child HealthLondonUK
| | - John S. Duncan
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of NeurologyUniversity College LondonLondonUK
| | | | - Martin M. Tisdall
- Developmental Neurosciences Research and Teaching DepartmentUCL Great Ormond Street Institute of Child HealthLondonUK
- Department of NeurosurgeryGreat Ormond Street HospitalLondonUK
| | - Torsten Baldeweg
- Developmental Neurosciences Research and Teaching DepartmentUCL Great Ormond Street Institute of Child HealthLondonUK
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Wu J, Liu P, Geng C, Liu C, Li J, Zhu Q, Li A. Principal neurons in the olfactory cortex mediate bidirectional modulation of seizures. J Physiol 2023; 601:3557-3584. [PMID: 37384845 DOI: 10.1113/jp284731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 06/15/2023] [Indexed: 07/01/2023] Open
Abstract
Although the piriform cortex (PC) has been previously implicated as a critical node for seizure generation and propagation, the underlying neural mechanism has remained unclear. Here, we found increased excitability in PC neurons during amygdala kindling acquisition. Optogenetic or chemogenetic activation of PC pyramidal neurons promoted kindling progression, whereas inhibition of these neurons retarded seizure activities induced by electrical kindling in the amygdala. Furthermore, chemogenetic inhibition of PC pyramidal neurons alleviated the severity of kainic acid-induced acute seizures. These results demonstrate that PC pyramidal neurons bidirectionally modulate seizures in temporal lobe epilepsy, providing evidence for the efficacy of PC pyramidal neurons as a potential therapeutic target for epileptogenesis. KEY POINTS: While the piriform cortex (PC) is an important olfactory centre critically involved in olfactory processing and plays a crucial role in epilepsy due to its close connection with the limbic system, how the PC regulates epileptogenesis is largely unknown. In this study, we evaluated the neuronal activity and the role of pyramidal neurons in the PC in the mouse amygdala kindling model of epilepsy. PC pyramidal neurons are hyperexcited during epileptogenesis. Optogenetic and chemogenetic activation of PC pyramidal neurons significantly promoted seizures in the amygdala kindling model, whereas selective inhibition of these neurons produced an anti-epileptic effect for both electrical kindling and kainic acid-induced acute seizures. The results of the present study indicate that PC pyramidal neurons bidirectionally modulate seizure activity.
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Affiliation(s)
- Jing Wu
- Jiangsu Key Laboratory of Brain Disease and Bioinformation, Research Center for Biochemistry and Molecular Biology, Xuzhou Medical University, Xuzhou, China
| | - Penglai Liu
- Jiangsu Key Laboratory of Brain Disease and Bioinformation, Research Center for Biochemistry and Molecular Biology, Xuzhou Medical University, Xuzhou, China
| | - Chi Geng
- Jiangsu Key Laboratory of Brain Disease and Bioinformation, Research Center for Biochemistry and Molecular Biology, Xuzhou Medical University, Xuzhou, China
| | - Changyu Liu
- Jiangsu Key Laboratory of Brain Disease and Bioinformation, Research Center for Biochemistry and Molecular Biology, Xuzhou Medical University, Xuzhou, China
| | - Jiaxin Li
- Jiangsu Key Laboratory of Brain Disease and Bioinformation, Research Center for Biochemistry and Molecular Biology, Xuzhou Medical University, Xuzhou, China
| | - Qiuju Zhu
- Jiangsu Key Laboratory of Brain Disease and Bioinformation, Research Center for Biochemistry and Molecular Biology, Xuzhou Medical University, Xuzhou, China
| | - Anan Li
- Jiangsu Key Laboratory of Brain Disease and Bioinformation, Research Center for Biochemistry and Molecular Biology, Xuzhou Medical University, Xuzhou, China
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13
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Lehmann LM, Barker-Haliski M. Loss of normal Alzheimer's disease-associated Presenilin 2 function alters antiseizure medicine potency and tolerability in the 6-Hz focal seizure model. Front Neurol 2023; 14:1223472. [PMID: 37592944 PMCID: PMC10427874 DOI: 10.3389/fneur.2023.1223472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 07/14/2023] [Indexed: 08/19/2023] Open
Abstract
Introduction Patients with early-onset Alzheimer's disease (EOAD) experience seizures and subclinical epileptiform activity, which may accelerate cognitive and functional decline. Antiseizure medicines (ASMs) may be a tractable disease-modifying strategy; numerous ASMs are marketed with well-established safety. However, little information is available to guide ASM selection as few studies have rigorously quantified ASM potency and tolerability in traditional seizure models in rodents with EOAD-associated risk factors. Presenilin 2 (PSEN2) variants evoke EOAD, and these patients experience seizures. This study thus established the anticonvulsant profile of mechanistically distinct ASMs in the frontline 6-Hz limbic seizure test evoked in PSEN2-knockout (KO) mice to better inform seizure management in EOAD. Methods The median effective dose (ED50) of prototype ASMs was quantified in the 6-Hz test in male and female PSEN2-KO and wild-type (WT) C57BL/6J mice (3-4 months old). Minimal motor impairment (MMI) was assessed to estimate a protective index (PI). Immunohistological detection of cFos established the extent to which 6-Hz stimulation activates discrete brain regions in KO vs. WT mice. Results There were significant genotype-related differences in the potency and tolerability of several ASMs. Valproic acid and levetiracetam were significantly more potent in male KO than in WT mice. Additionally, high doses of valproic acid significantly worsened MMI in KO mice. Conversely, carbamazepine was significantly less potent in female KO vs. WT mice. In both male and female KO mice vs. WTs, perampanel and lamotrigine were equally potent. However, there were marked genotype-related shifts in PI of both carbamazepine and perampanel, with KO mice exhibiting less MMI at the highest doses tested. Gabapentin was ineffective against 6-Hz seizures in KO mice vs. WTs without MMI changes. Neuronal activation 90 min following 6-Hz stimulation was significantly increased in the posterior parietal association cortex overlying CA1 and in the piriform cortex of WT mice, while stimulation-induced increases in cFos immunoreactivity were absent in KO mice. Discussion Acute ASM potency and tolerability in the high-throughput 6-Hz test may be significantly altered with loss of normal PSEN2 function. Seizures in discrete EOAD populations may benefit from precisely selected medicines optimized for primary ASM pharmacological mechanisms.
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Affiliation(s)
| | - Melissa Barker-Haliski
- Department of Pharmacy, School of Pharmacy, University of Washington, Seattle, WA, United States
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14
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Kharlamova AS, Godovalova OS, Otlyga EG, Proshchina AE. Primary and secondary olfactory centres in human ontogeny. Neurosci Res 2023; 190:1-16. [PMID: 36521642 DOI: 10.1016/j.neures.2022.12.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 11/19/2022] [Accepted: 12/08/2022] [Indexed: 12/14/2022]
Abstract
The olfactory centres are the evolutionary oldest and most conservative area of the telencephalon. Olfactory deficiencies are involved in a large spectrum of neurologic disorders and neurodegenerative diseases. The growing interest in human olfaction has been also been driven by COVID-19-induced transitional anosmia. Nevertheless, recent data on the human olfactory centres concerning normal histology and morphogenesis are rare. Published data in the field are mainly restricted to classic studies with non-uniform nomenclature and varied definitions of certain olfactory areas. While the olfactory system in model animals (rats, mice, and more rarely non-human primates) has been extensively investigated, the developmental timetable of olfactory centres in both human prenatal and postnatal ontogeny are poorly understood and unsystemised, which complicates the process of analysing human material, including medical researches. The main purpose of this review is to provide and discuss relevant morphological data on the normal ontogeny of the human olfactory centres, with a focus on the timetable of maturation and developmental cytoarchitecture, and with special reference to the definitions and terminology of certain olfactory areas.
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Affiliation(s)
- A S Kharlamova
- Avtsyn Research Institute of Human Morphology of FSBSI "Petrovsky National Research Centre of Surgery", Tsyurupy st., 3, 117418 Moscow, Russia.
| | - O S Godovalova
- Moscow Regional Research Institute of Obstetrics and Gynecology, Pokrovka St., 22A, 101000 Moscow, Russia
| | - E G Otlyga
- Avtsyn Research Institute of Human Morphology of FSBSI "Petrovsky National Research Centre of Surgery", Tsyurupy st., 3, 117418 Moscow, Russia
| | - A E Proshchina
- Avtsyn Research Institute of Human Morphology of FSBSI "Petrovsky National Research Centre of Surgery", Tsyurupy st., 3, 117418 Moscow, Russia
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15
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Steinbart D, Yaakub SN, Steinbrenner M, Guldin LS, Holtkamp M, Keller SS, Weber B, Rüber T, Heckemann RA, Ilyas-Feldmann M, Hammers A. Automatic and manual segmentation of the piriform cortex: Method development and validation in patients with temporal lobe epilepsy and Alzheimer's disease. Hum Brain Mapp 2023; 44:3196-3209. [PMID: 37052063 PMCID: PMC10171523 DOI: 10.1002/hbm.26274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Revised: 02/10/2023] [Accepted: 02/24/2023] [Indexed: 04/14/2023] Open
Abstract
The piriform cortex (PC) is located at the junction of the temporal and frontal lobes. It is involved physiologically in olfaction as well as memory and plays an important role in epilepsy. Its study at scale is held back by the absence of automatic segmentation methods on MRI. We devised a manual segmentation protocol for PC volumes, integrated those manually derived images into the Hammers Atlas Database (n = 30) and used an extensively validated method (multi-atlas propagation with enhanced registration, MAPER) for automatic PC segmentation. We applied automated PC volumetry to patients with unilateral temporal lobe epilepsy with hippocampal sclerosis (TLE; n = 174 including n = 58 controls) and to the Alzheimer's Disease Neuroimaging Initiative cohort (ADNI; n = 151, of whom with mild cognitive impairment (MCI), n = 71; Alzheimer's disease (AD), n = 33; controls, n = 47). In controls, mean PC volume was 485 mm3 on the right and 461 mm3 on the left. Automatic and manual segmentations overlapped with a Jaccard coefficient (intersection/union) of ~0.5 and a mean absolute volume difference of ~22 mm3 in healthy controls, ~0.40/ ~28 mm3 in patients with TLE, and ~ 0.34/~29 mm3 in patients with AD. In patients with TLE, PC atrophy lateralised to the side of hippocampal sclerosis (p < .001). In patients with MCI and AD, PC volumes were lower than those of controls bilaterally (p < .001). Overall, we have validated automatic PC volumetry in healthy controls and two types of pathology. The novel finding of early atrophy of PC at the stage of MCI possibly adds a novel biomarker. PC volumetry can now be applied at scale.
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Affiliation(s)
- David Steinbart
- Charité - Universitätsmedizin Berlin, Freie Universität and Humboldt-Universität zu Berlin, Department of Neurology, Epilepsy-Center Berlin-Brandenburg, Berlin, Germany
- King's College London & Guy's and St Thomas' PET Centre, School of Biomedical Engineering and Imaging Sciences, St Thomas' Hospital, London, UK
| | - Siti N Yaakub
- King's College London & Guy's and St Thomas' PET Centre, School of Biomedical Engineering and Imaging Sciences, St Thomas' Hospital, London, UK
- School of Psychology, Faculty of Health, University of Plymouth, Plymouth, UK
| | - Mirja Steinbrenner
- Charité - Universitätsmedizin Berlin, Freie Universität and Humboldt-Universität zu Berlin, Department of Neurology, Epilepsy-Center Berlin-Brandenburg, Berlin, Germany
| | - Lynn S Guldin
- King's College London & Guy's and St Thomas' PET Centre, School of Biomedical Engineering and Imaging Sciences, St Thomas' Hospital, London, UK
| | - Martin Holtkamp
- Charité - Universitätsmedizin Berlin, Freie Universität and Humboldt-Universität zu Berlin, Department of Neurology, Epilepsy-Center Berlin-Brandenburg, Berlin, Germany
| | - Simon S Keller
- Department of Pharmacology and Therapeutics, Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, UK
- Department of Neuroradiology, The Walton Centre NHS Foundation Trust, Liverpool, UK
| | - Bernd Weber
- Center for Economics and Neuroscience, University of Bonn, Bonn, Germany
- Institute of Experimental Epileptology and Cognition Research, University Hospital Bonn, Bonn, Germany
| | - Theodor Rüber
- Institute of Experimental Epileptology and Cognition Research, University Hospital Bonn, Bonn, Germany
| | - Rolf A Heckemann
- Department of Medical Radiation Sciences, University of Gothenburg, Gothenburg, Sweden
| | - Maria Ilyas-Feldmann
- Charité - Universitätsmedizin Berlin, Freie Universität and Humboldt-Universität zu Berlin, Department of Neurology, Epilepsy-Center Berlin-Brandenburg, Berlin, Germany
| | - Alexander Hammers
- King's College London & Guy's and St Thomas' PET Centre, School of Biomedical Engineering and Imaging Sciences, St Thomas' Hospital, London, UK
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16
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Limbic and olfactory cortical circuits in focal seizures. Neurobiol Dis 2023; 178:106007. [PMID: 36682502 DOI: 10.1016/j.nbd.2023.106007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 01/17/2023] [Accepted: 01/18/2023] [Indexed: 01/22/2023] Open
Abstract
Epilepsies affecting the limbic regions are common and generate seizures often resistant to pharmacological treatment. Clinical evidence demonstrates that diverse regions of the mesial portion of the temporal lobe participate in limbic seizures; these include the hippocampus, the entorhinal, perirhinal and parahippocampal regions and the piriform cortex. The network mechanisms involved in the generation of olfactory-limbic epileptiform patterns will be here examined, with particular emphasis on acute interictal and ictal epileptiform discharges obtained by treatment with pro-convulsive drugs and by high-frequency stimulations on in vitro preparations, such as brain slices and the isolated guinea pig brain. The interactions within olfactory-limbic circuits can be summarized as follows: independent, region-specific seizure-like events (SLE) are generated in the olfactory and in the limbic cortex; SLEs generated in the hippocampal-parahippocampal regions tend to remain within these areas; the perirhinal region controls the neocortical propagation and the generalization of limbic seizures; interictal spiking in the olfactory regions prevents the invasion by SLEs generated in limbic regions. The potential relevance of these observations for human focal epilepsy is discussed.
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17
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Bearden DJ, Selawski R, Chern JJ, Martinez EDV, Bhalla S, Al-Ramadhani RR, Ono KE, Pedersen NP, Zhang G, Drane DL, Kheder A. Intracranial investigation of piriform cortex epilepsy during odor presentation. Neurocase 2023; 29:14-17. [PMID: 37021713 PMCID: PMC10556192 DOI: 10.1080/13554794.2023.2199936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 01/30/2023] [Indexed: 04/07/2023]
Abstract
The piriform cortex (PC) is part of the olfactory system, principally receiving input from the lateral olfactory tract and projecting to downstream components of the olfactory network, including the amygdala. Based on preclinical studies, PC is vulnerable to injury and can be easily kindled as an onset site for seizures. While the role of PC in human epilepsy has been studied indirectly and the subject of speculation, cases of demonstrated PC seizure onset from direct intracranial recording are rare. We present a pediatric patient with drug-resistant focal reflex epilepsy and right mesial temporal sclerosis with habitual seizures triggered by coconut aroma. The patient underwent stereoelectroencephalography with implantation of olfactory cortices including PC, through which we identified PC seizure onset, mapped high-frequency activity associated with presentation of olfactory stimuli and performance on cognitive tasks, and reproduced habitual seizures via cortical stimulation of PC. Coconut odor did not trigger seizures in our work with the patient. Surgical workup resulted in resection of the patient's right amygdala, PC, and mesial temporal pole, following which she has been seizure free for 20 months without functional decline in cognition or smell. Histological findings from resected tissue showed astrogliosis and subpial gliosis.
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Affiliation(s)
- Donald J. Bearden
- Children’s Healthcare of Atlanta, Department of Neurology, Atlanta, GA, USA
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA
| | - Robyn Selawski
- Children’s Healthcare of Atlanta, Department of Neurology, Atlanta, GA, USA
| | - Joshua J. Chern
- Department of Neurosurgery, Children’s Healthcare of Atlanta, GA, USA
| | - Eva del Valle Martinez
- Children’s Healthcare of Atlanta, Department of Neurology, Atlanta, GA, USA
- Carlos Albizu University, Department of Psychology, San Juan, Puerto Rico
| | - Sonam Bhalla
- Children’s Healthcare of Atlanta, Department of Neurology, Atlanta, GA, USA
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA
| | - Ruba R Al-Ramadhani
- University of Pittsburgh Medical Center, Children’s Department of Pediatric Neurology, PA, USA
| | - Kim E. Ono
- Children’s Healthcare of Atlanta, Department of Neurology, Atlanta, GA, USA
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA
| | - Nigel P. Pedersen
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA
| | - Guojun Zhang
- Children’s Healthcare of Atlanta, Department of Neurology, Atlanta, GA, USA
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA
| | - Daniel L. Drane
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA
- Department of Neurology, University of Washington School of Medicine, Seattle, WA, USA
| | - Ammar Kheder
- Children’s Healthcare of Atlanta, Department of Neurology, Atlanta, GA, USA
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA
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18
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Prentice RN, Rizwan SB. Translational Considerations in the Development of Intranasal Treatments for Epilepsy. Pharmaceutics 2023; 15:pharmaceutics15010233. [PMID: 36678862 PMCID: PMC9865314 DOI: 10.3390/pharmaceutics15010233] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 11/09/2022] [Accepted: 11/29/2022] [Indexed: 01/13/2023] Open
Abstract
Epilepsy is a common and serious neurological disorder, to which a high proportion of patients continue to be considered "drug-resistant", despite the availability of a host of anti-seizure drugs. Investigation into new treatment strategies is therefore of great importance. One such strategy is the use of the nose to deliver drugs directly to the brain with the help of pharmaceutical formulation to overcome the physical challenges presented by this route. The following review explores intranasal delivery of anti-seizure drugs, covering the link between the nose and seizures, pathways from the nose to the brain, current formulations in clinical use, animal seizure models and their proposed application in studying intranasal treatments, and a critical discussion of relevant pre-clinical studies in the literature.
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19
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Milligan TA. Quelling the Area Tempesta: Removal of the Piriform Cortex Improves the Outcomes of Surgery for Temporal Lobe Epilepsy. Epilepsy Curr 2023; 23:23-25. [PMID: 36923328 PMCID: PMC10009122 DOI: 10.1177/15357597221137410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Resection of the Piriform Cortex for Temporal Lobe Epilepsy: A Novel Approach on Imaging Segmentation and Surgical Application Leon-Rojas JE, Iqbal S, Vos SB, Rodionov R, Miserocchi A, McEvoy AW, Vakharia VN, Mancini L, Galovic M, Sparks RE, Ourselin S, Cardoso JM, Koepp MJ, Duncan JS. Br J Neurosurg . 2021;1-6. doi:10.1080/02688697.2021.1966385 Background: The piriform cortex (PC) occupies both banks of the entorhinal sulcus and has an important role in the pathophysiology of temporal lobe epilepsy (TLE). A recent study showed that resection of more than 50% of PC increased the odds of becoming seizure free by a factor of 16. Objective: We report the feasibility of manual segmentation of PC and application of the Geodesic Information Flows (GIF) algorithm to automated segmentation, to guide resection. Methods: Manual segmentation of PC was performed by two blinded independent examiners in 60 patients with TLE (55% Left TLE, 52% female) with a median age of 35 years (IQR, 29–47 years) and 20 controls (60% Women) with a median age of 39.5 years (IQR, 31–49). The GIF algorithm was used to create an automated pipeline for parcellating PC which was used to guide excision as part of temporal lobe resection for TLE. Results: Right PC was larger in patients and controls. Parcellation of PC was used to guide anterior temporal lobe resection, with subsequent seizure freedom and no visual field or language deficit. Conclusion: Reliable segmentation of PC is feasible and can be applied prospectively to guide neurosurgical resection that increases the chances of a good outcome from temporal lobe resection for TLE.
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20
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Piper RJ, Richardson RM, Worrell G, Carmichael DW, Baldeweg T, Litt B, Denison T, Tisdall MM. Towards network-guided neuromodulation for epilepsy. Brain 2022; 145:3347-3362. [PMID: 35771657 PMCID: PMC9586548 DOI: 10.1093/brain/awac234] [Citation(s) in RCA: 48] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 05/30/2022] [Accepted: 06/16/2022] [Indexed: 11/30/2022] Open
Abstract
Epilepsy is well-recognized as a disorder of brain networks. There is a growing body of research to identify critical nodes within dynamic epileptic networks with the aim to target therapies that halt the onset and propagation of seizures. In parallel, intracranial neuromodulation, including deep brain stimulation and responsive neurostimulation, are well-established and expanding as therapies to reduce seizures in adults with focal-onset epilepsy; and there is emerging evidence for their efficacy in children and generalized-onset seizure disorders. The convergence of these advancing fields is driving an era of 'network-guided neuromodulation' for epilepsy. In this review, we distil the current literature on network mechanisms underlying neurostimulation for epilepsy. We discuss the modulation of key 'propagation points' in the epileptogenic network, focusing primarily on thalamic nuclei targeted in current clinical practice. These include (i) the anterior nucleus of thalamus, now a clinically approved and targeted site for open loop stimulation, and increasingly targeted for responsive neurostimulation; and (ii) the centromedian nucleus of the thalamus, a target for both deep brain stimulation and responsive neurostimulation in generalized-onset epilepsies. We discuss briefly the networks associated with other emerging neuromodulation targets, such as the pulvinar of the thalamus, piriform cortex, septal area, subthalamic nucleus, cerebellum and others. We report synergistic findings garnered from multiple modalities of investigation that have revealed structural and functional networks associated with these propagation points - including scalp and invasive EEG, and diffusion and functional MRI. We also report on intracranial recordings from implanted devices which provide us data on the dynamic networks we are aiming to modulate. Finally, we review the continuing evolution of network-guided neuromodulation for epilepsy to accelerate progress towards two translational goals: (i) to use pre-surgical network analyses to determine patient candidacy for neurostimulation for epilepsy by providing network biomarkers that predict efficacy; and (ii) to deliver precise, personalized and effective antiepileptic stimulation to prevent and arrest seizure propagation through mapping and modulation of each patients' individual epileptogenic networks.
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Affiliation(s)
- Rory J Piper
- Department of Neurosurgery, Great Ormond Street Hospital, London, UK
- Developmental Neurosciences, UCL Great Ormond Street Institute of Child Health, University College London, London, UK
| | - R Mark Richardson
- Department of Neurosurgery, Massachusetts General Hospital and Harvard Medical School, Boston, USA
| | | | | | - Torsten Baldeweg
- Developmental Neurosciences, UCL Great Ormond Street Institute of Child Health, University College London, London, UK
| | - Brian Litt
- Department of Neurology and Bioengineering, University of Pennsylvania, Philadelphia, USA
| | | | - Martin M Tisdall
- Department of Neurosurgery, Great Ormond Street Hospital, London, UK
- Developmental Neurosciences, UCL Great Ormond Street Institute of Child Health, University College London, London, UK
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21
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Social defeat drives hyperexcitation of the piriform cortex to induce learning and memory impairment but not mood-related disorders in mice. Transl Psychiatry 2022; 12:380. [PMID: 36088395 PMCID: PMC9464232 DOI: 10.1038/s41398-022-02151-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 08/27/2022] [Accepted: 09/02/2022] [Indexed: 12/05/2022] Open
Abstract
Clinical studies have shown that social defeat is an important cause of mood-related disorders, accompanied by learning and memory impairment in humans. The mechanism of mood-related disorders has been widely studied. However, the specific neural network involved in learning and memory impairment caused by social defeat remains unclear. In this study, behavioral test results showed that the mice induced both learning and memory impairments and mood-related disorders after exposure to chronic social defeat stress (CSDS). c-Fos immunofluorescence and fiber photometry recording confirmed that CaMKIIα expressing neurons of the piriform cortex (PC) were selectively activated by exposure to CSDS. Next, chemogenetics and optogenetics were performed to activate PC CaMKIIα expressing neurons, which showed learning and memory impairment but not mood-related disorders. Furthermore, chemogenetic inhibition of PC CaMKIIα expressing neurons significantly alleviated learning and memory impairment induced by exposure to CSDS but did not relieve mood-related disorders. Therefore, our data suggest that the overactivation of PC CaMKIIα expressing neurons mediates CSDS-induced learning and memory impairment, but not mood-related disorders, and provides a potential therapeutic target for learning and memory impairment induced by social defeat.
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22
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Iqbal S, Leon-Rojas JE, Galovic M, Vos SB, Hammers A, de Tisi J, Koepp MJ, Duncan JS. Volumetric analysis of the piriform cortex in temporal lobe epilepsy. Epilepsy Res 2022; 185:106971. [PMID: 35810570 PMCID: PMC10510027 DOI: 10.1016/j.eplepsyres.2022.106971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 05/13/2022] [Accepted: 06/22/2022] [Indexed: 11/03/2022]
Abstract
The piriform cortex, at the confluence of the temporal and frontal lobes, generates seizures in response to chemical convulsants and electrical stimulation. Resection of more than 50% of the piriform cortex in anterior temporal lobe resection for refractory temporal lobe epilepsy (TLE) was associated with a 16-fold higher chance of seizure freedom. The objectives of the current study were to implement a robust protocol to measure piriform cortex volumes and to quantify the correlation of these volumes with clinical characteristics of TLE. Sixty individuals with unilateral TLE (33 left) and 20 healthy controls had volumetric analysis of left and right piriform cortex and hippocampi. A protocol for segmenting and measuring the volumes of the piriform cortices was implemented, with good inter-rater and test-retest reliability. The right piriform cortex volume was consistently larger than the left piriform cortex in both healthy controls and patients with TLE. In controls, the mean volume of the right piriform cortex was 17.7% larger than the left, and the right piriform cortex extended a mean of 6 mm (Range: -4 to 12) more anteriorly than the left. This asymmetry was also seen in left and right TLE. In TLE patients overall, the piriform cortices were not significantly smaller than in controls. Hippocampal sclerosis was associated with decreased ipsilateral and contralateral piriform cortex volumes. The piriform cortex volumes, both ipsilateral and contralateral to the epileptic temporal lobe, were smaller with a longer duration of epilepsy. There was no significant association between piriform cortex volumes and the frequency of focal seizures with impaired awareness or the number of anti-seizure medications taken. Implementation of robust segmentation will enable consistent neurosurgical resection in anterior temporal lobe surgery for refractory TLE..
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Affiliation(s)
- Sabahat Iqbal
- UK National Institute for Health Research University College London Hospitals Biomedical Research Centre, and Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, United Kingdom; Epilepsy Society MRI Unit, Chalfont Centre for Epilepsy, Chalfont St Peter, Buckinghamshire, United Kingdom
| | - Jose E Leon-Rojas
- UK National Institute for Health Research University College London Hospitals Biomedical Research Centre, and Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, United Kingdom; Epilepsy Society MRI Unit, Chalfont Centre for Epilepsy, Chalfont St Peter, Buckinghamshire, United Kingdom; Facultad de Ciencias Médicas de la Salud y de la Vida, Escuela de Medicina, Universidad Internacional del Ecuador, Quito, Ecuador
| | - Marian Galovic
- UK National Institute for Health Research University College London Hospitals Biomedical Research Centre, and Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, United Kingdom; Epilepsy Society MRI Unit, Chalfont Centre for Epilepsy, Chalfont St Peter, Buckinghamshire, United Kingdom; Department of Neurology, Zurich University Hospital, Zurich, Switzerland
| | - Sjoerd B Vos
- UK National Institute for Health Research University College London Hospitals Biomedical Research Centre, and Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, United Kingdom; Centre for Medical Image Computing (CMIC), Department of Computer Science, University College London, United Kingdom; Neuroradiological Academic Unit, UCL Queen Square Institute of Neurology, London, United Kingdom
| | - Alexander Hammers
- School of Biomedical Engineering and Imaging Sciences, Kings College, London, United Kingdom; Kings College London & Guys and St Thomas' PET Centre at St. Thomas' Hospital, United Kingdom
| | - Jane de Tisi
- UK National Institute for Health Research University College London Hospitals Biomedical Research Centre, and Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, United Kingdom
| | - Matthias J Koepp
- UK National Institute for Health Research University College London Hospitals Biomedical Research Centre, and Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, United Kingdom; Epilepsy Society MRI Unit, Chalfont Centre for Epilepsy, Chalfont St Peter, Buckinghamshire, United Kingdom
| | - John S Duncan
- UK National Institute for Health Research University College London Hospitals Biomedical Research Centre, and Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, United Kingdom; Epilepsy Society MRI Unit, Chalfont Centre for Epilepsy, Chalfont St Peter, Buckinghamshire, United Kingdom.
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Carlisle TC, Birlea M, Restrepo D, Filley CM. Headache-Associated Phantosmia as a Harbinger of Lewy Body Dementia. J Neuropsychiatry Clin Neurosci 2022; 35:92-97. [PMID: 35989571 PMCID: PMC11022529 DOI: 10.1176/appi.neuropsych.21110265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Olfactory hallucinations, or phantosmias, can occur in many neurological, psychiatric, and medical conditions, but no widely used standardized approach exists to comprehensively assess qualitative olfactory dysfunction in the clinical setting. Additionally, medical professionals, patients, and their family members may not recognize phantosmia as a potentially neurological problem. Given the many possible etiologies for symptomatic phantosmia, it is important to recognize this unusual presentation and elicit a meaningful history to explore the potential underlying cause. We describe a 77-year-old gentleman with a two-year history of headaches accompanied by smelling a foul odor and discuss the differential diagnosis for new onset and persistent phantosmia. This unusual case ultimately manifested features consistent with Lewy body dementia, highlighting the varied clinical presentations that are possible with this neurodegenerative disorder. We discuss the possible pathophysiology of phantosmia in Lewy body disorders, including a proposed mechanism for olfactory hallucinations arising prior to the typical well-formed hallucinations in Lewy body dementia.
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Affiliation(s)
- Tara C Carlisle
- Departments of Neurology, Behavioral Neurology (Carlisle, Filley) and Headache (Birlea) sections, Psychiatry (Filley), and Cell and Developmental Biology (Restrepo), University of Colorado School of Medicine, Aurora; Marcus Institute for Brain Health, Aurora (Filley)
| | - Marius Birlea
- Departments of Neurology, Behavioral Neurology (Carlisle, Filley) and Headache (Birlea) sections, Psychiatry (Filley), and Cell and Developmental Biology (Restrepo), University of Colorado School of Medicine, Aurora; Marcus Institute for Brain Health, Aurora (Filley)
| | - Diego Restrepo
- Departments of Neurology, Behavioral Neurology (Carlisle, Filley) and Headache (Birlea) sections, Psychiatry (Filley), and Cell and Developmental Biology (Restrepo), University of Colorado School of Medicine, Aurora; Marcus Institute for Brain Health, Aurora (Filley)
| | - Christopher M Filley
- Departments of Neurology, Behavioral Neurology (Carlisle, Filley) and Headache (Birlea) sections, Psychiatry (Filley), and Cell and Developmental Biology (Restrepo), University of Colorado School of Medicine, Aurora; Marcus Institute for Brain Health, Aurora (Filley)
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Spatio-Temporal Alterations in Synaptic Density During Epileptogenesis in the Rat Brain. Neuroscience 2022; 499:142-151. [PMID: 35878719 DOI: 10.1016/j.neuroscience.2022.07.020] [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: 05/05/2022] [Revised: 07/07/2022] [Accepted: 07/18/2022] [Indexed: 11/22/2022]
Abstract
Synaptic vesicle glycoprotein 2A (SV2A) is a transmembrane protein that binds levetiracetam and is involved in neurotransmission via an unknown mechanism. SV2A-immunoreactivity is reduced in animal models of epilepsy, and in postmortem hippocampi from patients with temporal lobe epilepsy. It is not known if other regions outside the hippocampus are affected in epilepsy, and whether SV2A is expression permanently reduced or regulated over time. In this study, we induced a generalized status epilepticus (SE) by systemic administration of lithium-pilocarpine to adult female rats. The brains from all animals experiencing SE were collected at different time points after the treatment. The radiotracer, [11C]-UCB-J, binds to SV2A with high affinity, and has been used for in vivo imaging as an a-proxy marker for synaptic density. Here we determined the level of tritiated UCB-J binding by semiquantitative autoradiography in the cerebral cortex, hippocampus, thalamus, and hypothalamus, and in subregions of these. A prominent and highly significant reduction in SV2A binding capacity was observed over the first days after SE in the cerebral cortex and the hippocampus, but not in the thalamus and hypothalamus. The magnitude in reduction was larger and occurred earlier in the hippocampus and the piriform cortex, than in other cortical subregions. Interestingly, in all areas examined, the binding capacity returned to control levels 12 weeks after the SE comparable to the chronic phase. These data show that lithium-pilocarpine-induced epileptogenesis involves both loss and gain of synapses in the in a time-dependent manner.
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Clinical and Magnetic Resonance Imaging (MRI) Features, Tumour Localisation, and Survival of Dogs with Presumptive Brain Gliomas. Vet Sci 2022; 9:vetsci9060257. [PMID: 35737309 PMCID: PMC9230849 DOI: 10.3390/vetsci9060257] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 05/20/2022] [Accepted: 05/24/2022] [Indexed: 02/01/2023] Open
Abstract
Brain gliomas are common tumours diagnosed in dogs. However, limited information is available on the clinical features and overall survival time (OS) in dogs receiving palliative treatment. The aim of this study was to evaluate possible associations between presenting complaint, tumour localisation, Magnetic Resonance Imaging (MRI) features, survival times, and reason for the death of dogs with suspected intracranial glioma treated palliatively. Sixty dogs from a single institution were retrospectively included (from September 2017 to December 2021). Dogs were included if a presumptive diagnosis of brain glioma was obtained based on an MRI scan and medical history. French Bulldogs were overrepresented (40/60); 46 out of 60 dogs (77%) presented due to epileptic seizures (ES) and in 25/60 dogs (42%), cluster seizures or status epilepticus were the first manifestation of the disease. Dogs with suspected gliomas located in the piriform lobe showed a higher probability of presenting due to epilepsy compared to dogs with glioma in other regions, and more frequently died or were euthanised because of increased ES. Magnetic Resonance Imaging (MRI) features differed between localisations. Fronto-olfactory tumours were more frequently, whereas piriform tumours were less frequently, classified as suspected high-grade glioma. The median survival time was 61 days. Dogs with contrast-enhancing suspected gliomas had significantly shorter OS. This study provides additional information on the clinical features and survival of dogs with suspected brain gliomas treated palliatively.
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Hwang BY, Mampre D, Tsehay YK, Negoita S, Kim MJ, Coogan C, Eremiev A, Palla A, Weber-Levine C, Kang JY, Anderson WS. Piriform Cortex Ablation Volume Is Associated With Seizure Outcome in Mesial Temporal Lobe Epilepsy. Neurosurgery 2022; 91:414-421. [PMID: 35593730 DOI: 10.1227/neu.0000000000002041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 04/03/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Growing evidence suggests that piriform cortex resection during anterior temporal lobectomy is important for achieving good seizure outcome in mesial temporal lobe epilepsy (mTLE). However, the relationship between seizure outcome and piriform cortex ablation during MR-guided laser interstitial thermal therapy (MRgLITT) remains unclear. OBJECTIVE To determine whether ablation of piriform cortex was associated with seizure outcome in patients with mTLE undergoing MRgLITT. METHODS We performed preablation and postablation volumetric analyses of hippocampus, amygdala, piriform cortex, and ablation volumes in patients with mTLE who underwent MRgLITT at our institution from 2014 to 2019. RESULTS Thirty nine patients with mTLE were analyzed. In univariate logistic regression, percent piriform cortex ablation was associated with International League Against Epilepsy (ILAE) class 1 at 6 months (odds ratio [OR] 1.051, 95% CI [1.001-1.117], P = .045), whereas ablation volume, percent amygdala ablation, and percent hippocampus ablation were not (P > .05). At 1 year, ablation volume was associated with ILAE class 1 (OR 1.608, 95% CI [1.071-2.571], P = .021) while percent piriform cortex ablation became a trend (OR 1.050, 95% CI [0.994-1.109], P = .054), and both percent hippocampus ablation and percent amygdala ablation were not significantly associated with ILAE class 1 (P > .05). In multivariable logistic regression, only percent piriform cortex ablation was a significant predictor of seizure freedom at 6 months (OR 1.085, 95% CI [1.012-1.193], P = .019) and at 1 year (OR 1.074, 95% CI [1.003-1.178], P = .041). CONCLUSION Piriform cortex ablation volume is associated with seizure outcome in patients with mTLE undergoing MRgLITT. The piriform cortex should be considered a high yield ablation target to achieve good seizure outcome.
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Affiliation(s)
- Brian Y Hwang
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - David Mampre
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Yohannes K Tsehay
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Serban Negoita
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Min Jae Kim
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.,Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Christopher Coogan
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Alexander Eremiev
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Adhith Palla
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Carly Weber-Levine
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Joon Y Kang
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - William S Anderson
- Department of Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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Kim MJ, Hwang BY, Mampre D, Negoita S, Tsehay Y, Sair HI, Kang JY, Anderson WS. Apparent diffusion coefficient of piriform cortex and seizure outcome in mesial temporal lobe epilepsy after MR-guided laser interstitial thermal therapy: a single-institution experience. J Neurosurg 2022; 137:1601-1609. [PMID: 35535837 DOI: 10.3171/2022.3.jns212490] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Accepted: 03/08/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Piriform cortex (PC) is one of the critical structures in the epileptogenesis of mesial temporal lobe epilepsy (mTLE), but its role is poorly understood. The authors examined the utility of apparent diffusion coefficient (ADC; an MR-based marker of tissue pathology) of the PC as a predictor of seizure outcome in patients with mTLE undergoing MR-guided laser interstitial thermal therapy (MRgLITT). METHODS A total of 33 patients diagnosed with mTLE who underwent MRgLITT at the authors' institution were included in the study. The 6-month postoperative seizure outcomes were classified using the International League Against Epilepsy (ILAE) system as good (complete seizure freedom, ILAE class I) and poor (seizure present, ILAE classes II-VI). The PC and ablation volumes were manually segmented from both the preoperative and intraoperative MRI sequences, respectively. The mean ADC intensities of 1) preablation PC; 2) total ablation volume; 3) ablated portion of PC; and 4) postablation residual PC were calculated and compared between good and poor outcome groups. Additionally, the preoperative PC volumes and proportion of PC volume ablated were examined and compared between the subjects in the two outcome groups. RESULTS The mean age at surgery was 36.5 ± 3.0 years, and the mean follow-up duration was 1.9 ± 0.2 years. Thirteen patients (39.4%) had a good outcome. The proportion of PC ablated was significantly associated with seizure outcome (10.16 vs 3.30, p < 0.05). After accounting for the variability in diffusion tensor imaging acquisition parameters, patients with good outcome had a significantly higher mean ADC of the preablation PC (0.3770 vs -0.0108, p < 0.05) and the postoperative residual PC (0.4197 vs 0.0309, p < 0.05) regions compared to those with poor outcomes. No significant differences in ADC of the ablated portion of PC were observed (0.2758 vs -0.4628, p = 0.12) after performing multivariate analysis. CONCLUSIONS A higher proportion of PC ablated was associated with complete seizure freedom. Preoperative and postoperative residual ADC measures of PC were significantly higher in the good seizure outcome group in patients with mTLE who underwent MRgLITT, suggesting that ADC analysis can assist with postablation outcome prediction and patient stratification.
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Affiliation(s)
- Min Jae Kim
- 1Department of Neurosurgery, Johns Hopkins School of Medicine.,2Department of Neurology, Johns Hopkins School of Medicine.,3Department of Biomedical Engineering, Johns Hopkins School of Medicine; and
| | - Brian Y Hwang
- 1Department of Neurosurgery, Johns Hopkins School of Medicine
| | - David Mampre
- 1Department of Neurosurgery, Johns Hopkins School of Medicine
| | - Serban Negoita
- 1Department of Neurosurgery, Johns Hopkins School of Medicine
| | - Yohannes Tsehay
- 1Department of Neurosurgery, Johns Hopkins School of Medicine
| | - Haris I Sair
- 4Department of Radiology, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Joon Y Kang
- 2Department of Neurology, Johns Hopkins School of Medicine
| | - William S Anderson
- 1Department of Neurosurgery, Johns Hopkins School of Medicine.,3Department of Biomedical Engineering, Johns Hopkins School of Medicine; and
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28
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Gleichgerrcht E, Drane DL, Keller SS, Davis KA, Gross R, Willie JT, Pedersen N, de Bezenac C, Jensen J, Weber B, Kuzniecky R, Bonilha L. Association Between Anatomical Location of Surgically Induced Lesions and Postoperative Seizure Outcome in Temporal Lobe Epilepsy. Neurology 2022; 98:e141-e151. [PMID: 34716254 PMCID: PMC8762583 DOI: 10.1212/wnl.0000000000013033] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Accepted: 10/21/2021] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND AND OBJECTIVES To determine the association between surgical lesions of distinct gray and white structures and connections with favorable postoperative seizure outcomes. METHODS Patients with drug-resistant temporal lobe epilepsy (TLE) from 3 epilepsy centers were included. We employed a voxel-based and connectome-based mapping approach to determine the association between favorable outcomes and surgery-induced temporal lesions. Analyses were conducted controlling for multiple confounders, including total surgical resection/ablation volume, hippocampal volumes, side of surgery, and site where the patient was treated. RESULTS The cohort included 113 patients with TLE (54 women; 86 right-handed; mean age at seizure onset 16.5 years [SD 11.9]; 54.9% left) who were 61.1% free of disabling seizures (Engel Class 1) at follow-up. Postoperative seizure freedom in TLE was associated with (1) surgical lesions that targeted the hippocampus as well as the amygdala-piriform cortex complex and entorhinal cortices; (2) disconnection of temporal, frontal, and limbic regions through loss of white matter tracts within the uncinate fasciculus, anterior commissure, and fornix; and (3) functional disconnection of the frontal (superior and middle frontal gyri, orbitofrontal region) and temporal (superior and middle pole) lobes. DISCUSSION Better postoperative seizure freedom is associated with surgical lesions of specific structures and connections throughout the temporal lobes. These findings shed light on the key components of epileptogenic networks in TLE and constitute a promising source of new evidence for future improvements in surgical interventions. CLASSIFICATION OF EVIDENCE This study provides Class II evidence that for patients with TLE, postoperative seizure freedom is associated with surgical lesions of specific temporal lobe structures and connections.
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Affiliation(s)
- Ezequiel Gleichgerrcht
- From the Department of Neurology (E.G., L.B.) and Center for Biomedical Imaging (J.J.), Medical University of South Carolina, Charleston; Department of Neurology (D.L.D., N.P.), Emory University, Atlanta, GA; Institute of Systems, Molecular and Integrative Biology (S.S.K., C.d.B.), University of Liverpool; The Walton Centre NHS Foundation Trust (S.S.K.), Liverpool, UK; Department of Neurology (K.A.D.), University of Pennsylvania, Philadelphia; Department of Neurosurgery (R.G., J.T.W.), Emory University, Atlanta, GA; Department of Neurological Surgery (J.T.W.), Washington University in St. Louis, MO; and Department of Neurology (R.K.), Hofstra University/Northwell, NY.
| | - Daniel L Drane
- From the Department of Neurology (E.G., L.B.) and Center for Biomedical Imaging (J.J.), Medical University of South Carolina, Charleston; Department of Neurology (D.L.D., N.P.), Emory University, Atlanta, GA; Institute of Systems, Molecular and Integrative Biology (S.S.K., C.d.B.), University of Liverpool; The Walton Centre NHS Foundation Trust (S.S.K.), Liverpool, UK; Department of Neurology (K.A.D.), University of Pennsylvania, Philadelphia; Department of Neurosurgery (R.G., J.T.W.), Emory University, Atlanta, GA; Department of Neurological Surgery (J.T.W.), Washington University in St. Louis, MO; and Department of Neurology (R.K.), Hofstra University/Northwell, NY
| | - Simon S Keller
- From the Department of Neurology (E.G., L.B.) and Center for Biomedical Imaging (J.J.), Medical University of South Carolina, Charleston; Department of Neurology (D.L.D., N.P.), Emory University, Atlanta, GA; Institute of Systems, Molecular and Integrative Biology (S.S.K., C.d.B.), University of Liverpool; The Walton Centre NHS Foundation Trust (S.S.K.), Liverpool, UK; Department of Neurology (K.A.D.), University of Pennsylvania, Philadelphia; Department of Neurosurgery (R.G., J.T.W.), Emory University, Atlanta, GA; Department of Neurological Surgery (J.T.W.), Washington University in St. Louis, MO; and Department of Neurology (R.K.), Hofstra University/Northwell, NY
| | - Kathryn A Davis
- From the Department of Neurology (E.G., L.B.) and Center for Biomedical Imaging (J.J.), Medical University of South Carolina, Charleston; Department of Neurology (D.L.D., N.P.), Emory University, Atlanta, GA; Institute of Systems, Molecular and Integrative Biology (S.S.K., C.d.B.), University of Liverpool; The Walton Centre NHS Foundation Trust (S.S.K.), Liverpool, UK; Department of Neurology (K.A.D.), University of Pennsylvania, Philadelphia; Department of Neurosurgery (R.G., J.T.W.), Emory University, Atlanta, GA; Department of Neurological Surgery (J.T.W.), Washington University in St. Louis, MO; and Department of Neurology (R.K.), Hofstra University/Northwell, NY
| | - Robert Gross
- From the Department of Neurology (E.G., L.B.) and Center for Biomedical Imaging (J.J.), Medical University of South Carolina, Charleston; Department of Neurology (D.L.D., N.P.), Emory University, Atlanta, GA; Institute of Systems, Molecular and Integrative Biology (S.S.K., C.d.B.), University of Liverpool; The Walton Centre NHS Foundation Trust (S.S.K.), Liverpool, UK; Department of Neurology (K.A.D.), University of Pennsylvania, Philadelphia; Department of Neurosurgery (R.G., J.T.W.), Emory University, Atlanta, GA; Department of Neurological Surgery (J.T.W.), Washington University in St. Louis, MO; and Department of Neurology (R.K.), Hofstra University/Northwell, NY
| | - Jon T Willie
- From the Department of Neurology (E.G., L.B.) and Center for Biomedical Imaging (J.J.), Medical University of South Carolina, Charleston; Department of Neurology (D.L.D., N.P.), Emory University, Atlanta, GA; Institute of Systems, Molecular and Integrative Biology (S.S.K., C.d.B.), University of Liverpool; The Walton Centre NHS Foundation Trust (S.S.K.), Liverpool, UK; Department of Neurology (K.A.D.), University of Pennsylvania, Philadelphia; Department of Neurosurgery (R.G., J.T.W.), Emory University, Atlanta, GA; Department of Neurological Surgery (J.T.W.), Washington University in St. Louis, MO; and Department of Neurology (R.K.), Hofstra University/Northwell, NY
| | - Nigel Pedersen
- From the Department of Neurology (E.G., L.B.) and Center for Biomedical Imaging (J.J.), Medical University of South Carolina, Charleston; Department of Neurology (D.L.D., N.P.), Emory University, Atlanta, GA; Institute of Systems, Molecular and Integrative Biology (S.S.K., C.d.B.), University of Liverpool; The Walton Centre NHS Foundation Trust (S.S.K.), Liverpool, UK; Department of Neurology (K.A.D.), University of Pennsylvania, Philadelphia; Department of Neurosurgery (R.G., J.T.W.), Emory University, Atlanta, GA; Department of Neurological Surgery (J.T.W.), Washington University in St. Louis, MO; and Department of Neurology (R.K.), Hofstra University/Northwell, NY
| | - Christophe de Bezenac
- From the Department of Neurology (E.G., L.B.) and Center for Biomedical Imaging (J.J.), Medical University of South Carolina, Charleston; Department of Neurology (D.L.D., N.P.), Emory University, Atlanta, GA; Institute of Systems, Molecular and Integrative Biology (S.S.K., C.d.B.), University of Liverpool; The Walton Centre NHS Foundation Trust (S.S.K.), Liverpool, UK; Department of Neurology (K.A.D.), University of Pennsylvania, Philadelphia; Department of Neurosurgery (R.G., J.T.W.), Emory University, Atlanta, GA; Department of Neurological Surgery (J.T.W.), Washington University in St. Louis, MO; and Department of Neurology (R.K.), Hofstra University/Northwell, NY
| | - Jens Jensen
- From the Department of Neurology (E.G., L.B.) and Center for Biomedical Imaging (J.J.), Medical University of South Carolina, Charleston; Department of Neurology (D.L.D., N.P.), Emory University, Atlanta, GA; Institute of Systems, Molecular and Integrative Biology (S.S.K., C.d.B.), University of Liverpool; The Walton Centre NHS Foundation Trust (S.S.K.), Liverpool, UK; Department of Neurology (K.A.D.), University of Pennsylvania, Philadelphia; Department of Neurosurgery (R.G., J.T.W.), Emory University, Atlanta, GA; Department of Neurological Surgery (J.T.W.), Washington University in St. Louis, MO; and Department of Neurology (R.K.), Hofstra University/Northwell, NY
| | - Bernd Weber
- From the Department of Neurology (E.G., L.B.) and Center for Biomedical Imaging (J.J.), Medical University of South Carolina, Charleston; Department of Neurology (D.L.D., N.P.), Emory University, Atlanta, GA; Institute of Systems, Molecular and Integrative Biology (S.S.K., C.d.B.), University of Liverpool; The Walton Centre NHS Foundation Trust (S.S.K.), Liverpool, UK; Department of Neurology (K.A.D.), University of Pennsylvania, Philadelphia; Department of Neurosurgery (R.G., J.T.W.), Emory University, Atlanta, GA; Department of Neurological Surgery (J.T.W.), Washington University in St. Louis, MO; and Department of Neurology (R.K.), Hofstra University/Northwell, NY
| | - Ruben Kuzniecky
- From the Department of Neurology (E.G., L.B.) and Center for Biomedical Imaging (J.J.), Medical University of South Carolina, Charleston; Department of Neurology (D.L.D., N.P.), Emory University, Atlanta, GA; Institute of Systems, Molecular and Integrative Biology (S.S.K., C.d.B.), University of Liverpool; The Walton Centre NHS Foundation Trust (S.S.K.), Liverpool, UK; Department of Neurology (K.A.D.), University of Pennsylvania, Philadelphia; Department of Neurosurgery (R.G., J.T.W.), Emory University, Atlanta, GA; Department of Neurological Surgery (J.T.W.), Washington University in St. Louis, MO; and Department of Neurology (R.K.), Hofstra University/Northwell, NY
| | - Leonardo Bonilha
- From the Department of Neurology (E.G., L.B.) and Center for Biomedical Imaging (J.J.), Medical University of South Carolina, Charleston; Department of Neurology (D.L.D., N.P.), Emory University, Atlanta, GA; Institute of Systems, Molecular and Integrative Biology (S.S.K., C.d.B.), University of Liverpool; The Walton Centre NHS Foundation Trust (S.S.K.), Liverpool, UK; Department of Neurology (K.A.D.), University of Pennsylvania, Philadelphia; Department of Neurosurgery (R.G., J.T.W.), Emory University, Atlanta, GA; Department of Neurological Surgery (J.T.W.), Washington University in St. Louis, MO; and Department of Neurology (R.K.), Hofstra University/Northwell, NY
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Chee K, Razmara A, Geller AS, Harris WB, Restrepo D, Thompson JA, Kramer DR. The role of the piriform cortex in temporal lobe epilepsy: A current literature review. Front Neurol 2022; 13:1042887. [PMID: 36479052 PMCID: PMC9720270 DOI: 10.3389/fneur.2022.1042887] [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: 09/13/2022] [Accepted: 11/07/2022] [Indexed: 11/22/2022] Open
Abstract
Temporal lobe epilepsy is the most common form of focal epilepsy and can have various detrimental consequences within many neurologic domains. Recent evidence suggests that the piriform cortex may also be implicated in seizure physiology. The piriform cortex is a primary component of the olfactory network and is located at the junction of the frontal and temporal lobes, wrapping around the entorhinal sulcus. Similar to the hippocampus, it is a tri-layered allocortical structure, with connections to many adjacent regions including the orbitofrontal cortex, amygdala, peri- and entorhinal cortices, and insula. Both animal and human studies have implicated the piriform cortex as a critical node in the temporal lobe epilepsy network. It has additionally been shown that resection of greater than half of the piriform cortex may significantly increase the odds of achieving seizure freedom. Laser interstitial thermal therapy has also been shown to be an effective treatment strategy with recent evidence hinting that ablation of the piriform cortex may be important for seizure control as well. We propose that sampling piriform cortex in intracranial stereoelectroencephalography (sEEG) procedures with the use of a temporal pole or amygdalar electrode would be beneficial for further understanding the role of the piriform cortex in temporal lobe epilepsy.
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Affiliation(s)
- Keanu Chee
- Department of Neurosurgery, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Ashkaun Razmara
- Department of Neurosurgery, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Aaron S Geller
- Department of Neurology, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - William B Harris
- Department of Neurosurgery, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Diego Restrepo
- Department of Developmental and Cell Biology, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - John A Thompson
- Department of Neurosurgery, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Daniel R Kramer
- Department of Neurosurgery, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
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30
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Ramnauth AD, Maynard KR, Kardian AS, Phan BN, Tippani M, Rajpurohit S, Hobbs JW, Cerceo Page S, Jaffe AE, Martinowich K. Induction of Bdnf from promoter I following electroconvulsive seizures contributes to structural plasticity in neurons of the piriform cortex. Brain Stimul 2022; 15:427-433. [PMID: 35183789 PMCID: PMC8957536 DOI: 10.1016/j.brs.2022.02.003] [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: 07/26/2021] [Revised: 01/19/2022] [Accepted: 02/10/2022] [Indexed: 11/02/2022] Open
Abstract
BACKGROUND Electroconvulsive therapy (ECT) efficacy is hypothesized to depend on induction of molecular and cellular events that trigger neuronal plasticity. Investigating how electroconvulsive seizures (ECS) impact plasticity in animal models can help inform our understanding of basic mechanisms by which ECT relieves symptoms of depression. ECS-induced plasticity is associated with differential expression of unique isoforms encoding the neurotrophin, brain-derived neurotrophic factor (BDNF). HYPOTHESIS We hypothesized that cells expressing the Bdnf exon 1-containing isoform are important for ECS-induced structural plasticity in the piriform cortex, a highly epileptogenic region that is responsive to ECS. METHODS We selectively labeled Bdnf exon 1-expressing neurons in mouse piriform cortex using Cre recombinase dependent on GFP technology (CRE-DOG). We then quantified changes in dendrite morphology and density of Bdnf exon 1-expressing neurons. RESULTS Loss of promoter I-derived BDNF caused changes in spine density and morphology in Bdnf exon 1-expressing neurons following ECS. CONCLUSIONS Promoter I-derived Bdnf is required for ECS-induced dendritic structural plasticity in Bdnf exon 1-expressing neurons.
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Affiliation(s)
- Anthony D. Ramnauth
- Lieber Institute for Brain Development, Johns Hopkins Medical Campus, Baltimore, Maryland, USA,Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Kristen R. Maynard
- Lieber Institute for Brain Development, Johns Hopkins Medical Campus, Baltimore, Maryland, USA
| | - Alisha S. Kardian
- Lieber Institute for Brain Development, Johns Hopkins Medical Campus, Baltimore, Maryland, USA
| | - BaDoi N. Phan
- Lieber Institute for Brain Development, Johns Hopkins Medical Campus, Baltimore, Maryland, USA,Computational Biology Department, School of Computer Science, Carnegie Mellon University, Pittsburgh, PA, USA,Medical Scientist Training Program, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Madhavi Tippani
- Lieber Institute for Brain Development, Johns Hopkins Medical Campus, Baltimore, Maryland, USA
| | - Sumita Rajpurohit
- Lieber Institute for Brain Development, Johns Hopkins Medical Campus, Baltimore, Maryland, USA
| | - John W. Hobbs
- Lieber Institute for Brain Development, Johns Hopkins Medical Campus, Baltimore, Maryland, USA
| | - Stephanie Cerceo Page
- Lieber Institute for Brain Development, Johns Hopkins Medical Campus, Baltimore, Maryland, USA
| | - Andrew E. Jaffe
- Lieber Institute for Brain Development, Johns Hopkins Medical Campus, Baltimore, Maryland, USA,Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, MD, USA.,Department of Mental Health, Johns Hopkins University, Baltimore, MD, USA.,Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.,Department of Psychiatry & Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Keri Martinowich
- Lieber Institute for Brain Development, Johns Hopkins Medical Campus, Baltimore, Maryland, USA,Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, MD, USA.,Department of Psychiatry & Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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31
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Noto T, Zhou G, Yang Q, Lane G, Zelano C. Human Primary Olfactory Amygdala Subregions Form Distinct Functional Networks, Suggesting Distinct Olfactory Functions. Front Syst Neurosci 2021; 15:752320. [PMID: 34955769 PMCID: PMC8695617 DOI: 10.3389/fnsys.2021.752320] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 11/08/2021] [Indexed: 12/02/2022] Open
Abstract
Three subregions of the amygdala receive monosynaptic projections from the olfactory bulb, making them part of the primary olfactory cortex. These primary olfactory areas are located at the anterior-medial aspect of the amygdala and include the medial amygdala (MeA), cortical amygdala (CoA), and the periamygdaloid complex (PAC). The vast majority of research on the amygdala has focused on the larger basolateral and basomedial subregions, which are known to be involved in implicit learning, threat responses, and emotion. Fewer studies have focused on the MeA, CoA, and PAC, with most conducted in rodents. Therefore, our understanding of the functions of these amygdala subregions is limited, particularly in humans. Here, we first conducted a review of existing literature on the MeA, CoA, and PAC. We then used resting-state fMRI and unbiased k-means clustering techniques to show that the anatomical boundaries of human MeA, CoA, and PAC accurately parcellate based on their whole-brain resting connectivity patterns alone, suggesting that their functional networks are distinct, relative both to each other and to the amygdala subregions that do not receive input from the olfactory bulb. Finally, considering that distinct functional networks are suggestive of distinct functions, we examined the whole-brain resting network of each subregion and speculated on potential roles that each region may play in olfactory processing. Based on these analyses, we speculate that the MeA could potentially be involved in the generation of rapid motor responses to olfactory stimuli (including fight/flight), particularly in approach/avoid contexts. The CoA could potentially be involved in olfactory-related reward processing, including learning and memory of approach/avoid responses. The PAC could potentially be involved in the multisensory integration of olfactory information with other sensory systems. These speculations can be used to form the basis of future studies aimed at clarifying the olfactory functions of these under-studied primary olfactory areas.
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Affiliation(s)
- Torben Noto
- Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Guangyu Zhou
- Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Qiaohan Yang
- Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Gregory Lane
- Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Christina Zelano
- Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
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Torske A, Koch K, Eickhoff S, Freiherr J. Localizing the human brain response to olfactory stimulation: A meta-analytic approach. Neurosci Biobehav Rev 2021; 134:104512. [PMID: 34968523 DOI: 10.1016/j.neubiorev.2021.12.035] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 11/18/2021] [Accepted: 12/20/2021] [Indexed: 11/28/2022]
Abstract
The human sense of smell and the ability to detect and distinguish odors allows for the extraction of valuable information from the environment, thereby driving human behavior. Not only can the sense of smell help to monitor the safety of inhaled air, but it can also help to evaluate the edibility of food. Therefore, in an effort to further our understanding of the human sense of smell, the aim of this meta-analysis was to provide the scientific community with activation probability maps of the functional anatomy of the olfactory system, in addition to separate activation maps for specific odor categories (pleasant, food, and aversive odors). The activation likelihood estimation (ALE) method was utilized to quantify all relevant and available data to perform a formal statistical analysis on the inter-study concordance of various odor categories. A total of 81 studies (108 contrasts, 1053 foci) fulfilled our inclusion criteria. Significant ALE peaks were observed in all odor categories in brain areas typically associated with the functional neuroanatomy of olfaction including the piriform cortex, amygdala, insula, and orbitofrontal cortex, amongst others. Additional contrast analyses indicate clear differences in neural activation patterns between odor categories.
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Affiliation(s)
- A Torske
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Technical University of Munich, Germany; Neuroimaging Center (TUM-NIC), Klinikum rechts der Isar, Technical University of Munich, Munich, Germany; Graduate School of Systemic Neurosciences, Ludwig Maximilians Universität München, Martinsried, Germany
| | - K Koch
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Technical University of Munich, Germany; Neuroimaging Center (TUM-NIC), Klinikum rechts der Isar, Technical University of Munich, Munich, Germany; Graduate School of Systemic Neurosciences, Ludwig Maximilians Universität München, Martinsried, Germany
| | - S Eickhoff
- Institute of Systems Neuroscience, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany; Institute of Neuroscience and Medicine, Brain & Behaviour (INM-7), Research Centre Jülich, Jülich, Germany
| | - J Freiherr
- Department of Psychiatry and Psychotherapy, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany; Institute for Process Engineering and Packaging IVV, Sensory Analytics and Technologies, Fraunhofer Freising, Germany.
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Konkoly J, Kormos V, Gaszner B, Sándor Z, Kecskés A, Alomari A, Szilágyi A, Szilágyi B, Zelena D, Pintér E. The Role of TRPA1 Channels in the Central Processing of Odours Contributing to the Behavioural Responses of Mice. Pharmaceuticals (Basel) 2021; 14:ph14121336. [PMID: 34959735 PMCID: PMC8703823 DOI: 10.3390/ph14121336] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 12/14/2021] [Accepted: 12/14/2021] [Indexed: 11/16/2022] Open
Abstract
Transient receptor potential ankyrin 1 (TRPA1), a nonselective cation channel, contributes to several (patho)physiological processes. Smell loss is an early sign in several neurodegenerative disorders, such as multiple sclerosis, Parkinson’s and Alzheimer’s diseases; therefore, we focused on its role in olfaction and social behaviour with the aim to reveal its potential therapeutic use. The presence of Trpa1 mRNA was studied along the olfactory tract of mice by combined RNAscope in situ hybridisation and immunohistochemistry. The aversive effects of fox and cat odour were examined in parallel with stress hormone levels. In vitro calcium imaging was applied to test if these substances can directly activate TRPA1 receptors. The role of TRPA1 in social behaviour was investigated by comparing Trpa1 wild-type and knockout mice (KO). Trpa1 mRNA was detected in the olfactory bulb and piriform cortex, while its expression was weak in the olfactory epithelium. Fox, but not cat odour directly activated TRPA1 channels in TRPA1-overexpressing Chinese Hamster Ovary cell lines. Accordingly, KO animals showed less aversion against fox, but not cat odour. The social interest of KO mice was reduced during social habituation–dishabituation and social interaction, but not during resident–intruder tests. TRPA1 may contribute to odour processing at several points of the olfactory tract and may play an important role in shaping the social behaviour of mice. Thus, TRPA1 may influence the development of certain social disorders, serving as a potential drug target in the future.
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Affiliation(s)
- János Konkoly
- Department of Pharmacology and Pharmacotherapy, Medical School, University of Pécs, H-7624 Pécs, Hungary; (J.K.); (V.K.); (Z.S.); (A.K.); (A.A.)
- Centre for Neuroscience, Szentágothai Research Centre of the University of Pécs, H-7624 Pécs, Hungary; (B.G.); (D.Z.)
| | - Viktória Kormos
- Department of Pharmacology and Pharmacotherapy, Medical School, University of Pécs, H-7624 Pécs, Hungary; (J.K.); (V.K.); (Z.S.); (A.K.); (A.A.)
- Centre for Neuroscience, Szentágothai Research Centre of the University of Pécs, H-7624 Pécs, Hungary; (B.G.); (D.Z.)
- Research Group for Mood Disorders, Department of Anatomy, Medical School, University of Pécs, H-7624 Pécs, Hungary
| | - Balázs Gaszner
- Centre for Neuroscience, Szentágothai Research Centre of the University of Pécs, H-7624 Pécs, Hungary; (B.G.); (D.Z.)
- Research Group for Mood Disorders, Department of Anatomy, Medical School, University of Pécs, H-7624 Pécs, Hungary
| | - Zoltán Sándor
- Department of Pharmacology and Pharmacotherapy, Medical School, University of Pécs, H-7624 Pécs, Hungary; (J.K.); (V.K.); (Z.S.); (A.K.); (A.A.)
- Centre for Neuroscience, Szentágothai Research Centre of the University of Pécs, H-7624 Pécs, Hungary; (B.G.); (D.Z.)
| | - Angéla Kecskés
- Department of Pharmacology and Pharmacotherapy, Medical School, University of Pécs, H-7624 Pécs, Hungary; (J.K.); (V.K.); (Z.S.); (A.K.); (A.A.)
- Centre for Neuroscience, Szentágothai Research Centre of the University of Pécs, H-7624 Pécs, Hungary; (B.G.); (D.Z.)
| | - Ammar Alomari
- Department of Pharmacology and Pharmacotherapy, Medical School, University of Pécs, H-7624 Pécs, Hungary; (J.K.); (V.K.); (Z.S.); (A.K.); (A.A.)
- Centre for Neuroscience, Szentágothai Research Centre of the University of Pécs, H-7624 Pécs, Hungary; (B.G.); (D.Z.)
| | - Alíz Szilágyi
- Institute of Physiology, Medical School, University of Pécs, H-7624 Pécs, Hungary; (A.S.); (B.S.)
- Institute of Experimental Medicine, H-1085 Budapest, Hungary
| | - Beatrix Szilágyi
- Institute of Physiology, Medical School, University of Pécs, H-7624 Pécs, Hungary; (A.S.); (B.S.)
- Institute of Experimental Medicine, H-1085 Budapest, Hungary
| | - Dóra Zelena
- Centre for Neuroscience, Szentágothai Research Centre of the University of Pécs, H-7624 Pécs, Hungary; (B.G.); (D.Z.)
- Institute of Physiology, Medical School, University of Pécs, H-7624 Pécs, Hungary; (A.S.); (B.S.)
- Institute of Experimental Medicine, H-1085 Budapest, Hungary
| | - Erika Pintér
- Department of Pharmacology and Pharmacotherapy, Medical School, University of Pécs, H-7624 Pécs, Hungary; (J.K.); (V.K.); (Z.S.); (A.K.); (A.A.)
- Centre for Neuroscience, Szentágothai Research Centre of the University of Pécs, H-7624 Pécs, Hungary; (B.G.); (D.Z.)
- Correspondence:
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Gage M, Putra M, Gomez-Estrada C, Golden M, Wachter L, Gard M, Thippeswamy T. Differential Impact of Severity and Duration of Status Epilepticus, Medical Countermeasures, and a Disease-Modifier, Saracatinib, on Brain Regions in the Rat Diisopropylfluorophosphate Model. Front Cell Neurosci 2021; 15:772868. [PMID: 34720886 PMCID: PMC8555467 DOI: 10.3389/fncel.2021.772868] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 09/28/2021] [Indexed: 11/29/2022] Open
Abstract
Acute organophosphate (OP) toxicity poses a significant threat to both military and civilian personnel as it can lead to a variety of cholinergic symptoms including the development of status epilepticus (SE). Depending on its severity, SE can lead to a spectrum of neurological changes including neuroinflammation and neurodegeneration. In this study, we determined the impact of SE severity and duration on disease promoting parameters such as gliosis and neurodegeneration and the efficacy of a disease modifier, saracatinib (AZD0530), a Src/Fyn tyrosine kinase inhibitor. Animals were exposed to 4 mg/kg diisopropylfluorophosphate (DFP, s.c.) followed by medical countermeasures. We had five experimental groups: controls (no DFP), animals with no continuous convulsive seizures (CS), animals with ∼20-min continuous CS, 31-60-min continuous CS, and > 60-min continuous CS. These groups were then assessed for astrogliosis, microgliosis, and neurodegeneration 8 days after DFP exposure. The 31-60-min and > 60-min groups, but not ∼20-min group, had significantly upregulated gliosis and neurodegeneration in the hippocampus compared to controls. In the piriform cortex and amygdala, however, all three continuous CS groups had significant upregulation in both gliosis and neurodegeneration. In a separate cohort of animals that had ∼20 and > 60-min of continuous CS, we administered saracatinib for 7 days beginning three hours after DFP. There was bodyweight loss and mortality irrespective of the initial SE severity and duration. However, in survived animals, saracatinib prevented spontaneous recurrent seizures (SRS) during the first week in both severity groups. In the ∼20-min CS group, compared to the vehicle, saracatinib significantly reduced neurodegeneration in the piriform cortex and amygdala. There were no significant differences in the measured parameters between the naïve control and saracatinib on its own (without DFP) groups. Overall, this study demonstrates the differential effects of the initial SE severity and duration on the localization of gliosis and neurodegeneration. We have also demonstrated the disease-modifying potential of saracatinib. However, its’ dosing regimen should be optimized based on initial severity and duration of CS during SE to maximize therapeutic effects and minimize toxicity in the DFP model as well as in other OP models such as soman.
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Affiliation(s)
- Meghan Gage
- Department of Biomedical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA, United States.,Neuroscience Interdepartmental Program, Iowa State University, Ames, IA, United States
| | - Marson Putra
- Department of Biomedical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA, United States.,Neuroscience Interdepartmental Program, Iowa State University, Ames, IA, United States
| | - Crystal Gomez-Estrada
- Department of Biomedical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA, United States
| | - Madison Golden
- Department of Biomedical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA, United States
| | - Logan Wachter
- Department of Biomedical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA, United States
| | - Megan Gard
- Department of Biomedical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA, United States
| | - Thimmasettappa Thippeswamy
- Department of Biomedical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA, United States.,Neuroscience Interdepartmental Program, Iowa State University, Ames, IA, United States
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Liu DD, Lauro PM, Phillips RK, Leary OP, Zheng B, Roth JL, Blum AS, Segar DJ, Asaad WF. Two-trajectory laser amygdalohippocampotomy: Anatomic modeling and initial seizure outcomes. Epilepsia 2021; 62:2344-2356. [PMID: 34338302 DOI: 10.1111/epi.17019] [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: 03/08/2021] [Revised: 07/13/2021] [Accepted: 07/14/2021] [Indexed: 02/06/2023]
Abstract
OBJECTIVE Laser interstitial thermal therapy (LITT) for mesial temporal lobe epilepsy (mTLE) is typically performed with one trajectory to target the medial temporal lobe (MTL). MTL structures such as piriform and entorhinal cortex are epileptogenic, but due to their relative geometry, they are difficult to target with one trajectory while simultaneously maintaining adequate ablation of the amygdala and hippocampus. We hypothesized that a two-trajectory approach could improve ablation of all relevant MTL structures. First, we created large-scale computer simulations to compare idealized one- vs two-trajectory approaches. A two-trajectory approach was then validated in an initial cohort of patients. METHODS We used magnetic resonance imaging (MRI) from the Human Connectome Project (HCP) to create subject-specific target structures consisting of hippocampus, amygdala, and piriform/entorhinal/perirhinal cortex. An algorithm searched for safe potential trajectories along the hippocampal axis (catheter one) and along the amygdala-piriform axis (catheter two) and compared this to a single trajectory optimized over all structures. The proportion of each structure ablated at various burn radii was evaluated. A cohort of 11 consecutive patients with mTLE received two-trajectory LITT; demographic, operative, and outcome data were collected. RESULTS The two-trajectory approach was superior to the one-trajectory approach at nearly all burn radii for all hippocampal subfields and amygdala nuclei (p < .05). Two-laser trajectories achieved full ablation of MTL cortical structures at physiologically realistic burn radii, whereas one-laser trajectories could not. Five patients with at least 1 year of follow-up (mean = 21.8 months) experienced Engel class I outcomes; 6 patients with less than 1 year of follow-up (mean = 6.6 months) are on track for Engel class I outcomes. SIGNIFICANCE Our anatomic analyses and initial clinical results suggest that LITT amygdalohippocampotomy performed via two-laser trajectories may promote excellent seizure outcomes. Future studies are required to validate the long-term clinical efficacy and safety of this approach.
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Affiliation(s)
- David D Liu
- Department of Neurosurgery, The Warren Alpert Medical School, Brown University, Providence, RI, USA
| | - Peter M Lauro
- Department of Neurosurgery, The Warren Alpert Medical School, Brown University, Providence, RI, USA.,Department of Neuroscience, Brown University, Providence, RI, USA
| | - Ronald K Phillips
- Department of Neurosurgery, The Warren Alpert Medical School, Brown University, Providence, RI, USA
| | - Owen P Leary
- Department of Neurosurgery, The Warren Alpert Medical School, Brown University, Providence, RI, USA
| | - Bryan Zheng
- Department of Neurosurgery, The Warren Alpert Medical School, Brown University, Providence, RI, USA
| | - Julie L Roth
- Department of Neurology, The Warren Alpert Medical School, Brown University, Providence, RI, USA
| | - Andrew S Blum
- Department of Neurology, The Warren Alpert Medical School, Brown University, Providence, RI, USA
| | - David J Segar
- Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Wael F Asaad
- Department of Neurosurgery, The Warren Alpert Medical School, Brown University, Providence, RI, USA.,Department of Neuroscience, Brown University, Providence, RI, USA.,Norman Prince Neurosciences Institute, Rhode Island Hospital, Providence, RI, USA
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36
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Traub RD, Tu Y, Whittington MA. Cell assembly formation and structure in a piriform cortex model. Rev Neurosci 2021; 33:111-132. [PMID: 34271607 DOI: 10.1515/revneuro-2021-0056] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Accepted: 06/19/2021] [Indexed: 11/15/2022]
Abstract
The piriform cortex is rich in recurrent excitatory synaptic connections between pyramidal neurons. We asked how such connections could shape cortical responses to olfactory lateral olfactory tract (LOT) inputs. For this, we constructed a computational network model of anterior piriform cortex with 2000 multicompartment, multiconductance neurons (500 semilunar, 1000 layer 2 and 500 layer 3 pyramids; 200 superficial interneurons of two types; 500 deep interneurons of three types; 500 LOT afferents), incorporating published and unpublished data. With a given distribution of LOT firing patterns, and increasing the strength of recurrent excitation, a small number of firing patterns were observed in pyramidal cell networks: first, sparse firings; then temporally and spatially concentrated epochs of action potentials, wherein each neuron fires one or two spikes; then more synchronized events, associated with bursts of action potentials in some pyramidal neurons. We suggest that one function of anterior piriform cortex is to transform ongoing streams of input spikes into temporally focused spike patterns, called here "cell assemblies", that are salient for downstream projection areas.
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Affiliation(s)
- Roger D Traub
- AI Foundations, IBM T.J. Watson Research Center, Yorktown Heights, NY10598, USA
| | - Yuhai Tu
- AI Foundations, IBM T.J. Watson Research Center, Yorktown Heights, NY10598, USA
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37
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Ryu B, Nagappan S, Santos-Valencia F, Lee P, Rodriguez E, Lackie M, Takatoh J, Franks KM. Chronic loss of inhibition in piriform cortex following brief, daily optogenetic stimulation. Cell Rep 2021; 35:109001. [PMID: 33882304 PMCID: PMC8102022 DOI: 10.1016/j.celrep.2021.109001] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Revised: 12/10/2020] [Accepted: 03/24/2021] [Indexed: 12/02/2022] Open
Abstract
It is well established that seizures beget seizures, yet the cellular processes that underlie progressive epileptogenesis remain unclear. Here, we use optogenetics to briefly activate targeted populations of mouse piriform cortex (PCx) principal neurons in vivo. After just 3 or 4 days of stimulation, previously subconvulsive stimuli trigger massive, generalized seizures. Highly recurrent allocortices are especially prone to “optokindling.” Optokindling upsets the balance of recurrent excitation and feedback inhibition. To understand how this balance is disrupted, we then selectively reactivate the same neurons in vitro. Surprisingly, we find no evidence of heterosynaptic potentiation; instead, we observe a marked, pathway-specific decrease in feedback inhibition. We find no loss of inhibitory interneurons; rather, decreased GABA synthesis in feedback inhibitory neurons appears to underlie weakened inhibition. Optokindling will allow precise identification of the molecular processes by which brain activity patterns can progressively and pathologically disrupt the balance of cortical excitation and inhibition. Ryu et al. use optogenetics to briefly activate principal neurons in mouse piriform cortex. After 4 days, previously innocuous stimuli evoke massive, generalized seizures. “Optokindling” does not strengthen recurrent excitation; instead, it weakens feedback inhibition by decreasing synaptic cleft GABA concentrations and slowing vesicle refilling, consistent with decreased GABA synthesis.
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Affiliation(s)
- Brendan Ryu
- Department of Neurobiology, Duke University Medical School, Durham, NC 27705, USA
| | | | | | - Psyche Lee
- Department of Neurobiology, Duke University Medical School, Durham, NC 27705, USA
| | - Erica Rodriguez
- Department of Neurobiology, Duke University Medical School, Durham, NC 27705, USA
| | - Meredith Lackie
- Department of Neurobiology, Duke University Medical School, Durham, NC 27705, USA
| | - Jun Takatoh
- Department of Neurobiology, Duke University Medical School, Durham, NC 27705, USA
| | - Kevin M Franks
- Department of Neurobiology, Duke University Medical School, Durham, NC 27705, USA.
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Zhou G, Olofsson JK, Koubeissi MZ, Menelaou G, Rosenow J, Schuele SU, Xu P, Voss JL, Lane G, Zelano C. Human hippocampal connectivity is stronger in olfaction than other sensory systems. Prog Neurobiol 2021; 201:102027. [PMID: 33640412 DOI: 10.1016/j.pneurobio.2021.102027] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 01/20/2021] [Accepted: 02/21/2021] [Indexed: 12/17/2022]
Abstract
During mammalian evolution, primate neocortex expanded, shifting hippocampal functional networks away from primary sensory cortices, towards association cortices. Reflecting this rerouting, human resting hippocampal functional networks preferentially include higher association cortices, while those in rodents retained primary sensory cortices. Research on human visual, auditory and somatosensory systems shows evidence of this rerouting. Olfaction, however, is unique among sensory systems in its relative structural conservation throughout mammalian evolution, and it is unknown whether human primary olfactory cortex was subject to the same rerouting. We combined functional neuroimaging and intracranial electrophysiology to directly compare hippocampal functional networks across human sensory systems. We show that human primary olfactory cortex-including the anterior olfactory nucleus, olfactory tubercle and piriform cortex-has stronger functional connectivity with hippocampal networks at rest, compared to other sensory systems. This suggests that unlike other sensory systems, olfactory-hippocampal connectivity may have been retained in mammalian evolution. We further show that olfactory-hippocampal connectivity oscillates with nasal breathing. Our findings suggest olfaction might provide insight into how memory and cognition depend on hippocampal interactions.
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Affiliation(s)
- Guangyu Zhou
- Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
| | - Jonas K Olofsson
- Department of Psychology, Stockholm University, Stockholm, Sweden; Emotional Brain Institute, Nathan S. Kline Institute, Orangeburg, NY, USA; Department of Child and Adolescent Psychiatry, New York University School of Medicine, New York, NY, USA
| | | | | | - Joshua Rosenow
- Department of Neurosurgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Stephan U Schuele
- Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Pengfei Xu
- Beijing Key Laboratory of Applied Experimental Psychology, Faculty of Psychology, Beijing Normal University, Beijing, China; Center for Neuroimaging, Shenzhen Institute of Neuroscience, Shenzhen, China; Guangdong-Hong Kong-Macao Greater Bay Area Research Institute for Neuroscience and Neurotechnologies, Kwun Tong, Hong Kong, China
| | - Joel L Voss
- Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA; Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA; Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Gregory Lane
- Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Christina Zelano
- Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
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Borger V, Schneider M, Taube J, Potthoff AL, Keil VC, Hamed M, Aydin G, Ilic I, Solymosi L, Elger CE, Güresir E, Fimmers R, Schuss P, Helmstaedter C, Surges R, Vatter H. Resection of piriform cortex predicts seizure freedom in temporal lobe epilepsy. Ann Clin Transl Neurol 2020; 8:177-189. [PMID: 33263942 PMCID: PMC7818082 DOI: 10.1002/acn3.51263] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 11/07/2020] [Accepted: 11/10/2020] [Indexed: 11/12/2022] Open
Abstract
Objective Transsylvian selective amygdalo‐hippocampectomy (tsSAHE) represents a generally recognized surgical procedure for drug‐resistant mesial temporal lobe epilepsy (mTLE). Although postoperative seizure freedom can be achieved in about 70% of tsSAHE, there is a considerable amount of patients with persisting postoperative seizures. This might partly be explained by differing extents of resection of various tsSAHE target volumes. In this study we analyzed the resected proportions of hippocampus, amygdala as well as piriform cortex in regard of postoperative seizure outcome. Methods Between 2012 and 2017, 82 of 103 patients with mTLE who underwent tsSAHE at the authors’ institution were included in the analysis. Resected proportions of hippocampus, amygdala and temporal piriform cortex as target structures of tsSAHE were volumetrically assessed and stratified according to favorable (International League Against Epilepsy (ILAE) class 1) and unfavorable (ILAE class 2–6) seizure outcome. Results Patients with favorable seizure outcome revealed a significantly larger proportion of resected temporal piriform cortex volumes compared to patients with unfavorable seizure outcome (median resected proportional volumes were 51% (IQR 42–61) versus (vs.) 13 (IQR 11–18), P = 0.0001). Resected proportions of hippocampus and amygdala did not significantly differ for these groups (hippocampus: 81% (IQR 73–88) vs. 80% (IQR 74–92) (P = 0.7); amygdala: 100% (IQR 100–100) vs. 100% (IQR 100–100) (P = 0.7)). Interpretation These results strongly suggest temporal piriform cortex to constitute a key target resection volume to achieve seizure freedom following tsSAHE.
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Affiliation(s)
- Valeri Borger
- Department of Neurosurgery, University Hospital Bonn, Bonn, Germany
| | | | - Julia Taube
- Department of Epileptology, University Hospital Bonn, Bonn, Germany
| | | | - Vera C Keil
- Department of Neuroradiology, University Hospital Bonn, Bonn, Germany
| | - Motaz Hamed
- Department of Neurosurgery, University Hospital Bonn, Bonn, Germany
| | - Gülsah Aydin
- Department of Neurosurgery, University Hospital Bonn, Bonn, Germany
| | - Inja Ilic
- Department of Neurosurgery, University Hospital Bonn, Bonn, Germany
| | - László Solymosi
- Department of Neuroradiology, University Hospital Bonn, Bonn, Germany
| | | | - Erdem Güresir
- Department of Neurosurgery, University Hospital Bonn, Bonn, Germany
| | - Rolf Fimmers
- Institute of Medical Biometry, Informatics and Epidemiology, University Hospital Bonn, Bonn, Germany
| | - Patrick Schuss
- Department of Neurosurgery, University Hospital Bonn, Bonn, Germany
| | | | - Rainer Surges
- Department of Epileptology, University Hospital Bonn, Bonn, Germany
| | - Hartmut Vatter
- Department of Neurosurgery, University Hospital Bonn, Bonn, Germany
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Akeret K, Stumpo V, Staartjes VE, Vasella F, Velz J, Marinoni F, Dufour JP, Imbach LL, Regli L, Serra C, Krayenbühl N. Topographic brain tumor anatomy drives seizure risk and enables machine learning based prediction. Neuroimage Clin 2020; 28:102506. [PMID: 33395995 PMCID: PMC7711280 DOI: 10.1016/j.nicl.2020.102506] [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: 08/11/2020] [Revised: 10/05/2020] [Accepted: 11/10/2020] [Indexed: 12/17/2022]
Abstract
OBJECTIVE The aim of this study was to identify relevant risk factors for epileptic seizures upon initial diagnosis of a brain tumor and to develop and validate a machine learning based prediction to allow for a tailored risk-based antiepileptic therapy. METHODS Clinical, electrophysiological and high-resolution imaging data was obtained from a consecutive cohort of 1051 patients with newly diagnosed brain tumors. Factor-associated seizure risk difference allowed to determine the relevance of specific topographic, demographic and histopathologic variables available at the time of diagnosis for seizure risk. The data was divided in a 70/30 ratio into a training and test set. Different machine learning based predictive models were evaluated before a generalized additive model (GAM) was selected considering its traceability while maintaining high performance. Based on a clinical stratification of the risk factors, three different GAM were trained and internally validated. RESULTS A total of 923 patients had full data and were included. Specific topographic anatomical patterns that drive seizure risk could be identified. The involvement of allopallial, mesopallial or primary motor/somatosensory neopallial structures by brain tumors results in a significant and clinically relevant increase in seizure risk. While topographic input was most relevant for the GAM, the best prediction was achieved by a combination of topographic, demographic and histopathologic information (Validation: AUC: 0.79, Accuracy: 0.72, Sensitivity: 0.81, Specificity: 0.66). CONCLUSIONS This study identifies specific phylogenetic anatomical patterns as epileptic drivers. A GAM allowed the prediction of seizure risk using topographic, demographic and histopathologic data achieving fair performance while maintaining transparency.
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Affiliation(s)
- Kevin Akeret
- Department of Neurosurgery, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
| | - Vittorio Stumpo
- Department of Neurosurgery, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland; Institute of Neurosurgery, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Victor E Staartjes
- Department of Neurosurgery, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland; Amsterdam UMC, Vrije Universiteit Amsterdam, Neurosurgery, Amsterdam Movement Sciences, Amsterdam, The Netherlands
| | - Flavio Vasella
- Department of Neurosurgery, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Julia Velz
- Department of Neurosurgery, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Federica Marinoni
- Department of Neurosurgery, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Jean-Philippe Dufour
- Department of Neurosurgery, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Lukas L Imbach
- Division of Epileptology, Department of Neurology, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Luca Regli
- Department of Neurosurgery, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Carlo Serra
- Department of Neurosurgery, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Niklaus Krayenbühl
- Department of Neurosurgery, Clinical Neuroscience Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland; Division of Pediatric Neurosurgery, University Children's Hospital, Zurich, Switzerland
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41
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Piriform cortex alterations in the Ts65Dn model for down syndrome. Brain Res 2020; 1747:147031. [PMID: 32726601 DOI: 10.1016/j.brainres.2020.147031] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 07/02/2020] [Accepted: 07/22/2020] [Indexed: 11/22/2022]
Abstract
The piriform cortex is involved in olfactory information processing, that is altered in Down Syndrome. Moreover, piriform cortex has a crucial involvement in epilepsy generation and is one of the first regions affected in Alzheimer's Disease, both maladies being prevalent among Down Syndrome individuals. In this work, we studied the alterations in neuronal morphology, synaptology and structural plasticity in the piriform cortex of the Ts65Dn mouse model, which is the most used model for the study of this syndrome and mimics some of their alterations. We have observed that Ts65Dn piriform cortex displays: a reduction in dendritic arborisation, a higher density of inhibitory synapses (GAD67), a lower density of excitatory synapses (vGLUT1) and a higher density of inhibitory postsynaptic puncta (gephyrin). Under electron microscopy the excitatory presynaptic and postsynaptic elements were larger in trisomic mice than in controls. Similar results were obtained using confocal microscopy. There were less immature neurons in piriform cortex layer II in addition to a reduction in the expression of PSA-NCAM in the neuropil that subsequently can reflect impairment in structural plasticity. These data support the idea of an impaired environment with altered ratio of inhibition and excitation that involves a reduction in plasticity and dendritic atrophy, providing a possible substrate for the olfactory processing impairment observed in DS individuals.
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Hwang BY, Mampre D, Penn R, Anderson WS, Kang J, Kamath V. Olfactory Testing in Temporal Lobe Epilepsy: a Systematic Review. Curr Neurol Neurosci Rep 2020; 20:65. [PMID: 33169232 DOI: 10.1007/s11910-020-01083-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/24/2020] [Indexed: 12/23/2022]
Abstract
PURPOSE OF REVIEW Olfactory testing is a potentially safe, cost-effective, bedside evaluation tool for diagnosis, monitoring, and risk assessment for surgery in temporal lobe epilepsy (TLE) patients, but testing methods and relevant olfactory domains are not standardized. We conducted a systematic review to evaluate olfactory tests in TLE and summarize the results of the literature. RECENT FINDINGS Olfactory tests varied significantly in odorant administration tools and devices, target odorants, evaluation timing, and grading scales. The Smell Threshold Test and University of Pennsylvania Smell Identification Test were the most validated single-domain tests for odor detection and odor identification, respectively. For multi-domain tests, Odor Memory/Discrimination Test and the Sniffin' Sticks test were the most validated. Results of olfactory tests in TLE are presented by domain. Rigorous validation, standardization, and comparative analysis of existing olfactory tests by domain is urgently needed to establish the utility and efficacy of olfactory testing in TLE.
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Affiliation(s)
- Brian Y Hwang
- Division of Functional Neurosurgery, Department of Neurosurgery, Johns Hopkins School of Medicine, 600 N. Wolfe Street, Meyer 8-181, Baltimore, MD, 21287, USA.
| | - David Mampre
- Division of Functional Neurosurgery, Department of Neurosurgery, Johns Hopkins School of Medicine, 600 N. Wolfe Street, Meyer 8-181, Baltimore, MD, 21287, USA
| | - Rachel Penn
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - William S Anderson
- Division of Functional Neurosurgery, Department of Neurosurgery, Johns Hopkins School of Medicine, 600 N. Wolfe Street, Meyer 8-181, Baltimore, MD, 21287, USA
| | - Joon Kang
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Vidyulata Kamath
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA
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43
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Ueno H, Suemitsu S, Murakami S, Kitamura N, Wani K, Takahashi Y, Matsumoto Y, Okamoto M, Ishihara T. Pentylenetetrazol kindling induces cortical astrocytosis and increased expression of extracellular matrix molecules in mice. Brain Res Bull 2020; 163:120-134. [PMID: 32726668 DOI: 10.1016/j.brainresbull.2020.07.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Revised: 07/13/2020] [Accepted: 07/17/2020] [Indexed: 11/30/2022]
Abstract
Although epilepsy is one of the most common chronic neurological disorders with a prevalence of approximately 1.0 %, the underlying pathophysiology remains to be elucidated. Understanding the molecular and cellular mechanisms involved in the development of epilepsy is important for the development of appropriate therapeutic strategy. In this study, we investigated the effects of status epilepticus on astrocytes, microglia, and extracellular matrix (ECM) molecules in the somatosensory cortex and piriform cortex of mice. Activation of astrocytes was observed in many cortices except the retrosplenial granular cortex after pentylenetetrazol (PTZ)-induced kindling in mice. Activated astrocytes in the cortex were found in layers 1-3 but not in layers 4-6. In the somatosensory and piriform cortices, no change was observed in the number of parvalbumin (PV)-positive neurons and PV-positive neurons covered with perineuronal nets. However, the amount of ECM in the extracellular space increased. The expression of VGLUT1- and GAD67-positive synapses also increased. Thus, in the PTZ-kindling epilepsy mice model, an increase in the number of ECM molecules and activation of astrocytes were observed in the somatosensory cortex and piriform cortex. These results indicate that PTZ-induced seizures affect not only the hippocampus but also other cortical areas. Our study findings may help to develop new therapeutic approaches to prevent seizures or their sequelae.
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Affiliation(s)
- Hiroshi Ueno
- Department of Medical Technology, Kawasaki University of Medical Welfare, Kurashiki, 701-0193, Japan.
| | - Shunsuke Suemitsu
- Department of Psychiatry, Kawasaki Medical School, Kurashiki, 701-0192, Japan.
| | - Shinji Murakami
- Department of Psychiatry, Kawasaki Medical School, Kurashiki, 701-0192, Japan.
| | - Naoya Kitamura
- Department of Psychiatry, Kawasaki Medical School, Kurashiki, 701-0192, Japan.
| | - Kenta Wani
- Department of Psychiatry, Kawasaki Medical School, Kurashiki, 701-0192, Japan.
| | - Yu Takahashi
- Department of Psychiatry, Kawasaki Medical School, Kurashiki, 701-0192, Japan.
| | - Yosuke Matsumoto
- Department of Neuropsychiatry, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, 700-8558, Japan.
| | - Motoi Okamoto
- Department of Medical Technology, Graduate School of Health Sciences, Okayama University, Okayama, 700-8558, Japan.
| | - Takeshi Ishihara
- Department of Psychiatry, Kawasaki Medical School, Kurashiki, 701-0192, Japan.
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Hanael E, Veksler R, Friedman A, Bar-Klein G, Senatorov VV, Kaufer D, Konstantin L, Elkin M, Chai O, Peery D, Shamir MH. Blood-brain barrier dysfunction in canine epileptic seizures detected by dynamic contrast-enhanced magnetic resonance imaging. Epilepsia 2020; 60:1005-1016. [PMID: 31032909 DOI: 10.1111/epi.14739] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Revised: 03/28/2019] [Accepted: 04/01/2019] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Dogs with spontaneous or acquired epilepsy exhibit resemblance in etiology and disease course to humans, potentially offering a translational model of the human disease. Blood-brain barrier dysfunction (BBBD) has been shown to partake in epileptogenesis in experimental models of epilepsy. To test the hypothesis that BBBD can be detected in dogs with naturally occurring seizures, we developed a linear dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) analysis algorithm that was validated in clinical cases of seizing dogs and experimental epileptic rats. METHODS Forty-six dogs with naturally occurring seizures of different etiologies and 12 induced epilepsy rats were imaged using DCE-MRI. Six healthy dogs and 12 naive rats served as control. DCE-MRI was analyzed by linear-dynamic method. BBBD scores were calculated in whole brain and in specific brain regions. Immunofluorescence analysis for transforming growth factor beta (TGF-β) pathway proteins was performed on the piriform cortex of epileptic dogs. RESULTS We found BBBD in 37% of dogs with seizures. A significantly higher cerebrospinal fluid to serum albumin ratio was found in dogs with BBBD relative to dogs with intact blood-brain barrier (BBB). A significant difference was found between epileptic and control rats when BBBD scores were calculated for the piriform cortex at 48 hours and 1 month after status epilepticus. Mean BBBD score of the piriform lobe in idiopathic epilepsy (IE) dogs was significantly higher compared to control. Immunohistochemistry results suggested active TGF-β signaling and neuroinflammation in the piriform cortex of dogs with IE, showing increased levels of serum albumin colocalized with glial acidic fibrillary protein and pSMAD2 in an area where BBBD had been detected by linear DCE-MRI. SIGNIFICANCE Detection of BBBD in dogs with naturally occurring epilepsy provides the ground for future studies for evaluation of novel treatment targeting the disrupted BBB. The involvement of the piriform lobe seen using our linear DCE-MRI protocol and algorithm emphasizes the possibility of using dogs as a translational model for the human disease.
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Affiliation(s)
- Erez Hanael
- Hebrew University Koret School of Veterinary Medicine-Veterinary Teaching Hospital, Rehovot, Israel
| | - Ronel Veksler
- Departments of Physiology and Cell Biology, Brain, and Cognitive Sciences, Zlotowski Center for Neuroscience, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Alon Friedman
- Departments of Physiology and Cell Biology, Brain, and Cognitive Sciences, Zlotowski Center for Neuroscience, Ben-Gurion University of the Negev, Beer Sheva, Israel.,Department of Medical Neuroscience and Brain Repair Center, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Guy Bar-Klein
- Institute of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland.,Howard Hughes Medical Institute, Chevy Chase, Maryland
| | - Vladimir V Senatorov
- Helen Wills Neuroscience Institute, University of California, Berkeley, Berkeley, California
| | - Daniela Kaufer
- Helen Wills Neuroscience Institute, University of California, Berkeley, Berkeley, California.,Department of Integrative Biology, University of California, Berkeley, Berkeley, California
| | - Lilach Konstantin
- Hebrew University Koret School of Veterinary Medicine-Veterinary Teaching Hospital, Rehovot, Israel
| | - Maria Elkin
- Hebrew University Koret School of Veterinary Medicine-Veterinary Teaching Hospital, Rehovot, Israel
| | - Orit Chai
- Hebrew University Koret School of Veterinary Medicine-Veterinary Teaching Hospital, Rehovot, Israel
| | - Dana Peery
- Hebrew University Koret School of Veterinary Medicine-Veterinary Teaching Hospital, Rehovot, Israel
| | - Merav H Shamir
- Hebrew University Koret School of Veterinary Medicine-Veterinary Teaching Hospital, Rehovot, Israel
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Lane G, Zhou G, Noto T, Zelano C. Assessment of direct knowledge of the human olfactory system. Exp Neurol 2020; 329:113304. [PMID: 32278646 DOI: 10.1016/j.expneurol.2020.113304] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Revised: 01/13/2020] [Accepted: 04/08/2020] [Indexed: 12/31/2022]
Affiliation(s)
- Gregory Lane
- Northwestern University Feinberg School of Medicine, Department of Neurology, 303 E Chicago Ave, Chicago, IL 60611, USA.
| | - Guangyu Zhou
- Northwestern University Feinberg School of Medicine, Department of Neurology, 303 E Chicago Ave, Chicago, IL 60611, USA.
| | - Torben Noto
- Northwestern University Feinberg School of Medicine, Department of Neurology, 303 E Chicago Ave, Chicago, IL 60611, USA
| | - Christina Zelano
- Northwestern University Feinberg School of Medicine, Department of Neurology, 303 E Chicago Ave, Chicago, IL 60611, USA
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46
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Abstract
Axons from the olfactory bulb (OB) project to multiple central structures of the brain, many of which, in turn, send axons back into the OB and/or to one another. These secondary sensory regions underlie many aspects of odor representation, valence, and learning, as well as serving some nonolfactory functions, though many details remain unclear. We here describe the connectivity and essential structural and functional properties of these postbulbar olfactory regions in the mammalian brain.
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Affiliation(s)
- Thomas A Cleland
- Department of Psychology, Cornell University, Ithaca, NY, United States.
| | - Christiane Linster
- Department of Neurobiology and Behavior, Cornell University, Ithaca, NY, United States
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47
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Joshi S, Bayat A, Jones A, Xiao X, Koubeissi MZ. The effects of ammonia stimulation on kainate-induced status epilepticus and anterior piriform cortex electrophysiology. Epilepsy Behav 2020; 104:106885. [PMID: 31935647 DOI: 10.1016/j.yebeh.2019.106885] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 12/19/2019] [Accepted: 12/19/2019] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Strong olfactory stimulation (OS) with such substances as toluene or ammonia has been reported to suppress seizures. We aimed to investigate the role of ammonia stimulation on acute kainic acid (KA)-induced seizures. We also investigated any possible effects of ammonia stimulation on the electrophysiology of the anterior piriform cortex (APC). METHODS Adult male Sprague-Dawley rats were implanted with bilateral hippocampal electrodes and an electrode in the left APC. Animals were exposed to either distilled water (control) or ammonia stimulation for 20 s every 5 min during KA induction of status epilepticus (SE). The electroencephalogram (EEG) was analyzed for seizure frequency, duration, severity, and total KA doses given prior to reaching SE. Seizure-free EEG epochs that coincided with OS were chosen and analyzed via wavelet analysis for any spectral changes. RESULTS We found no significant differences in seizure frequency, duration, severity, or administered KA doses before SE between the groups. In the experimental group, a wavelet analysis of variance (WANOVA) revealed a significant stimulation-induced increase of power in the delta and alpha bands prior to the first KA injection and higher power in the delta and theta bands after KA injection. CONCLUSIONS Whereas the spectral analysis of the APC revealed specific OS-induced changes, our findings suggest that OS with ammonia does not result in altering the threshold of attaining KA-induced SE. This does not rule out a potential role for OS in reducing recurrent seizures in the KA or other epilepsy models.
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Affiliation(s)
- Sweta Joshi
- Department of Neurology, George Washington University, 2150 Pennsylvania Ave, NW, Washington, DC 20037, USA
| | - Arezou Bayat
- Department of Neurology, George Washington University, 2150 Pennsylvania Ave, NW, Washington, DC 20037, USA
| | - Andrew Jones
- Translational Health Sciences, George Washington University, 2100 Pennsylvania Ave, NW, Washington, DC 20037, USA
| | - Xiao Xiao
- School of Engineering and Applied Science, George Washington University, 800 22nd St NW, Washington, DC 20052, USA
| | - Mohamad Z Koubeissi
- Department of Neurology, George Washington University, 2150 Pennsylvania Ave, NW, Washington, DC 20037, USA.
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48
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Kurada L, Bayat A, Joshi S, Chahine A, Koubeissi MZ. Antiepileptic effects of electrical stimulation of the piriform cortex. Exp Neurol 2020; 325:113070. [DOI: 10.1016/j.expneurol.2019.113070] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2019] [Revised: 09/17/2019] [Accepted: 09/24/2019] [Indexed: 12/26/2022]
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49
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Liu X, Li X, Zhao G, Wang F, Wang L. Sexual dimorphic distribution of cannabinoid 1 receptor mRNA in adult C57BL/6J mice. J Comp Neurol 2020; 528:1986-1999. [DOI: 10.1002/cne.24868] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2019] [Revised: 01/18/2020] [Accepted: 01/20/2020] [Indexed: 12/13/2022]
Affiliation(s)
- Xue Liu
- Shenzhen Key Lab of Neuropsychiatric Modulation, Guangdong Provincial Key Laboratory of Brain Connectome and Behavior, CAS Key Laboratory of Brain Connectome and Manipulation, the Brain Cognition and Brain Disease Institute (BCBDI), Shenzhen Institutes of Advanced Technology, Chinese Academy of SciencesShenzhen‐Hong Kong Institute of Brain Science‐Shenzhen Fundamental Research Institutions Shenzhen China
- University of Chinese Academy of Sciences Beijing China
| | - Xulin Li
- Shenzhen Key Lab of Neuropsychiatric Modulation, Guangdong Provincial Key Laboratory of Brain Connectome and Behavior, CAS Key Laboratory of Brain Connectome and Manipulation, the Brain Cognition and Brain Disease Institute (BCBDI), Shenzhen Institutes of Advanced Technology, Chinese Academy of SciencesShenzhen‐Hong Kong Institute of Brain Science‐Shenzhen Fundamental Research Institutions Shenzhen China
| | - Gaoyang Zhao
- Shenzhen Key Lab of Neuropsychiatric Modulation, Guangdong Provincial Key Laboratory of Brain Connectome and Behavior, CAS Key Laboratory of Brain Connectome and Manipulation, the Brain Cognition and Brain Disease Institute (BCBDI), Shenzhen Institutes of Advanced Technology, Chinese Academy of SciencesShenzhen‐Hong Kong Institute of Brain Science‐Shenzhen Fundamental Research Institutions Shenzhen China
- University of Chinese Academy of Sciences Beijing China
| | - Feng Wang
- Shenzhen Key Lab of Neuropsychiatric Modulation, Guangdong Provincial Key Laboratory of Brain Connectome and Behavior, CAS Key Laboratory of Brain Connectome and Manipulation, the Brain Cognition and Brain Disease Institute (BCBDI), Shenzhen Institutes of Advanced Technology, Chinese Academy of SciencesShenzhen‐Hong Kong Institute of Brain Science‐Shenzhen Fundamental Research Institutions Shenzhen China
| | - Liping Wang
- Shenzhen Key Lab of Neuropsychiatric Modulation, Guangdong Provincial Key Laboratory of Brain Connectome and Behavior, CAS Key Laboratory of Brain Connectome and Manipulation, the Brain Cognition and Brain Disease Institute (BCBDI), Shenzhen Institutes of Advanced Technology, Chinese Academy of SciencesShenzhen‐Hong Kong Institute of Brain Science‐Shenzhen Fundamental Research Institutions Shenzhen China
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50
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Cheng H, Wang Y, Chen J, Chen Z. The piriform cortex in epilepsy: What we learn from the kindling model. Exp Neurol 2020; 324:113137. [DOI: 10.1016/j.expneurol.2019.113137] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 11/25/2019] [Accepted: 11/29/2019] [Indexed: 12/14/2022]
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