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Shimoda Y, Leite M, Graham RT, Marvin JS, Hasseman J, Kolb I, Looger LL, Magloire V, Kullmann DM. Extracellular glutamate and GABA transients at the transition from interictal spiking to seizures. Brain 2024; 147:1011-1024. [PMID: 37787057 PMCID: PMC10907087 DOI: 10.1093/brain/awad336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 08/29/2023] [Accepted: 09/16/2023] [Indexed: 10/04/2023] Open
Abstract
Focal epilepsy is associated with intermittent brief population discharges (interictal spikes), which resemble sentinel spikes that often occur at the onset of seizures. Why interictal spikes self-terminate whilst seizures persist and propagate is incompletely understood. We used fluorescent glutamate and GABA sensors in an awake rodent model of neocortical seizures to resolve the spatiotemporal evolution of both neurotransmitters in the extracellular space. Interictal spikes were accompanied by brief glutamate transients which were maximal at the initiation site and rapidly propagated centrifugally. GABA transients lasted longer than glutamate transients and were maximal ∼1.5 mm from the focus where they propagated centripetally. Prior to seizure initiation GABA transients were attenuated, whilst glutamate transients increased, consistent with a progressive failure of local inhibitory restraint. As seizures increased in frequency, there was a gradual increase in the spatial extent of spike-associated glutamate transients associated with interictal spikes. Neurotransmitter imaging thus reveals a progressive collapse of an annulus of feed-forward GABA release, allowing seizures to escape from local inhibitory restraint.
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Affiliation(s)
- Yoshiteru Shimoda
- Department of Clinical & Experimental Epilepsy, UCL Queen Square Institute of Neurology, University College London, London WC1N 3BG, UK
| | - Marco Leite
- Department of Clinical & Experimental Epilepsy, UCL Queen Square Institute of Neurology, University College London, London WC1N 3BG, UK
| | - Robert T Graham
- Department of Clinical & Experimental Epilepsy, UCL Queen Square Institute of Neurology, University College London, London WC1N 3BG, UK
| | - Jonathan S Marvin
- Janelia Research Campus, Howard Hughes Medical Institute, Ashburn, VA 20147, USA
| | - Jeremy Hasseman
- Janelia Research Campus, Howard Hughes Medical Institute, Ashburn, VA 20147, USA
| | - Ilya Kolb
- Janelia Research Campus, Howard Hughes Medical Institute, Ashburn, VA 20147, USA
| | - Loren L Looger
- Janelia Research Campus, Howard Hughes Medical Institute, Ashburn, VA 20147, USA
| | - Vincent Magloire
- Department of Clinical & Experimental Epilepsy, UCL Queen Square Institute of Neurology, University College London, London WC1N 3BG, UK
| | - Dimitri M Kullmann
- Department of Clinical & Experimental Epilepsy, UCL Queen Square Institute of Neurology, University College London, London WC1N 3BG, UK
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2
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Fukuyama K, Motomura E, Okada M. Age-Dependent Activation of Pannexin1 Function Contributes to the Development of Epileptogenesis in Autosomal Dominant Sleep-related Hypermotor Epilepsy Model Rats. Int J Mol Sci 2024; 25:1619. [PMID: 38338895 PMCID: PMC10855882 DOI: 10.3390/ijms25031619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Revised: 01/23/2024] [Accepted: 01/25/2024] [Indexed: 02/12/2024] Open
Abstract
To explore the processes of epileptogenesis/ictogenesis, this study determined the age-dependent development of the functional abnormalities in astroglial transmission associated with pannexin1-hemichannel using a genetic rat model of autosomal dominant sleep-related hypermotor epilepsy (ADSHE) named 'S286L-TG'. Pannexin1 expression in the plasma membrane of primary cultured cortical astrocytes and the orbitofrontal cortex (OFC), which is an ADSHE focus region, were determined using capillary immunoblotting. Astroglial D-serine releases induced by artificial high-frequency oscillation (HFO)-evoked stimulation, the removal of extracellular Ca2+, and the P2X7 receptor agonist (BzATP) were determined using ultra-high performance liquid chromatography (UHPLC). The expressions of pannexin1 in the plasma membrane fraction of the OFC in S286L-TG at four weeks old were almost equivalent when compared to the wild type. The pannexin1 expression in the OFC of the wild type non-statistically decreased age-dependently, whereas that in S286L-TG significantly increased age-dependently, resulting in relatively increasing pannexin1 expression from the 7- (at the onset of interictal discharge) and 10-week-old (after the ADSHE seizure onset) S286L-TG compared to the wild type. However, no functional abnormalities of astroglial pannexin1 expression or D-serine release through the pannexin1-hemichannels from the cultured astrocytes of S286L-TG could be detected. Acutely HFO-evoked stimulation, such as physiological ripple burst (200 Hz) and epileptogenic fast ripple burst (500 Hz), frequency-dependently increased both pannexin1 expression in the astroglial plasma membrane and astroglial D-serine release. Neither the selective inhibitors of pannexin1-hemichannel (10PANX) nor connexin43-hemichannel (Gap19) affected astroglial D-serine release during the resting stage, whereas HFO-evoked D-serine release was suppressed by both inhibitors. The inhibitory effect of 10PANX on the ripple burst-evoked D-serine release was more predominant than that of Gap19, whereas fast ripple burst-evoked D-serine release was predominantly suppressed by Gap19 rather than 10PANX. Astroglial D-serine release induced by acute exposure to BzATP was suppressed by 10PANX but not by Gap19. These results suggest that physiological ripple burst during the sleep spindle plays important roles in the organization of some components of cognition in healthy individuals, but conversely, it contributes to the initial development of epileptogenesis/ictogenesis in individuals who have ADSHE vulnerability via activation of the astroglial excitatory transmission associated with pannexin1-hemichannels.
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Affiliation(s)
| | | | - Motohiro Okada
- Department of Neuropsychiatry, Division of Neuroscience, Graduate School of Medicine, Mie University, Tsu 514-8507, Japan; (K.F.); (E.M.)
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3
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Çarçak N, Onat F, Sitnikova E. Astrocytes as a target for therapeutic strategies in epilepsy: current insights. Front Mol Neurosci 2023; 16:1183775. [PMID: 37583518 PMCID: PMC10423940 DOI: 10.3389/fnmol.2023.1183775] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 07/12/2023] [Indexed: 08/17/2023] Open
Abstract
Astrocytes are specialized non-neuronal glial cells of the central nervous system, contributing to neuronal excitability and synaptic transmission (gliotransmission). Astrocytes play a key roles in epileptogenesis and seizure generation. Epilepsy, as a chronic disorder characterized by neuronal hyperexcitation and hypersynchronization, is accompanied by substantial disturbances of glial cells and impairment of astrocytic functions and neuronal signaling. Anti-seizure drugs that provide symptomatic control of seizures primarily target neural activity. In epileptic patients with inadequate control of seizures with available anti-seizure drugs, novel therapeutic candidates are needed. These candidates should treat epilepsy with anti-epileptogenic and disease-modifying effects. Evidence from human and animal studies shows that astrocytes have value for developing new anti-seizure and anti-epileptogenic drugs. In this review, we present the key functions of astrocytes contributing to neuronal hyperexcitability and synaptic activity following an etiology-based approach. We analyze the role of astrocytes in both development (epileptogenesis) and generation of seizures (ictogenesis). Several promising new strategies that attempted to modify astroglial functions for treating epilepsy are being developed: (1) selective targeting of glia-related molecular mechanisms of glutamate transport; (2) modulation of tonic GABA release from astrocytes; (3) gliotransmission; (4) targeting the astrocytic Kir4.1-BDNF system; (5) astrocytic Na+/K+/ATPase activity; (6) targeting DNA hypo- or hypermethylation of candidate genes in astrocytes; (7) targeting astrocytic gap junction regulators; (8) targeting astrocytic adenosine kinase (the major adenosine-metabolizing enzyme); and (9) targeting microglia-astrocyte communication and inflammatory pathways. Novel disease-modifying therapeutic strategies have now been developed, such as astroglia-targeted gene therapy with a broad spectrum of genetic constructs to target astroglial cells.
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Affiliation(s)
- Nihan Çarçak
- Department of Pharmacology, Faculty of Pharmacy, Istanbul University, Istanbul, Turkey
- Institute of Health Sciences, Department of Neuroscience, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey
| | - Filiz Onat
- Institute of Health Sciences, Department of Neuroscience, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey
- Department of Medical Pharmacology, Faculty of Medicine, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey
| | - Evgenia Sitnikova
- Institute of Higher Nervous Activity and Neurophysiology of Russian Academy of Sciences, Moscow, Russia
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4
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Vasilopoulos N, Kaplanian A, Vinos M, Katsaiti Y, Christodoulou O, Denaxa M, Skaliora I. The role of selective SATB1 deletion in somatostatin expressing interneurons on endogenous network activity and the transition to epilepsy. J Neurosci Res 2023; 101:424-447. [PMID: 36541427 DOI: 10.1002/jnr.25156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Revised: 10/24/2022] [Accepted: 12/03/2022] [Indexed: 12/24/2022]
Abstract
Somatostatin (SST) expressing interneurons are the second most abundant group of inhibitory neurons in the neocortex. They mainly target the apical dendrites of excitatory pyramidal cells and are implicated in feedforward and feedback inhibition. In the present study, we employ a conditional knockout mouse, in which the transcription factor Satb1 is selectively deleted in SST-expressing interneurons resulting to the reduction of their number across the somatosensory barrel field. Our goal was to investigate the effect of the reduced number of Satb1 mutant SST-interneurons on (i) the endogenous cortical network activity (spontaneously recurring Up/Down states), and (ii) the transition to epileptiform activity. By conducting LFP recordings in acute brain slices from young male and female mice, we demonstrate that mutant animals exhibit significant changes in network excitability, reflected in increased Up state occurrence, decreased Up state duration and higher levels of extracellular spiking activity. Epileptiform activity was induced through two distinct and widely used in vitro protocols: the low magnesium and the 4-Aminopyridine (4-AP) model. In the former, slices from mutant animals manifested shorter latency for the expression of stable seizure-like events. In contrast, when epilepsy was induced by 4-AP, no significant differences were reported. We conclude that normal SST-interneuron function has a significant role both in the regulation of the endogenous network activity, and in the transition to seizure-like discharges in a context-dependent manner.
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Affiliation(s)
- Nikos Vasilopoulos
- Centre for Basic Research, Biomedical Research Foundation of the Academy of Athens (BRFAA), Athens, Greece
| | - Ani Kaplanian
- Centre for Basic Research, Biomedical Research Foundation of the Academy of Athens (BRFAA), Athens, Greece
| | - Michael Vinos
- Centre for Basic Research, Biomedical Research Foundation of the Academy of Athens (BRFAA), Athens, Greece.,Department of History and Philosophy of Science, National and Kapodistrian University of Athens (NKUA), Athens, Greece
| | - Yolanda Katsaiti
- Biomedical Sciences Research Center "Alexander Fleming", Vari, Greece.,Department of Biology, National and Kapodistrian University of Athens (NKUA), Athens, Greece
| | - Ourania Christodoulou
- Biomedical Sciences Research Center "Alexander Fleming", Vari, Greece.,Department of Biology, University of Crete, Heraklion, Greece
| | - Myrto Denaxa
- Biomedical Sciences Research Center "Alexander Fleming", Vari, Greece
| | - Irini Skaliora
- Centre for Basic Research, Biomedical Research Foundation of the Academy of Athens (BRFAA), Athens, Greece.,Department of History and Philosophy of Science, National and Kapodistrian University of Athens (NKUA), Athens, Greece
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5
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Abstract
Investigations into seizure initiation, in recent years, have focused almost entirely upon alterations of interneuronal function, chloride homeostasis, and extracellular potassium levels. In contrast, little attention has been directed toward a possible role of dendritic plateau potentials in the actual ictogenic transition, despite a substantial literature dating back 40 years regarding its importance generally in epilepsy. Here, we argue that an increase in dendritic excitability, coordinated across the population of pyramidal cells, is a key stage in ictogenesis.
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Affiliation(s)
- Andrew J. Trevelyan
- Newcastle University Biosciences Institute, Medical School, Framlington Place, Newcastle upon Tyne, United Kingdom
| | - Robert T. Graham
- Queen Square Institute of Neurology, University College London, United Kingdom
| | - R. Ryley Parrish
- Department of Cell Biology and Physiology, Brigham Young University, Provo, UT, USA
| | - Neela K. Codadu
- Queen Square Institute of Neurology, University College London, United Kingdom
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6
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Buckmaster PS, Reyes B, Kahn T, Wyeth M. Ventral Hippocampal Formation Is the Primary Epileptogenic Zone in a Rat Model of Temporal Lobe Epilepsy. J Neurosci 2022; 42:7482-7495. [PMID: 35995562 PMCID: PMC9525166 DOI: 10.1523/jneurosci.0429-22.2022] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 08/04/2022] [Accepted: 08/10/2022] [Indexed: 01/12/2023] Open
Abstract
Temporal lobe epilepsy is common, but mechanisms of seizure initiation are unclear. We evaluated seizure initiation in female and male rats that had been systemically treated with pilocarpine, a widely used model of temporal lobe epilepsy. Local field potential (LFP) recordings from many brain regions revealed variable sites of earliest recorded seizure activity, but mostly the ventral hippocampal formation. To test whether inactivation of the ventral hippocampal formation would reduce seizures, mini-osmotic pumps were used to continually and focally deliver TTX. High doses of TTX infused unilaterally into the ventral hippocampal formation blocked seizures reversibly but also reduced LFP amplitudes in remote brain regions, indicating distant effects. A lower dose did not reduce LFP amplitudes in remote brain regions but did not reduce seizures when infused unilaterally. Instead, seizures tended to initiate in the contralateral ventral hippocampal formation. Bilateral infusion of the lower dose into the ventral hippocampal formation reduced seizure frequency 85%. Similar bilateral treatment in the amygdala was not effective. Bilateral infusion of the dorsal hippocampus reduced seizure frequency, but only 17%. Together, these findings reveal that the ventral hippocampal formation is a primary bilaterally independent epileptogenic zone, and the dorsal hippocampus is a secondary epileptogenic zone in pilocarpine-treated rats. This is consistent with many human patients, and the results further validate the LFP method for identifying seizure onset zones. Finally, the findings are more consistent with a focal mechanism of ictogenesis rather than one involving a network of interdependent nodes.SIGNIFICANCE STATEMENT To better understand how seizures start, investigators need to know where seizures start in the animal models they study. In the widely used pilocarpine-treated rat model of temporal lobe epilepsy, earliest seizure activity was most frequently recorded in the ventral hippocampal formation. Confirming the primary role of the ventral hippocampal formation, seizure frequency was reduced most effectively when it was inactivated focally, bilaterally, and continually with infused TTX. These findings suggest that the ventral hippocampal formation is the primary site of seizure initiation in this animal model of temporal lobe epilepsy, consistent with findings in many human patients.
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Affiliation(s)
- Paul S Buckmaster
- Departments of Comparative Medicine
- Neurology & Neurological Sciences, Stanford University, Stanford, California 94305
| | - Bianca Reyes
- Departments of Comparative Medicine
- College of Veterinary Medicine, Tuskegee University, Tuskegee, Alabama 36088
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7
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Lau LA, Staley KJ, Lillis KP. In vitro ictogenesis is stochastic at the single neuron level. Brain 2022; 145:531-541. [PMID: 34431994 PMCID: PMC9014754 DOI: 10.1093/brain/awab312] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 07/13/2021] [Accepted: 07/30/2021] [Indexed: 11/14/2022] Open
Abstract
Seizure initiation is the least understood and most disabling element of epilepsy. Studies of ictogenesis require high speed recordings at cellular resolution in the area of seizure onset. However, in vivo seizure onset areas cannot be determined at the level of resolution necessary to enable such studies. To circumvent these challenges, we used novel GCaMP7-based calcium imaging in the organotypic hippocampal slice culture model of post-traumatic epilepsy in mice. Organotypic hippocampal slice cultures generate spontaneous, recurrent seizures in a preparation in which it is feasible to image the activity of the entire network (with no unseen inputs existing). Chronic calcium imaging of the entire hippocampal network, with paired electrophysiology, revealed three patterns of seizure onset: (i) low amplitude fast activity; (ii) sentinel spike; and (iii) spike burst and low amplitude fast activity onset. These patterns recapitulate common features of human seizure onset, including low voltage fast activity and spike discharges. Weeks-long imaging of seizure activity showed a characteristic evolution in onset type and a refinement of the seizure onset zone. Longitudinal tracking of individual neurons revealed that seizure onset is stochastic at the single neuron level, suggesting that seizure initiation activates neurons in non-stereotyped sequences seizure to seizure. This study demonstrates for the first time that transitions to seizure are not initiated by a small number of neuronal 'bad actors' (such as overly connected hub cells), but rather by network changes which enable the onset of pathology among large populations of neurons.
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Affiliation(s)
- Lauren A Lau
- Department of Neurology, Massachusetts General Hospital, Boston, MA 02114, USA.,Harvard Medical School, Boston, MA 02115, USA
| | - Kevin J Staley
- Department of Neurology, Massachusetts General Hospital, Boston, MA 02114, USA.,Harvard Medical School, Boston, MA 02115, USA
| | - Kyle P Lillis
- Department of Neurology, Massachusetts General Hospital, Boston, MA 02114, USA.,Harvard Medical School, Boston, MA 02115, USA
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8
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Niemeyer JE, Gadamsetty P, Chun C, Sylvester S, Lucas JP, Ma H, Schwartz TH, Aksay ERF. Seizures initiate in zones of relative hyperexcitation in a zebrafish epilepsy model. Brain 2022; 145:2347-2360. [PMID: 35196385 DOI: 10.1093/brain/awac073] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 02/03/2022] [Accepted: 02/05/2022] [Indexed: 11/12/2022] Open
Abstract
Seizures are thought to arise from an imbalance of excitatory and inhibitory neuronal activity. While most classical studies suggest excessive excitatory neural activity plays a generative role, some recent findings challenge this view and instead argue that excessive activity in inhibitory neurons initiates seizures. We investigated this question of imbalance in a zebrafish seizure model with two-photon imaging of excitatory and inhibitory neuronal activity throughout the brain using a nuclear-localized calcium sensor. We found that seizures consistently initiated in circumscribed zones of the midbrain before propagating to other brain regions. Excitatory neurons were both more prevalent and more likely to be recruited than inhibitory neurons in initiation as compared with propagation zones. These findings support a mechanistic picture whereby seizures initiate in a region of hyper-excitation, then propagate more broadly once inhibitory restraint in the surround is overcome.
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Affiliation(s)
- James E Niemeyer
- Department of Neurological Surgery, Weill Cornell Medicine, New York, NY 10065, USA.,Feil Family Brain and Mind Research Institute, Weill Cornell Medicine, New York, NY 10065, USA
| | - Poornima Gadamsetty
- Department of Neurological Surgery, Weill Cornell Medicine, New York, NY 10065, USA
| | - Chanwoo Chun
- Institute for Computational Biomedicine and the Department of Physiology and Biophysics, Weill Cornell Medicine, New York, NY 10065, USA
| | - Sherika Sylvester
- Institute for Computational Biomedicine and the Department of Physiology and Biophysics, Weill Cornell Medicine, New York, NY 10065, USA
| | - Jacob P Lucas
- Department of Neurological Surgery, Weill Cornell Medicine, New York, NY 10065, USA
| | - Hongtao Ma
- Department of Neurological Surgery, Weill Cornell Medicine, New York, NY 10065, USA.,Feil Family Brain and Mind Research Institute, Weill Cornell Medicine, New York, NY 10065, USA
| | - Theodore H Schwartz
- Department of Neurological Surgery, Weill Cornell Medicine, New York, NY 10065, USA.,Feil Family Brain and Mind Research Institute, Weill Cornell Medicine, New York, NY 10065, USA
| | - Emre R F Aksay
- Institute for Computational Biomedicine and the Department of Physiology and Biophysics, Weill Cornell Medicine, New York, NY 10065, USA
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9
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Abstract
Epilepsy is one of the most common neurological disorders – estimated to affect at least 65 million worldwide. Most of the epilepsy research has so far focused on how to dampen neuronal discharges and to explain how changes in intrinsic neuronal activity or network function cause seizures. As a result, pharmacological therapy has largely been limited to symptomatic treatment targeted at neurons. Given the expanding spectrum of functions ascribed to the non-neuronal constituents of the brain, in both physiological brain function and in brain disorders, it is natural to closely consider the roles of astrocytes in epilepsy. It is now widely accepted that astrocytes are key controllers of the composition of the extracellular fluids, and may directly interact with neurons by releasing gliotransmitters. A central tenet is that astrocytic intracellular Ca2+ signals promote release of such signaling substances, either through synaptic or non-synaptic mechanisms. Accruing evidence suggests that astrocytic Ca2+ signals play important roles in both seizures and epilepsy, and this review aims to highlight the current knowledge of the roles of this central astrocytic signaling mechanism in ictogenesis and epileptogenesis.
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Affiliation(s)
- Kjell Heuser
- Department of Neurology, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Rune Enger
- Letten Centre and GliaLab, Division of Anatomy, Department of Molecular Medicine, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
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10
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Ong C, Damisah EC, Gruenbaum SE, Dhaher R, Deng Y, Sandhu MRS, Zaveri HP, Spencer DD, Eid T. Increased branched-chain amino acids at baseline and hours before a spontaneous seizure in the human epileptic brain. Epilepsia 2021; 62:e88-e97. [PMID: 33949690 DOI: 10.1111/epi.16920] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 04/14/2021] [Accepted: 04/15/2021] [Indexed: 11/30/2022]
Abstract
The objective of this study was to monitor the extracellular brain chemistry dynamics at baseline and in relation to spontaneous seizures in human patients with refractory epilepsy. Thirty patients with drug-resistant focal epilepsy underwent intracranial electroencephalography and concurrent brain microdialysis for up to 8 continuous days. Extracellular brain glutamate, glutamine, and the branched-chain amino acids (BCAAs) valine, leucine, and isoleucine were quantified in the dialysis samples by liquid chromatography-tandem mass spectrometry. Extracellular BCAAs and glutamate were chronically elevated at baseline by approximately 1.5-3-fold in brain regions of seizure onset and propagation versus regions not involved by seizures. Moreover, isoleucine increased significantly above baseline as early as 3 h before a spontaneous seizure. BCAAs play important roles in glutamatergic neurotransmission, mitochondrial function, neurodegeneration, and mammalian target of rapamycin signaling. Because all of these processes have been implicated in epilepsy, the results suggest a novel role of BCAAs in the pathogenesis of spontaneous seizures.
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Affiliation(s)
- Caroline Ong
- Department of Laboratory Medicine, Yale School of Medicine, New Haven, CT, USA
| | | | - Shaun E Gruenbaum
- Department of Anesthesiology, Yale School of Medicine, New Haven, CT, USA
| | - Roni Dhaher
- Department of Laboratory Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Yanhong Deng
- Yale Center for Analytical Sciences, Yale School of Medicine, New Haven, CT, USA
| | | | - Hitten P Zaveri
- Department of Neurology, Yale School of Medicine, New Haven, CT, USA
| | - Dennis D Spencer
- Department of Neurosurgery, Yale School of Medicine, New Haven, CT, USA
| | - Tore Eid
- Department of Laboratory Medicine, Yale School of Medicine, New Haven, CT, USA.,Department of Neurosurgery, Yale School of Medicine, New Haven, CT, USA.,Department of Cellular and Molecular Physiology, Yale School of Medicine, New Haven, CT, USA
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11
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de Curtis M, Garbelli R, Uva L. A hypothesis for the role of axon demyelination in seizure generation. Epilepsia 2021; 62:583-595. [PMID: 33493363 DOI: 10.1111/epi.16824] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 01/04/2021] [Accepted: 01/05/2021] [Indexed: 01/06/2023]
Abstract
Loss of myelin and altered oligodendrocyte distribution in the cerebral cortex are commonly observed both in postsurgical tissue derived from different focal epilepsies (such as focal cortical dysplasias and tuberous sclerosis) and in animal models of focal epilepsy. Moreover, seizures are a frequent symptom in demyelinating diseases, such as multiple sclerosis, and in animal models of demyelination and oligodendrocyte dysfunction. Finally, the excessive activity reported in demyelinated axons may promote hyperexcitability. We hypothesize that the extracellular potassium rise generated during epileptiform activity may be amplified by the presence of axons without appropriate myelin coating and by alterations in oligodendrocyte function. This process could facilitate the triggering of recurrent spontaneous seizures in areas of altered myelination and could result in further demyelination, thus promoting epileptogenesis.
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Affiliation(s)
- Marco de Curtis
- Epilepsy Unit, IRCCS Foundation Carlo Besta Neurological Institute, Milan, Italy
| | - Rita Garbelli
- Epilepsy Unit, IRCCS Foundation Carlo Besta Neurological Institute, Milan, Italy
| | - Laura Uva
- Epilepsy Unit, IRCCS Foundation Carlo Besta Neurological Institute, Milan, Italy
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12
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Abstract
Neurosteroids are a family of compounds that are synthesized in principal excitatory neurons and glial cells, and derive from the transformation of cholesterol into pregnenolone. The most studied neurosteroids—allopregnanolone and allotetrahydrodeoxycorticosterone (THDOC)—are known to modulate GABAA receptor-mediated transmission, thus playing a role in controlling neuronal network excitability. Given the role of GABAA signaling in epileptic disorders, neurosteroids have profound effects on seizure generation and play a role in the development of chronic epileptic conditions (i.e., epileptogenesis). We review here studies showing the effects induced by neurosteroids on epileptiform synchronization in in vitro brain slices, on epileptic activity in in vivo models, i.e., in animals that were made epileptic with chemoconvulsant treatment, and in epileptic patients. These studies reveal that neurosteroids can modulate ictogenesis and the occurrence of pathological network activity such as interictal spikes and high-frequency oscillations (80–500 Hz). Moreover, they can delay the onset of spontaneous seizures in animal models of mesial temporal lobe epilepsy. Overall, this evidence suggests that neurosteroids represent a new target for the treatment of focal epileptic disorders.
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Affiliation(s)
- Maxime Lévesque
- Montreal Neurological Institute-Hospital & Department of Neurology and Neurosurgery, 3801 University Street, Montreal, QC H3A 2B4, Canada;
- Correspondence: ; Tel.: +1-514-398-8909
| | - Giuseppe Biagini
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Via Università 4, 41121 Modena, Italy;
| | - Massimo Avoli
- Montreal Neurological Institute-Hospital & Department of Neurology and Neurosurgery, 3801 University Street, Montreal, QC H3A 2B4, Canada;
- Department of Physiology, McGill University, Montreal, QC H3A 2B4, Canada
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13
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Hanada T. Ionotropic Glutamate Receptors in Epilepsy: A Review Focusing on AMPA and NMDA Receptors. Biomolecules 2020; 10:E464. [PMID: 32197322 DOI: 10.3390/biom10030464] [Citation(s) in RCA: 114] [Impact Index Per Article: 28.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 03/13/2020] [Accepted: 03/14/2020] [Indexed: 12/22/2022] Open
Abstract
It is widely accepted that glutamate-mediated neuronal hyperexcitation plays a causative role in eliciting seizures. Among glutamate receptors, the roles of N-methyl-D-aspartate (NMDA) and α-amino-3-hydroxy-5-methylisoxazole-4-propionic acid (AMPA) receptors in physiological and pathological conditions represent major clinical research targets. It is well known that agonists of NMDA or AMPA receptors can elicit seizures in animal or human subjects, while antagonists have been shown to inhibit seizures in animal models, suggesting a potential role for NMDA and AMPA receptor antagonists in anti-seizure drug development. Several such drugs have been evaluated in clinical studies; however, the majority, mainly NMDA-receptor antagonists, failed to demonstrate adequate efficacy and safety for therapeutic use, and only an AMPA-receptor antagonist, perampanel, has been approved for the treatment of some forms of epilepsy. These results suggest that a misunderstanding of the role of each glutamate receptor in the ictogenic process may underlie the failure of these drugs to demonstrate clinical efficacy and safety. Accumulating knowledge of both NMDA and AMPA receptors, including pathological gene mutations, roles in autoimmune epilepsy, and evidence from drug-discovery research and pharmacological studies, may provide valuable information enabling the roles of both receptors in ictogenesis to be reconsidered. This review aimed to integrate information from several studies in order to further elucidate the specific roles of NMDA and AMPA receptors in epilepsy.
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Laiou P, Avramidis E, Lopes MA, Abela E, Müller M, Akman OE, Richardson MP, Rummel C, Schindler K, Goodfellow M. Quantification and Selection of Ictogenic Zones in Epilepsy Surgery. Front Neurol 2019; 10:1045. [PMID: 31632339 PMCID: PMC6779811 DOI: 10.3389/fneur.2019.01045] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Accepted: 09/16/2019] [Indexed: 01/23/2023] Open
Abstract
Network models of brain dynamics provide valuable insight into the healthy functioning of the brain and how this breaks down in disease. A pertinent example is the use of network models to understand seizure generation (ictogenesis) in epilepsy. Recently, computational models have emerged to aid our understanding of seizures and to predict the outcome of surgical perturbations to brain networks. Such approaches provide the opportunity to quantify the effect of removing regions of tissue from brain networks and thereby search for the optimal resection strategy. Here, we use computational models to elucidate how sets of nodes contribute to the ictogenicity of networks. In small networks we fully elucidate the ictogenicity of all possible sets of nodes and demonstrate that the distribution of ictogenicity across sets depends on network topology. However, the full elucidation is a combinatorial problem that becomes intractable for large networks. Therefore, we combine computational models with a genetic algorithm to search for minimal sets of nodes that contribute significantly to ictogenesis. We demonstrate the potential applicability of these methods in practice by identifying optimal sets of nodes to resect in networks derived from 20 individuals who underwent resective surgery for epilepsy. We show that they have the potential to aid epilepsy surgery by suggesting alternative resection sites as well as facilitating the avoidance of brain regions that should not be resected.
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Affiliation(s)
- Petroula Laiou
- Living Systems Institute, University of Exeter, Exeter, United Kingdom
- EPSRC Centre for Predictive Modelling in Healthcare, University of Exeter, Exeter, United Kingdom
- College of Engineering, Mathematics and Physical Sciences, University of Exeter, Exeter, United Kingdom
| | | | - Marinho A. Lopes
- Living Systems Institute, University of Exeter, Exeter, United Kingdom
- EPSRC Centre for Predictive Modelling in Healthcare, University of Exeter, Exeter, United Kingdom
- College of Engineering, Mathematics and Physical Sciences, University of Exeter, Exeter, United Kingdom
- Wellcome Trust Centre for Biomedical Modelling and Analysis, University of Exeter, Exeter, United Kingdom
| | - Eugenio Abela
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Michael Müller
- Support Center for Advanced Neuroimaging, University Institute for Diagnostic and Interventional Neuroradiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Department of Neurology, Inselspital, University Hospital Bern, Bern, Switzerland
| | - Ozgur E. Akman
- College of Engineering, Mathematics and Physical Sciences, University of Exeter, Exeter, United Kingdom
| | - Mark P. Richardson
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Christian Rummel
- Support Center for Advanced Neuroimaging, University Institute for Diagnostic and Interventional Neuroradiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Kaspar Schindler
- Department of Neurology, Inselspital, University Hospital Bern, Bern, Switzerland
| | - Marc Goodfellow
- Living Systems Institute, University of Exeter, Exeter, United Kingdom
- EPSRC Centre for Predictive Modelling in Healthcare, University of Exeter, Exeter, United Kingdom
- College of Engineering, Mathematics and Physical Sciences, University of Exeter, Exeter, United Kingdom
- Wellcome Trust Centre for Biomedical Modelling and Analysis, University of Exeter, Exeter, United Kingdom
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Jacob T, Lillis KP, Wang Z, Swiercz W, Rahmati N, Staley KJ. A Proposed Mechanism for Spontaneous Transitions between Interictal and Ictal Activity. J Neurosci 2019; 39:557-575. [PMID: 30446533 PMCID: PMC6335741 DOI: 10.1523/jneurosci.0719-17.2018] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Revised: 10/23/2018] [Accepted: 10/31/2018] [Indexed: 11/21/2022] Open
Abstract
Epileptic networks are characterized by two outputs: brief interictal spikes and rarer, more prolonged seizures. Although either output state is readily modeled in silico and induced experimentally, the transition mechanisms are unknown, in part because no models exhibit both output states spontaneously. In silico small-world neural networks were built using single-compartment neurons whose physiological parameters were derived from dual whole-cell recordings of pyramidal cells in organotypic hippocampal slice cultures that were generating spontaneous seizure-like activity. In silico, neurons were connected by abundant local synapses and rare long-distance synapses. Activity-dependent synaptic depression and gradual recovery delimited synchronous activity. Full synaptic recovery engendered interictal population spikes that spread via long-distance synapses. When synaptic recovery was incomplete, postsynaptic neurons required coincident activation of multiple presynaptic terminals to reach firing threshold. Only local connections were sufficiently dense to spread activity under these conditions. This coalesced network activity into traveling waves whose velocity varied with synaptic recovery. Seizures were comprised of sustained traveling waves that were similar to those recorded during experimental and human neocortical seizures. Sustained traveling waves occurred only when wave velocity, network dimensions, and the rate of synaptic recovery enabled wave reentry into previously depressed areas at precisely ictogenic levels of synaptic recovery. Wide-field, cellular-resolution GCamP7b calcium imaging demonstrated similar initial patterns of activation in the hippocampus, although the anatomical distribution of traveling waves of synaptic activation was altered by the pattern of synaptic connectivity in the organotypic hippocampal cultures.SIGNIFICANCE STATEMENT When computerized distributed neural network models are required to generate both features of epileptic networks (i.e., spontaneous interictal population spikes and seizures), the network structure is substantially constrained. These constraints provide important new hypotheses regarding the nature of epileptic networks and mechanisms of seizure onset.
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Affiliation(s)
- Theju Jacob
- Massachusetts General Hospital, Boston, Massachusetts 02114
- Harvard Medical School, Boston, MA 02115
| | - Kyle P Lillis
- Massachusetts General Hospital, Boston, Massachusetts 02114
- Harvard Medical School, Boston, MA 02115
| | - Zemin Wang
- Brigham and Women's Hospital, Boston, MA 02115, and
- Harvard Medical School, Boston, MA 02115
| | - Waldemar Swiercz
- Massachusetts General Hospital, Boston, Massachusetts 02114
- Harvard Medical School, Boston, MA 02115
| | - Negah Rahmati
- Massachusetts General Hospital, Boston, Massachusetts 02114
- Harvard Medical School, Boston, MA 02115
| | - Kevin J Staley
- Massachusetts General Hospital, Boston, Massachusetts 02114,
- Harvard Medical School, Boston, MA 02115
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Baird-Daniel E, Daniel AGS, Wenzel M, Li D, Liou JY, Laffont P, Zhao M, Yuste R, Ma H, Schwartz TH. Glial Calcium Waves are Triggered by Seizure Activity and Not Essential for Initiating Ictal Onset or Neurovascular Coupling. Cereb Cortex 2018; 27:3318-3330. [PMID: 28369176 DOI: 10.1093/cercor/bhx072] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Indexed: 12/12/2022] Open
Abstract
It has been postulated that glia play a critical role in modifying neuronal activity, mediating neurovascular coupling, and in seizure initiation. We investigated the role of glia in ictogenesis and neurovascular coupling through wide-field multicell and 2-photon single cell imaging of calcium and intrinsic signal imaging of cerebral blood volume in an in vivo rat model of focal neocortical seizures. Ictal events triggered a slowly propagating glial calcium wave that was markedly delayed after both neuronal and hemodynamic onset. Glial calcium waves exhibited a stereotypical spread that terminated prior to seizure offset and propagated to an area ~60% greater than the propagation area of neural and vascular signals. Complete blockage of glial activity with fluoroacetate resulted in no change in either neuronal or hemodynamic activity. These ictal glial waves were blocked by carbenoxolone, a gap junction blocker. Our in vivo data reveal that ictal events trigger a slowly propagating, stereotypical glial calcium wave, mediated by gap junctions, that is spatially and temporally independent of neuronal and hemodynamic activities. We introduce a novel ictally triggered propagating glial calcium wave calling into question the criticality of glial calcium wave in both ictal onset and neurovascular coupling.
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Affiliation(s)
- Eliza Baird-Daniel
- Department of Neurological Surgery, Feil Family Brain and Mind Research Institute, Sackler Brain and Spine Institute, Weill Cornell Medicine, New York-Presbyterian Hospital, New York, NY 10065, USA
| | - Andy G S Daniel
- Department of Neurological Surgery, Feil Family Brain and Mind Research Institute, Sackler Brain and Spine Institute, Weill Cornell Medicine, New York-Presbyterian Hospital, New York, NY 10065, USA
| | - Michael Wenzel
- Department of Biological Sciences, Columbia University, New York, NY 10027, USA
| | - Dan Li
- Department of Neurological Surgery, Feil Family Brain and Mind Research Institute, Sackler Brain and Spine Institute, Weill Cornell Medicine, New York-Presbyterian Hospital, New York, NY 10065, USA.,Department of Radiology, First Hospital of Jilin University, Changchun, Jilin 130021, China
| | - Jyun-You Liou
- Department of Physiology and Cellular Biophysics, Columbia University, New York, NY 10032, USA
| | - Philippe Laffont
- Department of Neurological Surgery, Feil Family Brain and Mind Research Institute, Sackler Brain and Spine Institute, Weill Cornell Medicine, New York-Presbyterian Hospital, New York, NY 10065, USA
| | - Mingrui Zhao
- Department of Neurological Surgery, Feil Family Brain and Mind Research Institute, Sackler Brain and Spine Institute, Weill Cornell Medicine, New York-Presbyterian Hospital, New York, NY 10065, USA
| | - Rafael Yuste
- Department of Biological Sciences, Columbia University, New York, NY 10027, USA
| | - Hongtao Ma
- Department of Neurological Surgery, Feil Family Brain and Mind Research Institute, Sackler Brain and Spine Institute, Weill Cornell Medicine, New York-Presbyterian Hospital, New York, NY 10065, USA
| | - Theodore H Schwartz
- Department of Neurological Surgery, Feil Family Brain and Mind Research Institute, Sackler Brain and Spine Institute, Weill Cornell Medicine, New York-Presbyterian Hospital, New York, NY 10065, USA
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Fan X, Gaspard N, Legros B, Lucchetti F, Ercek R, Nonclercq A. Dynamics underlying interictal to ictal transition in temporal lobe epilepsy: insights from a neural mass model. Eur J Neurosci 2018; 47:258-268. [PMID: 29282779 DOI: 10.1111/ejn.13812] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Revised: 11/27/2017] [Accepted: 12/18/2017] [Indexed: 12/15/2022]
Abstract
We propose an approach that combines a neural mass model and clinical intracranial electroencephalographic (iEEG) recordings to explore the potential pathophysiological mechanisms (at the neuronal population level) of ictogenesis. Thirty iEEG recordings from 10 temporal lobe epilepsy (TLE) patients around seizure onset were investigated. Physiologically meaningful parameters [average excitatory (Ae ), slow (B), and fast (G) inhibitory synaptic gain] were identified during interictal to ictal transition. Four ratios (Ae /G, Ae /B, Ae /(B + G), and B/G) were derived from these parameters, and their evolution over time was analyzed. The excitation/inhibition ratio increased around seizure onset and decreased before seizure offset, indicating the impairment and re-emergence of excitation/inhibition balance around seizure onset and before seizure offset, respectively. Moreover, the slow inhibition may have an earlier effect on excitation/inhibition imbalance. We confirm the decrease in excitation/inhibition ratio upon seizure termination in human temporal lobe epilepsy, as revealed by optogenetic approaches both in vivo in animal models and in vitro. The increase in excitation/inhibition ratio around seizure occurrence could be an indicator to detect seizures.
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Affiliation(s)
- Xiaoya Fan
- Bio, Electro And Mechanical Systems (BEAMS), Université Libre de Bruxelles (ULB), Avenue F.D. Roosevelt 50 CP165/56, 1050, Brussels, Belgium
| | - Nicolas Gaspard
- Department of Neurology, Hôpital Erasme, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Benjamin Legros
- Department of Neurology, Hôpital Erasme, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Federico Lucchetti
- Bio, Electro And Mechanical Systems (BEAMS), Université Libre de Bruxelles (ULB), Avenue F.D. Roosevelt 50 CP165/56, 1050, Brussels, Belgium.,Laboratoire de Neurophysiologie Sensorielle et Cognitive, Hôpital Brugmann, Brussels, Belgium
| | - Rudy Ercek
- Laboratories of Image, Signal processing and Acoustics (LISA), Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Antoine Nonclercq
- Bio, Electro And Mechanical Systems (BEAMS), Université Libre de Bruxelles (ULB), Avenue F.D. Roosevelt 50 CP165/56, 1050, Brussels, Belgium
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Shiri Z, Lévesque M, Etter G, Manseau F, Williams S, Avoli M. Optogenetic Low-Frequency Stimulation of Specific Neuronal Populations Abates Ictogenesis. J Neurosci 2017; 37:2999-3008. [PMID: 28209738 DOI: 10.1523/JNEUROSCI.2244-16.2017] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Revised: 01/27/2017] [Accepted: 02/09/2017] [Indexed: 11/21/2022] Open
Abstract
Despite many advances made in understanding the pathophysiology of epileptic disorders, seizures remain poorly controlled in approximately one-third of patients with mesial temporal lobe epilepsy. Here, we established the efficacy of cell type-specific low-frequency stimulation (LFS) in controlling ictogenesis in the mouse entorhinal cortex (EC) in an in vitro brain slice preparation. Specifically, we used 1 Hz optogenetic stimulation of calcium/calmodulin-dependent protein kinase II-positive principal cells as well as of parvalbumin- or somatostatin-positive interneurons to study the effects of such repetitive activation on epileptiform discharges induced by 4-aminopyridine. We found that 1 Hz stimulation of any of these cell types reduced the frequency and duration of ictal discharges in some trials, while completely blocking them in others. The field responses evoked by the stimulation of each cell type revealed that their duration and amplitude were higher when principal cells were targeted. Furthermore, following a short period of silence ranging from 67 to 135 s, ictal discharges were re-established with similar duration and frequency as before stimulation; however, this period of silence was longer following principal cell stimulation compared with parvalbumin- or somatostatin-positive interneuron stimulation. Our results show that LFS of either excitatory or inhibitory cell networks in EC are effective in controlling ictogenesis. Although optogenetic stimulation of either cell type significantly reduced the occurrence of ictal discharges, principal cell stimulation resulted in a more prolonged suppression of ictogenesis, and, thus, it may constitute a better approach for controlling seizures.SIGNIFICANCE STATEMENT Epilepsy is a neurological disorder characterized by an imbalance between excitation and inhibition leading to seizures. Many epileptic patients do not achieve adequate seizure control using antiepileptic drugs. Low-frequency stimulation (LFS) is an alternative tool for controlling epileptiform activity in these patients. However, despite the temporal and spatial control offered by LFS, such a procedure lacks cell specificity, which may limit its efficacy. Using an optogenetic approach, we report here that LFS of two interneuron subtypes and, even more so, of principal cells can reliably shorten or abolish seizures in vitro Our work suggests that targeted LFS may constitute a reliable means for controlling seizures in patients presenting with focal seizures.
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Cota VR, Drabowski BMB, de Oliveira JC, Moraes MFD. The epileptic amygdala: Toward the development of a neural prosthesis by temporally coded electrical stimulation. J Neurosci Res 2017; 94:463-85. [PMID: 27091311 DOI: 10.1002/jnr.23741] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2015] [Revised: 03/09/2016] [Accepted: 03/09/2016] [Indexed: 02/06/2023]
Abstract
Many patients with epilepsy do not obtain proper control of their seizures through conventional treatment. We review aspects of the pathophysiology underlying epileptic phenomena, with a special interest in the role of the amygdala, stressing the importance of hypersynchronism in both ictogenesis and epileptogenesis. We then review experimental studies on electrical stimulation of mesiotemporal epileptogenic areas, the amygdala included, as a means to treat medically refractory epilepsy. Regular high-frequency stimulation (HFS) commonly has anticonvulsant effects and sparse antiepileptogenic properties. On the other hand, HFS is related to acute and long-term increases in excitability related to direct neuronal activation, long-term potentiation, and kindling, raising concerns regarding its safety and jeopardizing in-depth understanding of its mechanisms. In turn, the safer regular low-frequency stimulation (LFS) has a robust antiepileptogenic effect, but its pro- or anticonvulsant effect seems to vary at random among studies. As an alternative, studies by our group on the development and investigation of temporally unstructured electrical stimulation applied to the amygdala have shown that nonperiodic stimulation (NPS), which is a nonstandard form of LFS, is capable of suppressing both acute and chronic spontaneous seizures. We hypothesize two noncompetitive mechanisms for the therapeutic role of amygdala in NPS, 1) a direct desynchronization of epileptic circuitry in the forebrain and brainstem and 2) an indirect desynchronization/inhibition through nucleus accumbens activation. We conclude by reintroducing the idea that hypersynchronism, rather than hyperexcitability, may be the key for epileptic phenomena and epilepsy treatment.
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Affiliation(s)
- Vinícius Rosa Cota
- Laboratório Interdisciplinar de Neuroengenharia e Neurociências, Departamento de Engenharia Elétrica (DEPEL), Universidade Federal de São João Del-Rei, São João Del-Rei, Minas Gerais, Brazil
| | - Bruna Marcela Bacellar Drabowski
- Laboratório Interdisciplinar de Neuroengenharia e Neurociências, Departamento de Engenharia Elétrica (DEPEL), Universidade Federal de São João Del-Rei, São João Del-Rei, Minas Gerais, Brazil
| | - Jasiara Carla de Oliveira
- Laboratório Interdisciplinar de Neuroengenharia e Neurociências, Departamento de Engenharia Elétrica (DEPEL), Universidade Federal de São João Del-Rei, São João Del-Rei, Minas Gerais, Brazil
| | - Márcio Flávio Dutra Moraes
- Núcleo de Neurociências, Instituto de Ciências Biológicas (ICB), Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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20
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Abstract
Recent studies of reflex epileptic mechanisms in human epilepsy using advanced methods of neurophysiology and functional neuroimaging have contributed much to elucidate pathophysiological processes of seizure generation. Whereas in lesional focal epilepsies reflex mechanisms usually relate directly to the anatomical focus, in system epilepsies they have helped to define which functional anatomical systems serving physiological function are recruited by the ictogenic mechanisms. Reflex epileptic seizures can often be prevented by avoidance or modification of triggers or by prophylactic benzodiazepine administration. Surgical options apply to focal cases. According to restricted experiences with pharmacotherapy, without controlled studies and little information on new AEDs, reflex seizures in system epilepsies appear to respond best to valproic acid and in focal epilepsies, to carbamazepine.
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Affiliation(s)
- Katia Lin
- a Serviço de Neurologia, Departamento de Clínica Médica , Hospital Universitário, Universidade Federal de Santa Catarina (UFSC) , Florianópolis , SC , Brazil
| | - Mirian Guaranha
- b Hospital São Paulo , Universidade Federal de São Paulo , São Paulo , Brazil
| | - Peter Wolf
- a Serviço de Neurologia, Departamento de Clínica Médica , Hospital Universitário, Universidade Federal de Santa Catarina (UFSC) , Florianópolis , SC , Brazil.,c Danish Epilepsy Centre , Dianalund , Denmark
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21
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Mendus D, Rankin-Gee EK, Mustapha M, Porter BE. Increased sensitivity to kindling in mice lacking TSP1. Neuroscience 2015; 305:302-8. [PMID: 26241338 PMCID: PMC6699182 DOI: 10.1016/j.neuroscience.2015.07.075] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2015] [Revised: 07/17/2015] [Accepted: 07/28/2015] [Indexed: 10/23/2022]
Abstract
The development of a hyperexcitable neuronal network is thought to be a critical event in epilepsy. Thrombospondins (TSPs) regulate synaptogenesis by binding the neuronal α2δ subunit of the voltage-gated calcium channel. TSPs regulate synapse formation during development and in the mature brain following injury. It is unclear if TSPs are involved in hyperexcitability that contributes to the development of epilepsy. Here we explore the development of epilepsy using a pentylenetetrazole (PTZ) kindling model in mice lacking TSP1 and TSP2. Unexpectedly, we found increased sensitivity to PTZ kindling in mice lacking TSP1, while mice lacking TSP2 kindled similar to wild-type. We found that the increased seizure susceptibility in the TSP1 knockout (KO) mice was not due to a compensatory increase in TSP2 mRNA as TSP1/2 KO mice were sensitive to PTZ, similar to the TSP1 KO mice. Furthermore, there were similar levels of TGF-B signal activation during kindling in the TSP1 KO mice compared to wild-type. We observed decreased expression of voltage-dependent calcium channel subunit CACNA2D1 mRNA in TSP1, TSP2, and TSP1/2 KO mice. Decreased CACNA2D2 mRNA was only detected in mice that lacked TSP1 and α2δ-1/2 protein levels in the cortex were lower in the TSP 1/2 KO mice. CACNA2D2 knockout mice have spontaneous seizures and increased PTZ seizure susceptibility. Here we report similar findings, TSP1, and TSP1/2 KO mice have low levels of CACNA2D2 mRNA expression and α2δ-1/2 receptor level in the cortex, and are more susceptible to seizures. CACNA2D2 mutations in mice and humans can cause epilepsy. Our data suggest TSP1 in particular may control CACNA2D2 levels and could be a modifier of seizure susceptibility.
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Affiliation(s)
- D Mendus
- The Department of Neurology, School of Medicine, Stanford University, Stanford, CA 94305, USA; The Department of Otolaryngology - Head and Neck Surgery, School of Medicine, Stanford University, Stanford, CA 94305, USA
| | - E K Rankin-Gee
- The Department of Neurology, School of Medicine, Stanford University, Stanford, CA 94305, USA
| | - M Mustapha
- The Department of Otolaryngology - Head and Neck Surgery, School of Medicine, Stanford University, Stanford, CA 94305, USA
| | - B E Porter
- The Department of Neurology, School of Medicine, Stanford University, Stanford, CA 94305, USA.
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Kano T, Inaba Y, D'Antuono M, Biagini G, Levésque M, Avoli M. Blockade of in vitro ictogenesis by low-frequency stimulation coincides with increased epileptiform response latency. J Neurophysiol 2015; 114:21-8. [PMID: 25925325 DOI: 10.1152/jn.00248.2015] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Accepted: 04/29/2015] [Indexed: 11/22/2022] Open
Abstract
Low-frequency stimulation, delivered through transcranial magnetic or deep-brain electrical procedures, reduces seizures in patients with pharmacoresistant epilepsy. A similar control of ictallike discharges is exerted by low-frequency electrical stimulation in rodent brain slices maintained in vitro during convulsant treatment. By employing field and "sharp" intracellular recordings, we analyzed here the effects of stimuli delivered at 0.1 or 1 Hz in the lateral nucleus of the amygdala on ictallike epileptiform discharges induced by the K(+) channel blocker 4-aminopyridine in the perirhinal cortex, in a rat brain slice preparation. We found that 1) ictal events were nominally abolished when the stimulus rate was brought from 0.1 to 1 Hz; 2) this effect was associated with an increased latency of the epileptiform responses recorded in perirhinal cortex following each stimulus; and 3) both changes recovered to control values following arrest of the 1-Hz stimulation protocol. The control of ictal activity by 1-Hz stimulation and the concomitant latency increase were significantly reduced by GABAB receptor antagonism. We propose that this frequency-dependent increase in latency represents a short-lasting, GABAB receptor-dependent adaptive mechanism that contributes to decrease epileptiform synchronization, thus blocking seizures in epileptic patients and animal models.
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Affiliation(s)
- Toshiyuki Kano
- Montreal Neurological Institute and Departments of Neurology & Neurosurgery and Physiology, McGill University, Montreal, Quebec, Canada
| | - Yuji Inaba
- Montreal Neurological Institute and Departments of Neurology & Neurosurgery and Physiology, McGill University, Montreal, Quebec, Canada; Shinshu University, School of Medicine, Matsumoto, Japan; and
| | - Margherita D'Antuono
- Montreal Neurological Institute and Departments of Neurology & Neurosurgery and Physiology, McGill University, Montreal, Quebec, Canada
| | - Giuseppe Biagini
- Montreal Neurological Institute and Departments of Neurology & Neurosurgery and Physiology, McGill University, Montreal, Quebec, Canada; Dipartimento di Scienze Biomediche, Metaboliche e Neuroscienze, Università di Modena e Reggio Emilia, Modena, Italy
| | - Maxime Levésque
- Montreal Neurological Institute and Departments of Neurology & Neurosurgery and Physiology, McGill University, Montreal, Quebec, Canada
| | - Massimo Avoli
- Montreal Neurological Institute and Departments of Neurology & Neurosurgery and Physiology, McGill University, Montreal, Quebec, Canada;
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Abstract
In patients being evaluated for epilepsy and in animal models of epilepsy, electrophysiological recordings are carried to capture seizures to determine the existence of epilepsy. Electroencephalography recordings from the scalp, or sometimes directly from the brain, are also used to locate brain areas where seizure begins, and in surgical treatment help plan the area for resection. As seizures are unpredictable and can occur infrequently, ictal recordings are not ideal in terms of time, cost, or risk when, for example, determining the efficacy of existing or new anti-seizure drugs, evaluating potential anti-epileptogenic interventions, or for prolonged intracerebral electrode studies. Thus, there is a need to identify and validate other electrophysiological biomarkers of epilepsy that could be used to diagnose, treat, cure, and prevent epilepsy. Electroencephalography recordings in the epileptic brain contain other interictal electrophysiological disturbances that can occur more frequently than seizures, such as interictal spikes (IIS) and sharp waves, and from invasive studies using wide bandwidth recording and small diameter electrodes, the discovery of pathological high-frequency oscillations (HFOs) and microseizures. Of IIS, HFOs, and microseizures, a significant amount of recent research has focused on HFOs in the pathophysiology of epilepsy. Results from studies in animals with epilepsy and presurgical patients have consistently found a strong association between HFOs and epileptogenic brain tissue that suggest HFOs could be a potential biomarker of epileptogenicity and epileptogenesis. Here, we discuss several aspects of HFOs, as well as IIS and microseizures, and the evidence that supports their role as biomarkers of epilepsy.
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Affiliation(s)
- Richard J Staba
- David Geffen School of Medicine at UCLA, Department of Neurology, Room 2-155, 710 Westwood Plaza, Los Angeles, CA, 90095, USA,
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Herrington R, Lévesque M, Avoli M. Neurosteroids modulate epileptiform activity and associated high-frequency oscillations in the piriform cortex. Neuroscience 2013; 256:467-77. [PMID: 24157930 DOI: 10.1016/j.neuroscience.2013.10.025] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2013] [Revised: 10/09/2013] [Accepted: 10/12/2013] [Indexed: 01/13/2023]
Abstract
Allotetrahydrodeoxycorticosterone (THDOC) belongs to a class of pregnane neurosteroidal compounds that enhance brain inhibition by interacting directly with GABAA signaling, mainly through an increase in tonic inhibitory current. Here, we addressed the role of THDOC in the modulation of interictal- and ictal-like activity and associated high-frequency oscillations (HFOs, 80-500 Hz; ripples: 80-200 Hz, fast ripples: 250-500 Hz) recorded in vitro in the rat piriform cortex, a highly excitable brain structure that is implicated in seizure generation and maintenance. We found that THDOC: (i) increased the duration of interictal discharges in the anterior piriform cortex while decreasing ictal discharge duration in both anterior and posterior piriform cortices; (ii) reduced the occurrence of HFOs associated to both interictal and ictal discharges; and (iii) prolonged the duration of 4-aminopyridine-induced, glutamatergic independent synchronous field potentials that are known to mainly result from the activation of GABAA receptors. Our results indicate that THDOC can modulate epileptiform synchronization in the piriform cortex presumably by potentiating GABAA receptor-mediated signaling. This evidence supports the view that neurosteroids regulate neuronal excitability and thus control the occurrence of seizures.
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Affiliation(s)
- R Herrington
- Montreal Neurological Institute, Department of Neurology and Neurosurgery, McGill University, Montréal, Qc, Canada
| | - M Lévesque
- Montreal Neurological Institute, Department of Neurology and Neurosurgery, McGill University, Montréal, Qc, Canada
| | - M Avoli
- Montreal Neurological Institute, Department of Neurology and Neurosurgery, McGill University, Montréal, Qc, Canada.
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Huberfeld G, Le Duigou C, Le Van Quyen M, Navarro V, Baulac M, Miles R. The paradox of the paroxysm: can seizure precipitants help explain human ictogenesis? Neuroscientist 2013; 19:523-40. [PMID: 23881918 DOI: 10.1177/1073858413497430] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
An epileptic brain is permanently in a diseased state, but seizures occur rarely and without warning. Here we examine this paradox, common to paroxysmal diseases. We review the problem in the context of the prototypic acquired epilepsies of the medial temporal lobe. We ask how an epileptic temporal lobe differs from a healthy one and examine biological mechanisms that may explain the transition to seizure. Attempts to predict seizure timing from analyses of brain electrical activity suggest that the neurological processes involved may be initiated significantly before a seizure. Furthermore, whereas seizures are said to occur without warning, some patients say they know when a seizure is imminent. Several factors, including sleep deprivation, oscillations in hormonal levels, or withdrawal from drugs, increase the probability of a seizure. We ask whether these seizure precipitants might act through common neuronal mechanisms. Several precipitating factors seem to involve relief from a neurosteroid modulation of gamma-amino butyric acid receptor type A (GABAA) receptors. We propose tests of this hypothesis.
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Affiliation(s)
- Gilles Huberfeld
- INSERM U975, Institut du Cerveau et la Moëlle Epinière, Paris, France
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26
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Abstract
Epilepsy is characterized by intermittent, paroxysmal, hypersynchronous electrical activity that may remain localized and/or spread and severely disrupt the brain's normal multitask and multiprocessing function. Epileptic seizures are the hallmarks of such activity. The ability to issue warnings in real time of impending seizures may lead to novel diagnostic tools and treatments for epilepsy. Applications may range from a warning to the patient to avert seizure-associated injuries, to automatic timely administration of an appropriate stimulus. Seizure prediction could become an integral part of the treatment of epilepsy through neuromodulation, especially in the new generation of closed-loop seizure control systems.
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Affiliation(s)
- Leon D Iasemidis
- The Harrington Department of Biomedical Engineering, School of Biological and Health Systems Engineering, Arizona State University, Tempe, AZ 85287-9709, USA.
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27
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Stead M, Bower M, Brinkmann BH, Lee K, Marsh WR, Meyer FB, Litt B, Van Gompel J, Worrell GA. Microseizures and the spatiotemporal scales of human partial epilepsy. Brain 2010; 133:2789-97. [PMID: 20685804 PMCID: PMC2929333 DOI: 10.1093/brain/awq190] [Citation(s) in RCA: 199] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2010] [Revised: 04/23/2010] [Accepted: 05/27/2010] [Indexed: 11/13/2022] Open
Abstract
Focal seizures appear to start abruptly and unpredictably when recorded from volumes of brain probed by clinical intracranial electroencephalograms. To investigate the spatiotemporal scale of focal epilepsy, wide-bandwidth electrophysiological recordings were obtained using clinical macro- and research microelectrodes in patients with epilepsy and control subjects with intractable facial pain. Seizure-like events not detectable on clinical macroelectrodes were observed on isolated microelectrodes. These 'microseizures' were sparsely distributed, more frequent in brain regions that generated seizures, and sporadically evolved into large-scale clinical seizures. Rare microseizures observed in control patients suggest that this phenomenon is ubiquitous, but their density distinguishes normal from epileptic brain. Epileptogenesis may involve the creation of these topographically fractured microdomains and ictogenesis (seizure generation), the dynamics of their interaction and spread.
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Affiliation(s)
- Matt Stead
- Department of Neurology, Mayo Systems Electrophysiology Laboratory, Mayo Clinic, 200 First Street SW, Rochester, MN 55901, USA.
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28
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Frei MG, Zaveri HP, Arthurs S, Bergey GK, Jouny C, Lehnertz K, Gotman J, Osorio I, Netoff TI, Freeman WJ, Jefferys J, Worrell G, Le Van Quyen M, Schiff SJ, Mormann F. Controversies in epilepsy: debates held during the Fourth International Workshop on Seizure Prediction. Epilepsy Behav 2010; 19:4-16. [PMID: 20708976 PMCID: PMC2943379 DOI: 10.1016/j.yebeh.2010.06.009] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2010] [Accepted: 06/09/2010] [Indexed: 01/21/2023]
Abstract
Debates on six controversial topics were held during the Fourth International Workshop on Seizure Prediction (IWSP4) convened in Kansas City, KS, USA, July 4-7, 2009. The topics were (1) Ictogenesis: Focus versus Network? (2) Spikes and Seizures: Step-relatives or Siblings? (3) Ictogenesis: A Result of Hyposynchrony? (4) Can Focal Seizures Be Caused by Excessive Inhibition? (5) Do High-Frequency Oscillations Provide Relevant Independent Information? (6) Phase Synchronization: Is It Worthwhile as Measured? This article, written by the IWSP4 organizing committee and the debaters, summarizes the arguments presented during the debates.
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Affiliation(s)
- Mark G. Frei
- Flint Hills Scientific, L.L.C., Lawrence, KS, USA, Organizing Committee Member, Fourth International Workshop on Seizure Prediction,Corresponding Author. Address: 2513 Via Linda Drive, Lawrence, KS 66047; Phone: (785) 838-3733; Fax: (785) 838-3715;
| | - Hitten P. Zaveri
- Yale University, New Haven, CT, USA, Organizing Committee Member, Fourth International Workshop on Seizure Prediction
| | - Susan Arthurs
- Alliance for Epilepsy Research, Dexter, MI, USA, Organizing Committee Member, Fourth International Workshop on Seizure Prediction
| | | | | | | | - Jean Gotman
- Montreal Neurological Institute, McGill University, Montréal, Québec, Canada
| | - Ivan Osorio
- Flint Hills Scientific, L.L.C., Lawrence, KS, USA, University of Kansas Medical Center, Kansas City, KS, USA, Organizing Committee Member, Fourth International Workshop on Seizure Prediction
| | | | | | | | | | - Michel Le Van Quyen
- Centre de Recherche de l’Institut du Cerveau et de la Moelle épinière (CRICM), Paris, France
| | | | - Florian Mormann
- University of Bonn, Bonn, Germany, California Institute of Technology, Pasadena, CA, USA
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29
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Bogaard A, Parent J, Zochowski M, Booth V. Interaction of cellular and network mechanisms in spatiotemporal pattern formation in neuronal networks. J Neurosci 2009; 29:1677-87. [PMID: 19211875 PMCID: PMC2717613 DOI: 10.1523/jneurosci.5218-08.2009] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2008] [Revised: 01/05/2009] [Accepted: 01/06/2009] [Indexed: 11/21/2022] Open
Abstract
Spatiotemporal patterning of neuronal activity is considered to be an important feature of cognitive processing in the brain as well as pathological brain states, such as seizures. Here, we investigate complex interactions between intrinsic properties of neurons and network structure in the generation of network spatiotemporal patterning in the context of seizure-like synchrony. We show that membrane excitability properties have differential effects on network activity patterning for different network topologies. We consider excitatory networks consisting of neurons with excitability properties varying between type I and type II that exhibit significantly different spike frequency responses to external current stimulation, especially at firing threshold. We find that networks with type II-like neurons show higher synchronization and bursting capacity across a range of network topologies than corresponding networks with type I-like neurons. These differences in activity patterning are persistent across different network sizes, connectivity strengths, magnitudes of random external input, and the addition of inhibitory interneurons to the network, making them highly likely to be relevant to brain function. Furthermore, we show that heterogeneous networks of mixed cell types show emergent dynamical patterns even for very low mixing ratios. Specifically, the addition of a small percentage of type II-like cells into a network of type I-like cells can markedly change the patterning of network activity. These findings suggest that cellular as well as network mechanisms can go hand in hand, leading to the generation of seizure-like discharges, suggesting that a single ictogenic mechanism alone may not be responsible for seizure generation.
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Affiliation(s)
| | | | - Michal Zochowski
- Departments of Physics
- Biophysics Research Division
- Neuroscience Graduate Program, and
- Michigan Center for Theoretical Physics, University of Michigan, Ann Arbor, Michigan 48109
| | - Victoria Booth
- Mathematics
- Anesthesiology, and
- Neuroscience Graduate Program, and
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Köhling R, Vreugdenhil M, Bracci E, Jefferys JG. Ictal epileptiform activity is facilitated by hippocampal GABAA receptor-mediated oscillations. J Neurosci 2000; 20:6820-9. [PMID: 10995826 PMCID: PMC6772821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2000] [Revised: 06/28/2000] [Accepted: 07/06/2000] [Indexed: 02/17/2023] Open
Abstract
The cellular and network mechanisms of the transition of brief interictal discharges to prolonged seizures are a crucial issue in epilepsy. Here we used hippocampal slices exposed to ACSF containing 0 Mg(2+) to explore mechanisms for the transition to prolonged (3-42 sec) seizure-like ("ictal") discharges. Epileptiform activity, evoked by Shaffer collateral stimulation, triggered prolonged bursts in CA1, in 50-60% of slices, from both adult and young (postnatal day 13-21) rats. In these cases the first component of the CA1 epileptiform burst was followed by a train of population spikes at frequencies in the gamma band and above (30-120 Hz, reminiscent of tetanically evoked gamma oscillations). The gamma burst in turn could be followed by slower repetitive "tertiary" bursts. Intracellular recordings from CA1 during the gamma phase revealed long depolarizations, action potentials rising from brief apparent hyperpolarizations, and a drop of input resistance. The CA1 gamma rhythm was completely blocked by bicuculline (10-50 microm), by ethoxyzolamide (100 microm), and strongly attenuated in hyperosmolar perfusate (50 mm sucrose). Subsequent tertiary bursts were also blocked by bicuculline, ethoxyzolamide, and in hyperosmolar perfusate. In all these cases intracellular recordings from CA3 revealed only short depolarizations. We conclude that under epileptogenic conditions, gamma band oscillations arise from GABA(A)ergic depolarizations and that this activity may lead to the generation of ictal discharges.
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Affiliation(s)
- R Köhling
- Division of Neuroscience (Neurophysiology), The Medical School, The University of Birmingham, Birmingham B15 2TT, United Kingdom
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