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Bartlett-Lee B, Dervan L, Miyake C, Watson RS, Chan SW, Anderson AE, Lai YC. Association of minor electrocardiographic (ECG) abnormalities with epilepsy duration in children: A manifestation of the epileptic heart? Seizure 2024; 118:1-7. [PMID: 38613877 DOI: 10.1016/j.seizure.2024.04.006] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Revised: 03/21/2024] [Accepted: 04/08/2024] [Indexed: 04/15/2024] Open
Abstract
PURPOSE Cardiac abnormalities resulting from chronic epilepsy ("the epileptic heart") constitute a well-recognized comorbidity. However, the association of cardiac alterations with epilepsy duration remains understudied. We sought to evaluate this association using electrocardiogram (ECG). METHODS We prospectively enrolled children between 1 months and 18 years of age without known cardiac conditions or ion channelopathies during routine clinic visits. ECGs were categorized as abnormal if there were alterations in rhythm; PR, QRS, or corrected QT interval; QRS axis or morphology; ST segment or T wave. An independent association between ECG abnormalities and epilepsy duration was evaluated using multivariable logistic regression modeling. RESULTS 213 children were enrolled. 100 ECGs (47%) exhibited at least one alteration; most commonly in the ST segment (37, 17%) and T wave (29, 11%). Children with normal ECGs had shorter epilepsy duration as compared to those with ECG abnormalities (46 [18-91] months vs. 73 [32-128 months], p = 0.004). A multivariable logistic regression model demonstrated that increasing epilepsy duration was independently associated with the presence of ECG abnormalities (OR=1.09, 95% CI=1.02-1.16, p = 0.008), adjusted for seizure frequency, generalized tonic-clonic/focal to bilateral tonic-clonic seizures as the predominant seizure type, and number of channel-modifying anti-seizure medications. Increasing epilepsy duration was also independently associated with the presence of ST/T wave abnormalities (OR=1.09, 95% CI=1.01-1.16, p = 0.017), adjusted for the same covariates. SIGNIFICANCE Increasing epilepsy duration is independently associated with the presence of minor ECG abnormalities. Additional studies are needed to evaluate whether this finding may represent a manifestation of the "epileptic heart".
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Affiliation(s)
- Brittnie Bartlett-Lee
- Division of Pediatric Neurology and Developmental Neuroscience, Baylor College of Medicine, 6651 Main street, Houston, TX 77030, United States
| | - Leslie Dervan
- Department of Pediatrics, University of Washington School of Medicine, Seattle Children's Research Institute, M/S FA2.112, 4800 Sand Point Way NE, Seattle, WA 98105, United States; Centers for Clinical and Translational Research, Seattle Children's Research Institute, M/S FA2.112, 4800 Sand Point Way NE, Seattle, WA 98105, United States
| | - Christina Miyake
- Division of Pediatric Cardiology, Baylor College of Medicine, 6651 Main street, Houston, TX 77030, United States
| | - R Scott Watson
- Department of Pediatrics, University of Washington School of Medicine, Seattle Children's Research Institute, M/S FA2.112, 4800 Sand Point Way NE, Seattle, WA 98105, United States; Centers for Child Health, Behavior, and Development, Seattle Children's Research Institute, M/S FA2.112, 4800 Sand Point Way NE, Seattle, WA 98105, United States
| | - See Wai Chan
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, Baylor College of Medicine, 6651 Main street, Houston, TX 77030, United States
| | - Anne E Anderson
- Division of Pediatric Neurology and Developmental Neuroscience, Baylor College of Medicine, 6651 Main street, Houston, TX 77030, United States
| | - Yi-Chen Lai
- Division of Pediatric Critical Care Medicine, Department of Pediatrics, Baylor College of Medicine, 6651 Main street, Houston, TX 77030, United States.
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2
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Peiffer M, Duquesne K, Van Oevelen A, Burssens A, De Mits S, Maas SA, Atkins PR, Anderson AE, Audenaert EA. Validation of a personalized ligament-constraining discrete element framework for computing ankle joint contact mechanics. Comput Methods Programs Biomed 2023; 231:107366. [PMID: 36720186 DOI: 10.1016/j.cmpb.2023.107366] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 01/09/2023] [Accepted: 01/21/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND AND OBJECTIVE Computer simulations of joint contact mechanics have great merit to improve our current understanding of articular ankle pathology. Owed to its computational simplicity, discrete element analysis (DEA) is an encouraging alternative to finite element analysis (FEA). However, previous DEA models lack subject-specific anatomy and may oversimplify the biomechanics of the ankle. The objective of this study was to develop and validate a personalized DEA framework that permits movement of the fibula and incorporates personalized cartilage thickness as well as ligamentous constraints. METHODS A linear and non-linear DEA framework, representing cartilage as compressive springs, was established, verified, and validated. Three-dimensional (3D) bony ankle models were constructed from cadaveric lower limb CT scans imaged during application of weight (85 kg) and/or torque (10 Nm). These 3D models were used to generate cartilage thickness and ligament insertion sites based on a previously validated statistical shape model. Ligaments were modelled as non-linear tension-only springs. Validation of contact stress prediction was performed using a simple, axially constrained tibiotalar DEA model against an equivalent FEA model. Validation of ligamentous constraints compared the final position of the ankle mortise to that of the cadaver after application of torque and sequential ligament sectioning. Finally, a combined ligamentous-constraining DEA model was validated for predicted contact stress against an equivalent ligament-constraining FEA model. RESULTS The linear and non-linear DEA model reproduced a mean articular contact stress within 0.36 MPa and 0.39 MPa of the FEA calculated stress, respectively. With respect to the ligamentous validation, the DEA ligament-balancing algorithm could reproduce the position of the distal fibula within the ankle mortise to within 0.97 mm of the experimental observed distal fibula. When combining the ligament-constraining and contact stress algorithm, DEA was able to reproduce a mean articular contact stress to within 0.50 MPa of the FEA calculated contact stress. CONCLUSION The DEA framework presented herein offers a computationally efficient alternative to FEA for the prediction of contact stress in the ankle joint, manifesting its potential to enhance the mechanical understanding of articular ankle pathologies on both a patient-specific and population-wide level. The novelty of this model lies in its personalized nature, inclusion of the distal tibiofibular joint and the use of non-linear ligament balancing to maintain the physiological ankle joint articulation.
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Affiliation(s)
- M Peiffer
- Department of Orthopaedics and Traumatology, Ghent University Hospital, Ghent, Belgium; Department of Human Structure and Repair, Ghent University, Ghent, Belgium; Department of Orthopaedics, University of Utah School of Medicine, Salt Lake City, Utah, USA.
| | - K Duquesne
- Department of Orthopaedics and Traumatology, Ghent University Hospital, Ghent, Belgium; Department of Human Structure and Repair, Ghent University, Ghent, Belgium
| | - A Van Oevelen
- Department of Orthopaedics and Traumatology, Ghent University Hospital, Ghent, Belgium; Department of Human Structure and Repair, Ghent University, Ghent, Belgium
| | - A Burssens
- Department of Orthopaedics and Traumatology, Ghent University Hospital, Ghent, Belgium
| | - S De Mits
- Department of Reumatology, Ghent University Hospital, Corneel Heymanslaan 10, 9000 Ghent, Belgium; Smart Space, Ghent University Hospital, Corneel Heymanslaan 10, 9000 Ghent, Belgium
| | - S A Maas
- Scientific Computing and Imaging Institute, University of Utah, Salt Lake City, Utah, USA; Department of Biomedical Engineering, University of Utah, Salt Lake City, Utah, USA
| | - P R Atkins
- Department of Orthopaedics, University of Utah School of Medicine, Salt Lake City, Utah, USA; Scientific Computing and Imaging Institute, University of Utah, Salt Lake City, Utah, USA
| | - A E Anderson
- Department of Orthopaedics, University of Utah School of Medicine, Salt Lake City, Utah, USA; Scientific Computing and Imaging Institute, University of Utah, Salt Lake City, Utah, USA; Department of Biomedical Engineering, University of Utah, Salt Lake City, Utah, USA; Department of Physical Therapy and Athletic Training, University of Utah, Salt Lake City, UT, United States
| | - E A Audenaert
- Department of Orthopaedics and Traumatology, Ghent University Hospital, Ghent, Belgium; Department of Human Structure and Repair, Ghent University, Ghent, Belgium; Department of Trauma and Orthopedics, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge CB2 0QQ, UK; Department of Electromechanics, Op3Mech research group, University of Antwerp, Antwerp, Belgium
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3
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Martinez LA, Born HA, Harris S, Regnier-Golanov A, Grieco JC, Weeber EJ, Anderson AE. Quantitative EEG Analysis in Angelman Syndrome: Candidate Method for Assessing Therapeutics. Clin EEG Neurosci 2023; 54:203-212. [PMID: 33203220 DOI: 10.1177/1550059420973095] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [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] [Indexed: 01/10/2023]
Abstract
The goal of these studies was to use quantitative (q)EEG techniques on data from children with Angelman syndrome (AS) using spectral power analysis, and to evaluate this as a potential biomarker and quantitative method to evaluate therapeutics. Although characteristic patterns are evident in visual inspection, using qEEG techniques has the potential to provide quantitative evidence of treatment efficacy. We first assessed spectral power from baseline EEG recordings collected from children with AS compared to age-matched neurotypical controls, which corroborated the previously reported finding of increased total power driven by elevated delta power in children with AS. We then retrospectively analyzed data collected during a clinical trial evaluating the safety and tolerability of minocycline (3 mg/kg/d) to compare pretreatment recordings from children with AS (4-12 years of age) to EEG activity at the end of treatment and following washout for EEG spectral power and epileptiform events. At baseline and during minocycline treatment, the AS subjects demonstrated increased delta power; however, following washout from minocycline treatment the AS subjects had significantly reduced EEG spectral power and epileptiform activity. Our findings support the use of qEEG analysis in evaluating AS and suggest that this technique may be useful to evaluate therapeutic efficacy in AS. Normalizing EEG power in AS therefore may become an important metric in screening therapeutics to gauge overall efficacy. As therapeutics transition from preclinical to clinical studies, it is vital to establish outcome measures that can quantitatively evaluate putative treatments for AS and neurological disorders with distinctive EEG patterns.
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Affiliation(s)
- Luis A Martinez
- Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA.,The Jan and Dan Duncan Neurological Research Institute, Texas Children's Hospital, Houston, TX, USA.,The Gordon and Mary Cain Pediatric Neurology Research Foundation Laboratories, Texas Children's Hospital, Houston, TX, USA
| | - Heather A Born
- Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA.,The Jan and Dan Duncan Neurological Research Institute, Texas Children's Hospital, Houston, TX, USA.,The Gordon and Mary Cain Pediatric Neurology Research Foundation Laboratories, Texas Children's Hospital, Houston, TX, USA
| | - Sarah Harris
- Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA.,The Jan and Dan Duncan Neurological Research Institute, Texas Children's Hospital, Houston, TX, USA.,The Gordon and Mary Cain Pediatric Neurology Research Foundation Laboratories, Texas Children's Hospital, Houston, TX, USA
| | - Angelique Regnier-Golanov
- Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA.,The Jan and Dan Duncan Neurological Research Institute, Texas Children's Hospital, Houston, TX, USA.,The Gordon and Mary Cain Pediatric Neurology Research Foundation Laboratories, Texas Children's Hospital, Houston, TX, USA
| | - Joseph C Grieco
- Department of Molecular Pharmacology and Physiology, University of South Florida, Tampa, FL, USA
| | - Edwin J Weeber
- Department of Molecular Pharmacology and Physiology, University of South Florida, Tampa, FL, USA
| | - Anne E Anderson
- Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA.,The Jan and Dan Duncan Neurological Research Institute, Texas Children's Hospital, Houston, TX, USA.,The Gordon and Mary Cain Pediatric Neurology Research Foundation Laboratories, Texas Children's Hospital, Houston, TX, USA.,Departments of Neuroscience and Neurology, Baylor College of Medicine, Houston, TX, USA
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4
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Egbenya DL, Hussain S, Lai YC, Anderson AE, Davanger S. Synapse-specific changes in Arc and BDNF in rat hippocampus following chronic temporal lobe epilepsy. Neurosci Res 2022; 191:1-12. [PMID: 36535366 DOI: 10.1016/j.neures.2022.12.006] [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: 06/22/2022] [Revised: 12/06/2022] [Accepted: 12/13/2022] [Indexed: 12/23/2022]
Abstract
Expression of immediate early genes (IEGs) in the brain is important for synaptic plasticity, and probably also in neurodegenerative conditions. To understand the cellular mechanisms of the underlying neuropathophysiological processes in epilepsy, we need to pinpoint changes in concentration of synaptic plasticity-related proteins at subsynaptic levels. In this study, we examined changes in synaptic expression of Activity-regulated cytoskeleton-associated (Arc) and Brai Derived Neurotrophic Factor (BDNF) in a rat model of kainate-induced temporal lobe epilepsy (TLE). Western blotting showed reduced concentrations of Arc and increased concentrations of BDNF in hippocampal synaptosomes in chronic TLE rats. Then, using quantitative electron microscopy, we found corresponding changes in subsynaptic regions in the hippocampus. Specifically, we detected significant reductions in the concentrations of Arc in the presynaptic terminal of Schaffer collateral glutamatergic synapses in the stratum radiatum of the CA1 area in TLE, as well as in their adjacent postsynaptic spines. In CA3, there was a significant reduction of Arc only in the presynaptic terminal cytoplasm. Conversely, in CA3, there was a significant increase in the expression of BDNF in the presynaptic terminal, but not in the postsynaptic spine. Significant increase in BDNF concentration in the CA1 postsynaptic density was also obtained. We hypothesize that the observed changes in Arc and BDNF may contribute to both cognitive impairment and increased excitotoxic vulnerability in chronic epilepsy.
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Affiliation(s)
- Daniel L Egbenya
- Laboratory for Synaptic Plasticity, Division of Anatomy, Department of Molecular Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway; Department of Physiology, School of Medical Sciences, College of Health and Allied Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Suleman Hussain
- Laboratory for Synaptic Plasticity, Division of Anatomy, Department of Molecular Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway; Institute of Oral Biology, Faculty of Dentistry, University of Oslo, Oslo, Norway.
| | - Yi-Chen Lai
- Jan and Dan Duncan Neurological Research Institute, Baylor College of Medicine, Houston, TX, USA
| | - Anne E Anderson
- Jan and Dan Duncan Neurological Research Institute, Baylor College of Medicine, Houston, TX, USA
| | - Svend Davanger
- Laboratory for Synaptic Plasticity, Division of Anatomy, Department of Molecular Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway
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5
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Ballester-Rosado CJ, Le JT, Lam TT, Mohila CA, Lam S, Anderson AE, Frost JD, Swann JW. A Role for Insulin-like Growth Factor 1 in the Generation of Epileptic Spasms in a murine model. Ann Neurol 2022; 92:45-60. [PMID: 35467038 PMCID: PMC9233100 DOI: 10.1002/ana.26383] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 04/21/2022] [Accepted: 04/23/2022] [Indexed: 11/05/2022]
Abstract
OBJECTIVE Infantile spasms are associated with a wide variety of clinical conditions, including perinatal brain injuries. We have created a model in which prolonged infusion of tetrodotoxin (TTX) into the neocortex, beginning in infancy, produces a localized lesion and reproduces the behavioral spasms, electroencephalogram (EEG) abnormalities, and drug responsiveness seen clinically. Here, we undertook experiments to explore the possibility that the growth factor IGF-1 plays a role in generating epileptic spasms. METHODS We combined long-term video EEG recordings with quantitative immunohistochemical and biochemical analyses to unravel IGF-1's role in spasm generation. Immunohistochemistry was undertaken in surgically resected tissue from infantile spasms patients. We used viral injections in neonatal conditional IGF-1R knock-out mice to show that an IGF-1-derived tripeptide (1-3)IGF-1, acts through the IGF-1 receptor to abolish spasms. RESULTS Immunohistochemical methods revealed widespread loss of IGF-1 from cortical neurons, but an increase in IGF-1 in the reactive astrocytes in the TTX-induced lesion. Very similar changes were observed in the neocortex from patients with spasms. In animals, we observed reduced signaling through the IGF-1 growth pathways in areas remote from the lesion. To show the reduction in IGF-1 expression plays a role in spasm generation, epileptic rats were treated with (1-3)IGF-1. We provide 3 lines of evidence that (1-3)IGF-1 activates the IGF-1 signaling pathway by acting through the receptor for IGF-1. Treatment with (1-3)IGF-1 abolished spasms and hypsarrhythmia-like activity in the majority of animals. INTERPRETATION Results implicate IGF-1 in the pathogenesis of infantile spasms and IGF-1 analogues as potential novel therapies for this neurodevelopmental disorder. ANN NEUROL 2022;92:45-60.
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Affiliation(s)
- Carlos J. Ballester-Rosado
- The Cain Foundation Laboratories, the Jan and Dan Duncan Neurological Research Institute, Texas Children’s Hospital, Houston, Texas, USA
- Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA
| | - John T. Le
- The Cain Foundation Laboratories, the Jan and Dan Duncan Neurological Research Institute, Texas Children’s Hospital, Houston, Texas, USA
- Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA
| | - Trang T. Lam
- The Cain Foundation Laboratories, the Jan and Dan Duncan Neurological Research Institute, Texas Children’s Hospital, Houston, Texas, USA
- Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA
| | - Carrie A. Mohila
- Department of Pathology and Immunology, Baylor College of Medicine
- Department of Pathology, Texas Children’s Hospital, Houston, Texas, USA
| | - Sandi Lam
- Department of Neurosurgery, Baylor College of Medicine, Houston, Texas, USA
| | - Anne E. Anderson
- The Cain Foundation Laboratories, the Jan and Dan Duncan Neurological Research Institute, Texas Children’s Hospital, Houston, Texas, USA
- Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA
- Department of Neuroscience, Baylor College of Medicine, Houston, Texas, USA
- Department of Neurology, Baylor College of Medicine, Houston, Texas, USA
| | - James D. Frost
- Department of Neurology, Baylor College of Medicine, Houston, Texas, USA
| | - John W. Swann
- The Cain Foundation Laboratories, the Jan and Dan Duncan Neurological Research Institute, Texas Children’s Hospital, Houston, Texas, USA
- Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA
- Department of Neuroscience, Baylor College of Medicine, Houston, Texas, USA
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6
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Febbo IG, Martinez LA, Warkins V, Vargas N, Anderson AE, Schrader LA. A Cellular & Network Level Investigation of Thalamocortical Neuron Oscillations & the Role of the Transcription Factor,
Shox2. FASEB J 2022. [DOI: 10.1096/fasebj.2022.36.s1.l8127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | - Luis A. Martinez
- Pediatrics‐NeurologyBaylor College of MedicineHoustonTX
- Foundation Laboratories and the Jan and Dan Duncan Neurological Research InstituteBaylor College of MedicineHoustonTX
| | | | | | - Anne E. Anderson
- Pediatrics‐NeurologyBaylor College of MedicineHoustonTX
- Foundation Laboratories and the Jan and Dan Duncan Neurological Research InstituteBaylor College of MedicineHoustonTX
| | - Laura A. Schrader
- NeuroscienceTulane UniversityNew OrleansLA
- Cell & Molecular BiologyTulane UniversityNew OrleansLA
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7
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Nguyen LH, Xu Y, Mahadeo T, Zhang L, Lin TV, Born HA, Anderson AE, Bordey A. Expression of 4E-BP1 in juvenile mice alleviates mTOR-induced neuronal dysfunction and epilepsy. Brain 2021; 145:1310-1325. [PMID: 34849602 DOI: 10.1093/brain/awab390] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 07/07/2021] [Revised: 09/01/2021] [Accepted: 09/22/2021] [Indexed: 11/13/2022] Open
Abstract
Hyperactivation of the mechanistic target of rapamycin (mTOR) pathway during fetal neurodevelopment alters neuron structure and function, leading to focal malformation of cortical development (FMCD) and intractable epilepsy. Recent evidence suggests a role for dysregulated cap-dependent translation downstream of mTOR in the formation of FMCD and seizures. However, it is unknown whether modifying translation once the developmental pathologies are established can reverse neuronal abnormalities and seizures. Addressing these issues is crucial with regards to therapeutics since these neurodevelopmental disorders are predominantly diagnosed during childhood, when patients present with symptoms. Here, we report increased phosphorylation of the mTOR effector and translational repressor, 4E-BP1, in patient FMCD tissue and in a mouse model of FMCD. Using temporally regulated conditional gene expression systems, we found that expression of a constitutively active form of 4E-BP1 that resists phosphorylation by mTOR in juvenile mice reduced neuronal cytomegaly and corrected several neuronal electrophysiological alterations, including depolarized resting membrane potential, irregular firing pattern, and aberrant expression of HCN4 channels. Further, 4E-BP1 expression in juvenile FMCD mice after epilepsy onset resulted in improved cortical spectral activity and decreased spontaneous seizure frequency in adults. Overall, our study uncovered a remarkable plasticity of the juvenile brain that facilitates novel therapeutic opportunities to treat FMCD-related epilepsy during childhood with potentially long-lasting effects in adults.
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Affiliation(s)
- Lena H Nguyen
- Department of Neurosurgery, Yale University School of Medicine; New Haven, CT 06510, USA.,Department of Cellular and Molecular Physiology, Yale University School of Medicine; New Haven, CT 06510, USA
| | - Youfen Xu
- Department of Neurosurgery, Yale University School of Medicine; New Haven, CT 06510, USA
| | - Travorn Mahadeo
- Department of Neurosurgery, Yale University School of Medicine; New Haven, CT 06510, USA
| | - Longbo Zhang
- Department of Neurosurgery, Yale University School of Medicine; New Haven, CT 06510, USA
| | - Tiffany V Lin
- Department of Neurosurgery, Yale University School of Medicine; New Haven, CT 06510, USA
| | - Heather A Born
- Cain Foundation Laboratories, Jan and Dan Duncan Neurological Research Institute at Texas Children's Hospital; Houston, TX 77030, USA.,Department of Pediatrics, Baylor College of Medicine; Houston, TX 77030, USA
| | - Anne E Anderson
- Cain Foundation Laboratories, Jan and Dan Duncan Neurological Research Institute at Texas Children's Hospital; Houston, TX 77030, USA.,Department of Pediatrics, Baylor College of Medicine; Houston, TX 77030, USA
| | - Angélique Bordey
- Department of Neurosurgery, Yale University School of Medicine; New Haven, CT 06510, USA.,Department of Cellular and Molecular Physiology, Yale University School of Medicine; New Haven, CT 06510, USA
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Berg EL, Petkova SP, Born HA, Adhikari A, Anderson AE, Silverman JL. Insulin-like growth factor-2 does not improve behavioral deficits in mouse and rat models of Angelman Syndrome. Mol Autism 2021; 12:59. [PMID: 34526125 PMCID: PMC8444390 DOI: 10.1186/s13229-021-00467-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 09/02/2021] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Angelman Syndrome (AS) is a rare neurodevelopmental disorder for which there is currently no cure or effective therapeutic. Since the genetic cause of AS is known to be dysfunctional expression of the maternal allele of ubiquitin protein ligase E3A (UBE3A), several genetic animal models of AS have been developed. Both the Ube3a maternal deletion mouse and rat models of AS reliably demonstrate behavioral phenotypes of relevance to AS and therefore offer suitable in vivo systems in which to test potential therapeutics. One promising candidate treatment is insulin-like growth factor-2 (IGF-2), which has recently been shown to ameliorate behavioral deficits in the mouse model of AS and improve cognitive abilities across model systems. METHODS We used both the Ube3a maternal deletion mouse and rat models of AS to evaluate the ability of IGF-2 to improve electrophysiological and behavioral outcomes. RESULTS Acute systemic administration of IGF-2 had an effect on electrophysiological activity in the brain and on a metric of motor ability; however the effects were not enduring or extensive. Additional metrics of motor behavior, learning, ambulation, and coordination were unaffected and IGF-2 did not improve social communication, seizure threshold, or cognition. LIMITATIONS The generalizability of these results to humans is difficult to predict and it remains possible that dosing schemes (i.e., chronic or subchronic dosing), routes, and/or post-treatment intervals other than that used herein may show more efficacy. CONCLUSIONS Despite a few observed effects of IGF-2, our results taken together indicate that IGF-2 treatment does not profoundly improve behavioral deficits in mouse or rat models of AS. These findings shed cautionary light on the potential utility of acute systemic IGF-2 administration in the treatment of AS.
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Affiliation(s)
- Elizabeth L. Berg
- MIND Institute and Department of Psychiatry and Behavioral Sciences, University of California Davis School of Medicine, Sacramento, CA USA
| | - Stela P. Petkova
- MIND Institute and Department of Psychiatry and Behavioral Sciences, University of California Davis School of Medicine, Sacramento, CA USA
| | - Heather A. Born
- Department of Pediatrics and Neurology, Baylor College of Medicine, Houston, TX USA
- Gene Therapy Program, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA USA
| | - Anna Adhikari
- MIND Institute and Department of Psychiatry and Behavioral Sciences, University of California Davis School of Medicine, Sacramento, CA USA
| | - Anne E. Anderson
- Department of Pediatrics and Neurology, Baylor College of Medicine, Houston, TX USA
| | - Jill L. Silverman
- MIND Institute and Department of Psychiatry and Behavioral Sciences, University of California Davis School of Medicine, Sacramento, CA USA
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9
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Abstract
The presence of unprovoked, recurrent seizures, particularly when drug resistant and associated with cognitive and behavioral deficits, warrants investigation for an underlying genetic cause. This article provides an overview of the major classes of genes associated with epilepsy phenotypes divided into functional categories along with the recommended work-up and therapeutic considerations. Gene discovery in epilepsy supports counseling and anticipatory guidance but also opens the door for precision medicine guiding therapy with a focus on those with disease-modifying effects.
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Affiliation(s)
- Luis A Martinez
- Department of Pediatrics, Section of Pediatric Neurology and Developmental Neuroscience, Baylor College of Medicine, Jan and Dan Duncan Neurological Research Institute, Texas Children's Hospital, 1250 Moursund Drive, Houston, TX 77030, USA
| | - Yi-Chen Lai
- Department of Pediatrics, Section of Pediatric Critical Care Medicine, Baylor College of Medicine, Jan and Dan Duncan Neurological Research Institute, Texas Children's Hospital, 1250 Moursund Drive, Houston, TX 77030, USA
| | - J Lloyd Holder
- Department of Pediatrics, Section of Pediatric Neurology and Developmental Neuroscience, Baylor College of Medicine, Jan and Dan Duncan Neurological Research Institute, Texas Children's Hospital, 1250 Moursund Drive, Houston, TX 77030, USA
| | - Anne E Anderson
- Department of Pediatrics, Section of Pediatric Neurology and Developmental Neuroscience, Baylor College of Medicine, Jan and Dan Duncan Neurological Research Institute, Texas Children's Hospital, 1250 Moursund Drive, Houston, TX 77030, USA.
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10
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Chan SW, Dervan LA, Watson RS, Anderson AE, Lai YC. Epilepsy duration is an independent factor for electrocardiographic changes in pediatric epilepsy. Epilepsia Open 2021; 6:588-596. [PMID: 34235879 PMCID: PMC8408606 DOI: 10.1002/epi4.12519] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 06/29/2021] [Accepted: 07/04/2021] [Indexed: 11/23/2022] Open
Abstract
Objective Cardiac alterations represent a potential epilepsy‐associated comorbidity. Whether cardiac changes occur as a function of epilepsy duration is not well understood. We sought to evaluate whether cardiac alterations represented a time‐dependent phenomenon in pediatric epilepsy. Methods We retrospectively followed pediatric epilepsy patients without preexisting cardiac conditions or ion channelopathies who had history of pediatric intensive care unit admission for convulsive seizures or status epilepticus between 4/2014 and 7/2017. All available 12‐lead electrocardiograms (ECGs) from these patients between 1/2006 and 5/2019 were included. We examined ECG studies for changes in rhythm; PR, QRS, or corrected QT intervals; QRS axis or morphology; ST segment; or T wave. Data were analyzed using multivariable models containing covariates associated with ECG changes or epilepsy duration from the univariate analyses. Results 127 children with 323 ECGs were included in the analyses. The median epilepsy duration was 3.9 years (IQR 1.3‐8.4 years) at the time of an ECG study and a median of 2 ECGs (IQR 1‐3) per subject. The clinical encounters associated with ECGs ranged from well‐child visits to status epilepticus. We observed changes in 171 ECGs (53%), with 83 children (65%) had at least 1 ECG with alterations. In a multivariable logistic regression model adjusting for potentially confounding variables and accounting for clustering by patient, epilepsy duration was independently associated with altered ECGs for each year of epilepsy (OR: 1.1, 95% CI: 1.0‐1.2, P = .002). Extrapolating from this model, children with epilepsy durations of 10 and 15 years had 2.9 and 4.9 times the odds of having ECG changes, respectively. Significance Cardiac alterations may become more common with increasing epilepsy duration in select pediatric epilepsy patients. Future studies are needed to determine the potential clinical implications and the generalizability of these observations.
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Affiliation(s)
- See Wai Chan
- Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - Leslie A Dervan
- Department of Pediatrics, University of Washington, Seattle, WA, USA.,Center for Clinical and Translational Research, Seattle Children's Research Institute, Seattle, WA, USA
| | - Robert Scott Watson
- Department of Pediatrics, University of Washington, Seattle, WA, USA.,Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, Seattle, WA, USA
| | - Anne E Anderson
- Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - Yi-Chen Lai
- Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
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11
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Lee CH, Le JT, Ballester-Rosado CJ, Anderson AE, Swann JW. Neocortical Slow Oscillations Implicated in the Generation of Epileptic Spasms. Ann Neurol 2021; 89:226-241. [PMID: 33068018 PMCID: PMC7855630 DOI: 10.1002/ana.25935] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 09/23/2020] [Accepted: 10/12/2020] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Epileptic spasms are a hallmark of severe seizure disorders. The neurophysiological mechanisms and the neuronal circuit(s) that generate these seizures are unresolved and are the focus of studies reported here. METHODS In the tetrodotoxin model, we used 16-channel microarrays and microwires to record electrophysiological activity in neocortex and thalamus during spasms. Chemogenetic activation was used to examine the role of neocortical pyramidal cells in generating spasms. Comparisons were made to recordings from infantile spasm patients. RESULTS Current source density and simultaneous multiunit activity analyses indicate that the ictal events of spasms are initiated in infragranular cortical layers. A dramatic pause of neuronal activity was recorded immediately prior to the onset of spasms. This preictal pause is shown to share many features with the down states of slow wave sleep. In addition, the ensuing interictal up states of slow wave rhythms are more intense in epileptic than control animals and occasionally appear sufficient to initiate spasms. Chemogenetic activation of neocortical pyramidal cells supported these observations, as it increased slow oscillations and spasm numbers and clustering. Recordings also revealed a ramp-up in the number of neocortical slow oscillations preceding spasms, which was also observed in infantile spasm patients. INTERPRETATION Our findings provide evidence that epileptic spasms can arise from the neocortex and reveal a previously unappreciated interplay between brain state physiology and spasm generation. The identification of neocortical up states as a mechanism capable of initiating epileptic spasms will likely provide new targets for interventional therapies. ANN NEUROL 2021;89:226-241.
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Affiliation(s)
- Chih-hong Lee
- Department of Neuroscience, Baylor College of Medicine, Houston, Texas, USA
- The Cain Foundation Laboratories, The Jan and Dan Duncan Neurological Research Institute, Texas Children’s Hospital, Houston, Texas, USA
- Department of Neurology, Chang Gung Memorial Hospital Linkou Medical Center and Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - John T. Le
- The Cain Foundation Laboratories, The Jan and Dan Duncan Neurological Research Institute, Texas Children’s Hospital, Houston, Texas, USA
- Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA
| | - Carlos J. Ballester-Rosado
- The Cain Foundation Laboratories, The Jan and Dan Duncan Neurological Research Institute, Texas Children’s Hospital, Houston, Texas, USA
- Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA
| | - Anne E. Anderson
- Department of Neuroscience, Baylor College of Medicine, Houston, Texas, USA
- The Cain Foundation Laboratories, The Jan and Dan Duncan Neurological Research Institute, Texas Children’s Hospital, Houston, Texas, USA
- Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA
- Department of Neurology, Baylor College of Medicine, Houston, Texas, USA
| | - John W. Swann
- Department of Neuroscience, Baylor College of Medicine, Houston, Texas, USA
- The Cain Foundation Laboratories, The Jan and Dan Duncan Neurological Research Institute, Texas Children’s Hospital, Houston, Texas, USA
- Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA
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12
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Dodge A, Peters MM, Greene HE, Dietrick C, Botelho R, Chung D, Willman J, Nenninger AW, Ciarlone S, Kamath SG, Houdek P, Sumová A, Anderson AE, Dindot SV, Berg EL, O'Geen H, Segal DJ, Silverman JL, Weeber EJ, Nash KR. Generation of a Novel Rat Model of Angelman Syndrome with a Complete Ube3a Gene Deletion. Autism Res 2020; 13:397-409. [PMID: 31961493 PMCID: PMC7787396 DOI: 10.1002/aur.2267] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [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: 07/31/2019] [Revised: 01/02/2020] [Accepted: 01/06/2020] [Indexed: 11/08/2022]
Abstract
Angelman syndrome (AS) is a rare genetic disorder characterized by severe intellectual disability, seizures, lack of speech, and ataxia. The gene responsible for AS was identified as Ube3a and it encodes for E6AP, an E3 ubiquitin ligase. Currently, there is very little known about E6AP's mechanism of action in vivo or how the lack of this protein in neurons may contribute to the AS phenotype. Elucidating the mechanistic action of E6AP would enhance our understanding of AS and drive current research into new avenues that could lead to novel therapeutic approaches that target E6AP's various functions. To facilitate the study of AS, we have generated a novel rat model in which we deleted the rat Ube3a gene using CRISPR. The AS rat phenotypically mirrors human AS with loss of Ube3a expression in the brain and deficits in motor coordination as well as learning and memory. This model offers a new avenue for the study of AS. Autism Res 2020, 13: 397-409. © 2020 International Society for Autism Research,Wiley Periodicals, Inc. LAY SUMMARY: Angelman syndrome (AS) is a rare genetic disorder characterized by severe intellectual disability, seizures, difficulty speaking, and ataxia. The gene responsible for AS was identified as UBE3A, yet very little is known about its function in vivo or how the lack of this protein in neurons may contribute to the AS phenotype. To facilitate the study of AS, we have generated a novel rat model in which we deleted the rat Ube3a gene using CRISPR. The AS rat mirrors human AS with loss of Ube3a expression in the brain and deficits in motor coordination as well as learning and memory. This model offers a new avenue for the study of AS.
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Affiliation(s)
- Andie Dodge
- Department of Molecular Pharmacology and Physiology, University of South Florida, Tampa, Florida
| | - Melinda M Peters
- Department of Molecular Pharmacology and Physiology, University of South Florida, Tampa, Florida
| | - Hayden E Greene
- Department of Molecular Pharmacology and Physiology, University of South Florida, Tampa, Florida
| | - Clifton Dietrick
- Department of Molecular Pharmacology and Physiology, University of South Florida, Tampa, Florida
| | - Robert Botelho
- Department of Molecular Pharmacology and Physiology, University of South Florida, Tampa, Florida
| | - Diana Chung
- Department of Molecular Pharmacology and Physiology, University of South Florida, Tampa, Florida
| | - Jonathan Willman
- Department of Molecular Pharmacology and Physiology, University of South Florida, Tampa, Florida
| | - Austin W Nenninger
- Department of Molecular Pharmacology and Physiology, University of South Florida, Tampa, Florida
| | - Stephanie Ciarlone
- Department of Molecular Pharmacology and Physiology, University of South Florida, Tampa, Florida
- PTC Therapeutics Inc., Plainfield, 07080, New Jersey
| | - Siddharth G Kamath
- Department of Molecular Pharmacology and Physiology, University of South Florida, Tampa, Florida
| | - Pavel Houdek
- Department of Neurohumoral Regulations, Institute of Physiology, Czech Academy of Sciences, Prague, Czech Republic
| | - Alena Sumová
- Department of Neurohumoral Regulations, Institute of Physiology, Czech Academy of Sciences, Prague, Czech Republic
| | - Anne E Anderson
- Department of Pediatrics, Baylor College of Medicine, Houston, Texas
| | - Scott V Dindot
- Department of Veterinary Pathobiology, Texas A&M, College Station, Texas
| | - Elizabeth L Berg
- School of Medicine, MIND Institute, Department of Psychiatry and Behavioral Sciences, University of California - Davis, Sacramento, California
| | - Henriette O'Geen
- Genome Center and MIND Institute, University of California - Davis, Davis, California
| | - David J Segal
- Genome Center and MIND Institute, University of California - Davis, Davis, California
| | - Jill L Silverman
- School of Medicine, MIND Institute, Department of Psychiatry and Behavioral Sciences, University of California - Davis, Sacramento, California
| | - Edwin J Weeber
- Department of Molecular Pharmacology and Physiology, University of South Florida, Tampa, Florida
- PTC Therapeutics Inc., Plainfield, 07080, New Jersey
| | - Kevin R Nash
- Department of Molecular Pharmacology and Physiology, University of South Florida, Tampa, Florida
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13
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Berg EL, Pride MC, Petkova SP, Lee RD, Copping NA, Shen Y, Adhikari A, Fenton TA, Pedersen LR, Noakes LS, Nieman BJ, Lerch JP, Harris S, Born HA, Peters MM, Deng P, Cameron DL, Fink KD, Beitnere U, O'Geen H, Anderson AE, Dindot SV, Nash KR, Weeber EJ, Wöhr M, Ellegood J, Segal DJ, Silverman JL. Translational outcomes in a full gene deletion of ubiquitin protein ligase E3A rat model of Angelman syndrome. Transl Psychiatry 2020; 10:39. [PMID: 32066685 PMCID: PMC7026078 DOI: 10.1038/s41398-020-0720-2] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Revised: 12/17/2019] [Accepted: 01/02/2020] [Indexed: 12/17/2022] Open
Abstract
Angelman syndrome (AS) is a rare neurodevelopmental disorder characterized by developmental delay, impaired communication, motor deficits and ataxia, intellectual disabilities, microcephaly, and seizures. The genetic cause of AS is the loss of expression of UBE3A (ubiquitin protein ligase E6-AP) in the brain, typically due to a deletion of the maternal 15q11-q13 region. Previous studies have been performed using a mouse model with a deletion of a single exon of Ube3a. Since three splice variants of Ube3a exist, this has led to a lack of consistent reports and the theory that perhaps not all mouse studies were assessing the effects of an absence of all functional UBE3A. Herein, we report the generation and functional characterization of a novel model of Angelman syndrome by deleting the entire Ube3a gene in the rat. We validated that this resulted in the first comprehensive gene deletion rodent model. Ultrasonic vocalizations from newborn Ube3am-/p+ were reduced in the maternal inherited deletion group with no observable change in the Ube3am+/p- paternal transmission cohort. We also discovered Ube3am-/p+ exhibited delayed reflex development, motor deficits in rearing and fine motor skills, aberrant social communication, and impaired touchscreen learning and memory in young adults. These behavioral deficits were large in effect size and easily apparent in the larger rodent species. Low social communication was detected using a playback task that is unique to rats. Structural imaging illustrated decreased brain volume in Ube3am-/p+ and a variety of intriguing neuroanatomical phenotypes while Ube3am+/p- did not exhibit altered neuroanatomy. Our report identifies, for the first time, unique AS relevant functional phenotypes and anatomical markers as preclinical outcomes to test various strategies for gene and molecular therapies in AS.
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Affiliation(s)
- E L Berg
- MIND Institute and Department of Psychiatry and Behavioral Sciences, University of California Davis School of Medicine, Sacramento, CA, USA
| | - M C Pride
- MIND Institute and Department of Psychiatry and Behavioral Sciences, University of California Davis School of Medicine, Sacramento, CA, USA
| | - S P Petkova
- MIND Institute and Department of Psychiatry and Behavioral Sciences, University of California Davis School of Medicine, Sacramento, CA, USA
| | - R D Lee
- MIND Institute and Department of Psychiatry and Behavioral Sciences, University of California Davis School of Medicine, Sacramento, CA, USA
| | - N A Copping
- MIND Institute and Department of Psychiatry and Behavioral Sciences, University of California Davis School of Medicine, Sacramento, CA, USA
| | - Y Shen
- MIND Institute and Department of Psychiatry and Behavioral Sciences, University of California Davis School of Medicine, Sacramento, CA, USA
| | - A Adhikari
- MIND Institute and Department of Psychiatry and Behavioral Sciences, University of California Davis School of Medicine, Sacramento, CA, USA
| | - T A Fenton
- MIND Institute and Department of Psychiatry and Behavioral Sciences, University of California Davis School of Medicine, Sacramento, CA, USA
| | - L R Pedersen
- MIND Institute and Department of Psychiatry and Behavioral Sciences, University of California Davis School of Medicine, Sacramento, CA, USA
| | - L S Noakes
- Mouse Imaging Centre, Toronto Centre for Phenogenomics, The Hospital for Sick Children, Toronto, ON, Canada
| | - B J Nieman
- Mouse Imaging Centre, Toronto Centre for Phenogenomics, The Hospital for Sick Children, Toronto, ON, Canada
| | - J P Lerch
- Wellcome Centre for Integrative Neuroimaging, The University of Oxford, Oxford, UK
| | - S Harris
- Department of Pediatrics and Neurology, Baylor College of Medicine, Houston, TX, USA
| | - H A Born
- Department of Pediatrics and Neurology, Baylor College of Medicine, Houston, TX, USA
| | - M M Peters
- Department of Molecular Pharmacology and Physiology, University of South Florida, Tampa, FL, USA
| | - P Deng
- Stem Cell Program, Institute for Regenerative Cures, and Department of Neurology, University of California Davis School of Medicine, Sacramento, CA, USA
| | - D L Cameron
- Stem Cell Program, Institute for Regenerative Cures, and Department of Neurology, University of California Davis School of Medicine, Sacramento, CA, USA
| | - K D Fink
- Stem Cell Program, Institute for Regenerative Cures, and Department of Neurology, University of California Davis School of Medicine, Sacramento, CA, USA
| | - U Beitnere
- MIND Institute, Genome Center, and Department of Biochemistry and Molecular Medicine, University of California Davis, Davis, CA, USA
| | - H O'Geen
- MIND Institute, Genome Center, and Department of Biochemistry and Molecular Medicine, University of California Davis, Davis, CA, USA
| | - A E Anderson
- Department of Pediatrics and Neurology, Baylor College of Medicine, Houston, TX, USA
| | - S V Dindot
- Department of Veterinary Pathobiology, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, USA
| | - K R Nash
- Department of Molecular Pharmacology and Physiology, University of South Florida, Tampa, FL, USA
| | - E J Weeber
- Department of Molecular Pharmacology and Physiology, University of South Florida, Tampa, FL, USA
| | - M Wöhr
- Behavioral Neuroscience, Experimental and Biological Psychology, Philipps-University of Marburg, Marburg, Germany
| | - J Ellegood
- Mouse Imaging Centre, Toronto Centre for Phenogenomics, The Hospital for Sick Children, Toronto, ON, Canada
| | - D J Segal
- MIND Institute, Genome Center, and Department of Biochemistry and Molecular Medicine, University of California Davis, Davis, CA, USA
| | - J L Silverman
- MIND Institute and Department of Psychiatry and Behavioral Sciences, University of California Davis School of Medicine, Sacramento, CA, USA.
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14
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Frigerio F, Flynn C, Han Y, Lyman K, Lugo JN, Ravizza T, Ghestem A, Pitsch J, Becker A, Anderson AE, Vezzani A, Chetkovich D, Bernard C. Neuroinflammation Alters Integrative Properties of Rat Hippocampal Pyramidal Cells. Mol Neurobiol 2018; 55:7500-7511. [PMID: 29427087 PMCID: PMC6070409 DOI: 10.1007/s12035-018-0915-1] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [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: 07/27/2017] [Accepted: 01/18/2018] [Indexed: 12/11/2022]
Abstract
Neuroinflammation is consistently found in many neurological disorders, but whether or not the inflammatory response independently affects neuronal network properties is poorly understood. Here, we report that intracerebroventricular injection of the prototypical inflammatory molecule lipopolysaccharide (LPS) in rats triggered a strong and long-lasting inflammatory response in hippocampal microglia associated with a concomitant upregulation of Toll-like receptor (TLR4) in pyramidal and hilar neurons. This, in turn, was associated with a significant reduction of the dendritic hyperpolarization-activated cyclic AMP-gated channel type 1 (HCN1) protein level while Kv4.2 channels were unaltered as assessed by western blot. Immunohistochemistry confirmed the HCN1 decrease in CA1 pyramidal neurons and showed that these changes were associated with a reduction of TRIP8b, an auxiliary subunit for HCN channels implicated in channel subcellular localization and trafficking. At the physiological level, this effect translated into a 50% decrease in HCN1-mediated currents (Ih) measured in the distal dendrites of hippocampal CA1 pyramidal cells. At the functional level, the band-pass-filtering properties of dendrites in the theta frequency range (4-12 Hz) and their temporal summation properties were compromised. We conclude that neuroinflammation can independently trigger an acquired channelopathy in CA1 pyramidal cell dendrites that alters their integrative properties. By directly changing cellular function, this phenomenon may participate in the phenotypic expression of various brain diseases.
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Affiliation(s)
- Federica Frigerio
- Department of Neuroscience, IRCCS-Mario Negri Institute for Pharmacological Research, Milan, Italy
| | - Corey Flynn
- INSERM U1106, INS, Institut de Neurosciences des Systèmes, Aix-Marseille Université, Marseille, France
| | - Ye Han
- Davee Department of Neurology and Clinical Neurosciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Kyle Lyman
- Davee Department of Neurology and Clinical Neurosciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Joaquin N Lugo
- Department of Psychology and Neuroscience, Institute of Biomedical Studies, Baylor University, Waco, TX, USA
| | - Teresa Ravizza
- Department of Neuroscience, IRCCS-Mario Negri Institute for Pharmacological Research, Milan, Italy
| | - Antoine Ghestem
- INSERM U1106, INS, Institut de Neurosciences des Systèmes, Aix-Marseille Université, Marseille, France
| | - Julika Pitsch
- Section for Translational Epilepsy Research, Department of Neuropathology, University of Bonn Medical Center, Bonn, Germany
| | - Albert Becker
- Section for Translational Epilepsy Research, Department of Neuropathology, University of Bonn Medical Center, Bonn, Germany
| | - Anne E Anderson
- Departments of Pediatrics, Neurology and Neuroscience, Baylor College of Medicine, Houston, TX, USA
| | - Annamaria Vezzani
- Department of Neuroscience, IRCCS-Mario Negri Institute for Pharmacological Research, Milan, Italy.
| | - Dane Chetkovich
- Davee Department of Neurology and Clinical Neurosciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Vanderbilt University Medical Center, Nashville, TN, USA
| | - Christophe Bernard
- INSERM U1106, INS, Institut de Neurosciences des Systèmes, Aix-Marseille Université, Marseille, France.
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15
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Egbenya DL, Hussain S, Lai YC, Xia J, Anderson AE, Davanger S. Changes in synaptic AMPA receptor concentration and composition in chronic temporal lobe epilepsy. Mol Cell Neurosci 2018; 92:93-103. [PMID: 30064010 DOI: 10.1016/j.mcn.2018.07.004] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Revised: 06/22/2018] [Accepted: 07/27/2018] [Indexed: 12/17/2022] Open
Abstract
Excitotoxicity caused by excessive stimulation of glutamate receptors, resulting in pathologically increased Ca2+-concentrations, is a decisive factor in neurodegenerative diseases. We investigated long-term changes in synaptic contents of AMPA receptor subunits that play important roles in calcium regulation in chronic epilepsy. Such plastic changes may be either adaptive or detrimental. We used a kainic acid (KA)-based rat model of chronic temporal lobe epilepsy (TLE). Using hippocampal synaptosomes, we found significant reductions in the concentration of the AMPA receptor subunits GluA1 and GluA2, and the NMDA receptor subunit NR2B. The relative size of GluA1 and GluA2 reductions were almost identical, at 28% and 27%, respectively. In order to determine whether the synaptic reduction of the AMPA receptor subunits actually reflected the pool of receptors present along the postsynaptic density (PSD), as opposed to cytoplasmic or extrasynaptic pools, we performed postembedding immunogold electron microscopy (EM) of GluA1 and GluA2 in Schaffer collateral synapses in the hippocampal CA1 area. We found significant reductions, at 32% and 52% of GluA1 and GluA2 subunits, respectively, along the PSD, indicating that these synapses undergo lasting changes in glutamatergic neurotransmission during chronic TLE. When compared to the overall concentration and composition of AMPA receptors expressed in the brain, there was a relative increase in GluA2-lacking AMPA receptor subunits following chronic epilepsy. These changes in synaptic AMPA receptor subunits may possibly contribute to further aggravate the excitotoxic vulnerability of the neurons as well as have significant implications for hippocampal cognitive functions.
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Affiliation(s)
- Daniel L Egbenya
- Laboratory for Synaptic Plasticity, Division of Anatomy, Department of Molecular Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Suleman Hussain
- Laboratory for Synaptic Plasticity, Division of Anatomy, Department of Molecular Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Yi-Chen Lai
- Jan and Dan Duncan Neurological Research Institute, Baylor College of Medicine, Houston, TX, USA
| | - Jun Xia
- Division of Life Science, Division of Biomedical Engineering and State Key Laboratory of Molecular Neuroscience, The Hong Kong University of Science and Technology, Clear Water Bay, Kowloon, Hong Kong, China
| | - Anne E Anderson
- Jan and Dan Duncan Neurological Research Institute, Baylor College of Medicine, Houston, TX, USA
| | - Svend Davanger
- Laboratory for Synaptic Plasticity, Division of Anatomy, Department of Molecular Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway.
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16
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Sánchez Fernández I, Gaínza-Lein M, Abend NS, Anderson AE, Arya R, Brenton JN, Carpenter JL, Chapman KE, Clark J, Gaillard WD, Glauser TA, Goldstein JL, Goodkin HP, Helseth AR, Jackson MC, Kapur K, Lai YC, McDonough TL, Mikati MA, Nayak A, Peariso K, Riviello JJ, Tasker RC, Tchapyjnikov D, Topjian AA, Wainwright MS, Wilfong A, Williams K, Loddenkemper T. Factors associated with treatment delays in pediatric refractory convulsive status epilepticus. Neurology 2018; 90:e1692-e1701. [PMID: 29643084 DOI: 10.1212/wnl.0000000000005488] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Accepted: 02/15/2018] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVE To identify factors associated with treatment delays in pediatric patients with convulsive refractory status epilepticus (rSE). METHODS This prospective, observational study was performed from June 2011 to March 2017 on pediatric patients (1 month to 21 years of age) with rSE. We evaluated potential factors associated with increased treatment delays in a Cox proportional hazards model. RESULTS We studied 219 patients (53% males) with a median (25th-75th percentiles [p25-p75]) age of 3.9 (1.2-9.5) years in whom rSE started out of hospital (141 [64.4%]) or in hospital (78 [35.6%]). The median (p25-p75) time from seizure onset to treatment was 16 (5-45) minutes to first benzodiazepine (BZD), 63 (33-146) minutes to first non-BZD antiepileptic drug (AED), and 170 (107-539) minutes to first continuous infusion. Factors associated with more delays to administration of the first BZD were intermittent rSE (hazard ratio [HR] 1.54, 95% confidence interval [CI] 1.14-2.09; p = 0.0467) and out-of-hospital rSE onset (HR 1.5, 95% CI 1.11-2.04; p = 0.0467). Factors associated with more delays to administration of the first non-BZD AED were intermittent rSE (HR 1.78, 95% CI 1.32-2.4; p = 0.001) and out-of-hospital rSE onset (HR 2.25, 95% CI 1.67-3.02; p < 0.0001). None of the studied factors were associated with a delayed administration of continuous infusion. CONCLUSION Intermittent rSE and out-of-hospital rSE onset are independently associated with longer delays to administration of the first BZD and the first non-BZD AED in pediatric rSE. These factors identify potential targets for intervention to reduce time to treatment.
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Affiliation(s)
- I Sánchez Fernández
- From the Division of Epilepsy and Clinical Neurophysiology, Department of Neurology (I.S.F., M.G.-L., J.C., M.C.J., K.K., T.L.), and Division of Critical Care, Departments of Neurology, Anesthesiology, and Perioperative and Pain Medicine (R.C.T.), Boston Children's Hospital, Harvard Medical School, MA; Department of Child Neurology (I.S.F.), Hospital Sant Joan de Déu, Universidad de Barcelona, Spain; Facultad de Medicina (M.G.-L.), Universidad Austral de Chile, Valdivia; Divisions of Neurology (N.S.A.) and Critical Care Medicine (A.A.T.), The Children's Hospital of Philadelphia, The Perelman School of Medicine at the University of Pennsylvania, Philadelphia; Section of Neurology and Developmental Neuroscience (A.E.A., Y.-C.L., A.N., J.J.R.), Department of Pediatrics, Texas Children's Hospital, Baylor College of Medicine, Houston; Divisions of Neurology (R.A., K.P.) and Pediatric Neurology (T.A.G.), Cincinnati Children's Hospital Medical Center, OH; Department of Neurology and Pediatrics (J.N.B., H.P.G.), University of Virginia Health System, Charlottesville; Center for Neuroscience (J.L.C., W.D.G.), Children's National Medical Center, George Washington University School of Medicine and Health Sciences, Washington, DC; Departments of Pediatrics and Neurology (K.E.C.), Children's Hospital Colorado, University of Colorado School of Medicine, Aurora; Department of Pediatrics (T.A.G.), University of Cincinnati College of Medicine, OH; Ruth D. & Ken M. Davee Pediatric Neurocritical Care Program (J.L.G., M.S.W.), Northwestern University Feinberg School of Medicine, Chicago, IL; Division of Pediatric Neurology (A.R.H., M.A.M., D.T.), Duke University Medical Center, Duke University, Durham, NC; Division of Child Neurology (T.L.M.), Department of Neurology, Columbia University Medical Center, Columbia University, New York, NY; Barrow Neurological Institute (A.W., K.W.), Phoenix Children's Hospital, AZ; and Department of Pediatrics (A.W., K.W.), University of Arizona School of Medicine, Phoenix
| | - M Gaínza-Lein
- From the Division of Epilepsy and Clinical Neurophysiology, Department of Neurology (I.S.F., M.G.-L., J.C., M.C.J., K.K., T.L.), and Division of Critical Care, Departments of Neurology, Anesthesiology, and Perioperative and Pain Medicine (R.C.T.), Boston Children's Hospital, Harvard Medical School, MA; Department of Child Neurology (I.S.F.), Hospital Sant Joan de Déu, Universidad de Barcelona, Spain; Facultad de Medicina (M.G.-L.), Universidad Austral de Chile, Valdivia; Divisions of Neurology (N.S.A.) and Critical Care Medicine (A.A.T.), The Children's Hospital of Philadelphia, The Perelman School of Medicine at the University of Pennsylvania, Philadelphia; Section of Neurology and Developmental Neuroscience (A.E.A., Y.-C.L., A.N., J.J.R.), Department of Pediatrics, Texas Children's Hospital, Baylor College of Medicine, Houston; Divisions of Neurology (R.A., K.P.) and Pediatric Neurology (T.A.G.), Cincinnati Children's Hospital Medical Center, OH; Department of Neurology and Pediatrics (J.N.B., H.P.G.), University of Virginia Health System, Charlottesville; Center for Neuroscience (J.L.C., W.D.G.), Children's National Medical Center, George Washington University School of Medicine and Health Sciences, Washington, DC; Departments of Pediatrics and Neurology (K.E.C.), Children's Hospital Colorado, University of Colorado School of Medicine, Aurora; Department of Pediatrics (T.A.G.), University of Cincinnati College of Medicine, OH; Ruth D. & Ken M. Davee Pediatric Neurocritical Care Program (J.L.G., M.S.W.), Northwestern University Feinberg School of Medicine, Chicago, IL; Division of Pediatric Neurology (A.R.H., M.A.M., D.T.), Duke University Medical Center, Duke University, Durham, NC; Division of Child Neurology (T.L.M.), Department of Neurology, Columbia University Medical Center, Columbia University, New York, NY; Barrow Neurological Institute (A.W., K.W.), Phoenix Children's Hospital, AZ; and Department of Pediatrics (A.W., K.W.), University of Arizona School of Medicine, Phoenix
| | - N S Abend
- From the Division of Epilepsy and Clinical Neurophysiology, Department of Neurology (I.S.F., M.G.-L., J.C., M.C.J., K.K., T.L.), and Division of Critical Care, Departments of Neurology, Anesthesiology, and Perioperative and Pain Medicine (R.C.T.), Boston Children's Hospital, Harvard Medical School, MA; Department of Child Neurology (I.S.F.), Hospital Sant Joan de Déu, Universidad de Barcelona, Spain; Facultad de Medicina (M.G.-L.), Universidad Austral de Chile, Valdivia; Divisions of Neurology (N.S.A.) and Critical Care Medicine (A.A.T.), The Children's Hospital of Philadelphia, The Perelman School of Medicine at the University of Pennsylvania, Philadelphia; Section of Neurology and Developmental Neuroscience (A.E.A., Y.-C.L., A.N., J.J.R.), Department of Pediatrics, Texas Children's Hospital, Baylor College of Medicine, Houston; Divisions of Neurology (R.A., K.P.) and Pediatric Neurology (T.A.G.), Cincinnati Children's Hospital Medical Center, OH; Department of Neurology and Pediatrics (J.N.B., H.P.G.), University of Virginia Health System, Charlottesville; Center for Neuroscience (J.L.C., W.D.G.), Children's National Medical Center, George Washington University School of Medicine and Health Sciences, Washington, DC; Departments of Pediatrics and Neurology (K.E.C.), Children's Hospital Colorado, University of Colorado School of Medicine, Aurora; Department of Pediatrics (T.A.G.), University of Cincinnati College of Medicine, OH; Ruth D. & Ken M. Davee Pediatric Neurocritical Care Program (J.L.G., M.S.W.), Northwestern University Feinberg School of Medicine, Chicago, IL; Division of Pediatric Neurology (A.R.H., M.A.M., D.T.), Duke University Medical Center, Duke University, Durham, NC; Division of Child Neurology (T.L.M.), Department of Neurology, Columbia University Medical Center, Columbia University, New York, NY; Barrow Neurological Institute (A.W., K.W.), Phoenix Children's Hospital, AZ; and Department of Pediatrics (A.W., K.W.), University of Arizona School of Medicine, Phoenix
| | - A E Anderson
- From the Division of Epilepsy and Clinical Neurophysiology, Department of Neurology (I.S.F., M.G.-L., J.C., M.C.J., K.K., T.L.), and Division of Critical Care, Departments of Neurology, Anesthesiology, and Perioperative and Pain Medicine (R.C.T.), Boston Children's Hospital, Harvard Medical School, MA; Department of Child Neurology (I.S.F.), Hospital Sant Joan de Déu, Universidad de Barcelona, Spain; Facultad de Medicina (M.G.-L.), Universidad Austral de Chile, Valdivia; Divisions of Neurology (N.S.A.) and Critical Care Medicine (A.A.T.), The Children's Hospital of Philadelphia, The Perelman School of Medicine at the University of Pennsylvania, Philadelphia; Section of Neurology and Developmental Neuroscience (A.E.A., Y.-C.L., A.N., J.J.R.), Department of Pediatrics, Texas Children's Hospital, Baylor College of Medicine, Houston; Divisions of Neurology (R.A., K.P.) and Pediatric Neurology (T.A.G.), Cincinnati Children's Hospital Medical Center, OH; Department of Neurology and Pediatrics (J.N.B., H.P.G.), University of Virginia Health System, Charlottesville; Center for Neuroscience (J.L.C., W.D.G.), Children's National Medical Center, George Washington University School of Medicine and Health Sciences, Washington, DC; Departments of Pediatrics and Neurology (K.E.C.), Children's Hospital Colorado, University of Colorado School of Medicine, Aurora; Department of Pediatrics (T.A.G.), University of Cincinnati College of Medicine, OH; Ruth D. & Ken M. Davee Pediatric Neurocritical Care Program (J.L.G., M.S.W.), Northwestern University Feinberg School of Medicine, Chicago, IL; Division of Pediatric Neurology (A.R.H., M.A.M., D.T.), Duke University Medical Center, Duke University, Durham, NC; Division of Child Neurology (T.L.M.), Department of Neurology, Columbia University Medical Center, Columbia University, New York, NY; Barrow Neurological Institute (A.W., K.W.), Phoenix Children's Hospital, AZ; and Department of Pediatrics (A.W., K.W.), University of Arizona School of Medicine, Phoenix
| | - R Arya
- From the Division of Epilepsy and Clinical Neurophysiology, Department of Neurology (I.S.F., M.G.-L., J.C., M.C.J., K.K., T.L.), and Division of Critical Care, Departments of Neurology, Anesthesiology, and Perioperative and Pain Medicine (R.C.T.), Boston Children's Hospital, Harvard Medical School, MA; Department of Child Neurology (I.S.F.), Hospital Sant Joan de Déu, Universidad de Barcelona, Spain; Facultad de Medicina (M.G.-L.), Universidad Austral de Chile, Valdivia; Divisions of Neurology (N.S.A.) and Critical Care Medicine (A.A.T.), The Children's Hospital of Philadelphia, The Perelman School of Medicine at the University of Pennsylvania, Philadelphia; Section of Neurology and Developmental Neuroscience (A.E.A., Y.-C.L., A.N., J.J.R.), Department of Pediatrics, Texas Children's Hospital, Baylor College of Medicine, Houston; Divisions of Neurology (R.A., K.P.) and Pediatric Neurology (T.A.G.), Cincinnati Children's Hospital Medical Center, OH; Department of Neurology and Pediatrics (J.N.B., H.P.G.), University of Virginia Health System, Charlottesville; Center for Neuroscience (J.L.C., W.D.G.), Children's National Medical Center, George Washington University School of Medicine and Health Sciences, Washington, DC; Departments of Pediatrics and Neurology (K.E.C.), Children's Hospital Colorado, University of Colorado School of Medicine, Aurora; Department of Pediatrics (T.A.G.), University of Cincinnati College of Medicine, OH; Ruth D. & Ken M. Davee Pediatric Neurocritical Care Program (J.L.G., M.S.W.), Northwestern University Feinberg School of Medicine, Chicago, IL; Division of Pediatric Neurology (A.R.H., M.A.M., D.T.), Duke University Medical Center, Duke University, Durham, NC; Division of Child Neurology (T.L.M.), Department of Neurology, Columbia University Medical Center, Columbia University, New York, NY; Barrow Neurological Institute (A.W., K.W.), Phoenix Children's Hospital, AZ; and Department of Pediatrics (A.W., K.W.), University of Arizona School of Medicine, Phoenix
| | - J N Brenton
- From the Division of Epilepsy and Clinical Neurophysiology, Department of Neurology (I.S.F., M.G.-L., J.C., M.C.J., K.K., T.L.), and Division of Critical Care, Departments of Neurology, Anesthesiology, and Perioperative and Pain Medicine (R.C.T.), Boston Children's Hospital, Harvard Medical School, MA; Department of Child Neurology (I.S.F.), Hospital Sant Joan de Déu, Universidad de Barcelona, Spain; Facultad de Medicina (M.G.-L.), Universidad Austral de Chile, Valdivia; Divisions of Neurology (N.S.A.) and Critical Care Medicine (A.A.T.), The Children's Hospital of Philadelphia, The Perelman School of Medicine at the University of Pennsylvania, Philadelphia; Section of Neurology and Developmental Neuroscience (A.E.A., Y.-C.L., A.N., J.J.R.), Department of Pediatrics, Texas Children's Hospital, Baylor College of Medicine, Houston; Divisions of Neurology (R.A., K.P.) and Pediatric Neurology (T.A.G.), Cincinnati Children's Hospital Medical Center, OH; Department of Neurology and Pediatrics (J.N.B., H.P.G.), University of Virginia Health System, Charlottesville; Center for Neuroscience (J.L.C., W.D.G.), Children's National Medical Center, George Washington University School of Medicine and Health Sciences, Washington, DC; Departments of Pediatrics and Neurology (K.E.C.), Children's Hospital Colorado, University of Colorado School of Medicine, Aurora; Department of Pediatrics (T.A.G.), University of Cincinnati College of Medicine, OH; Ruth D. & Ken M. Davee Pediatric Neurocritical Care Program (J.L.G., M.S.W.), Northwestern University Feinberg School of Medicine, Chicago, IL; Division of Pediatric Neurology (A.R.H., M.A.M., D.T.), Duke University Medical Center, Duke University, Durham, NC; Division of Child Neurology (T.L.M.), Department of Neurology, Columbia University Medical Center, Columbia University, New York, NY; Barrow Neurological Institute (A.W., K.W.), Phoenix Children's Hospital, AZ; and Department of Pediatrics (A.W., K.W.), University of Arizona School of Medicine, Phoenix
| | - J L Carpenter
- From the Division of Epilepsy and Clinical Neurophysiology, Department of Neurology (I.S.F., M.G.-L., J.C., M.C.J., K.K., T.L.), and Division of Critical Care, Departments of Neurology, Anesthesiology, and Perioperative and Pain Medicine (R.C.T.), Boston Children's Hospital, Harvard Medical School, MA; Department of Child Neurology (I.S.F.), Hospital Sant Joan de Déu, Universidad de Barcelona, Spain; Facultad de Medicina (M.G.-L.), Universidad Austral de Chile, Valdivia; Divisions of Neurology (N.S.A.) and Critical Care Medicine (A.A.T.), The Children's Hospital of Philadelphia, The Perelman School of Medicine at the University of Pennsylvania, Philadelphia; Section of Neurology and Developmental Neuroscience (A.E.A., Y.-C.L., A.N., J.J.R.), Department of Pediatrics, Texas Children's Hospital, Baylor College of Medicine, Houston; Divisions of Neurology (R.A., K.P.) and Pediatric Neurology (T.A.G.), Cincinnati Children's Hospital Medical Center, OH; Department of Neurology and Pediatrics (J.N.B., H.P.G.), University of Virginia Health System, Charlottesville; Center for Neuroscience (J.L.C., W.D.G.), Children's National Medical Center, George Washington University School of Medicine and Health Sciences, Washington, DC; Departments of Pediatrics and Neurology (K.E.C.), Children's Hospital Colorado, University of Colorado School of Medicine, Aurora; Department of Pediatrics (T.A.G.), University of Cincinnati College of Medicine, OH; Ruth D. & Ken M. Davee Pediatric Neurocritical Care Program (J.L.G., M.S.W.), Northwestern University Feinberg School of Medicine, Chicago, IL; Division of Pediatric Neurology (A.R.H., M.A.M., D.T.), Duke University Medical Center, Duke University, Durham, NC; Division of Child Neurology (T.L.M.), Department of Neurology, Columbia University Medical Center, Columbia University, New York, NY; Barrow Neurological Institute (A.W., K.W.), Phoenix Children's Hospital, AZ; and Department of Pediatrics (A.W., K.W.), University of Arizona School of Medicine, Phoenix
| | - K E Chapman
- From the Division of Epilepsy and Clinical Neurophysiology, Department of Neurology (I.S.F., M.G.-L., J.C., M.C.J., K.K., T.L.), and Division of Critical Care, Departments of Neurology, Anesthesiology, and Perioperative and Pain Medicine (R.C.T.), Boston Children's Hospital, Harvard Medical School, MA; Department of Child Neurology (I.S.F.), Hospital Sant Joan de Déu, Universidad de Barcelona, Spain; Facultad de Medicina (M.G.-L.), Universidad Austral de Chile, Valdivia; Divisions of Neurology (N.S.A.) and Critical Care Medicine (A.A.T.), The Children's Hospital of Philadelphia, The Perelman School of Medicine at the University of Pennsylvania, Philadelphia; Section of Neurology and Developmental Neuroscience (A.E.A., Y.-C.L., A.N., J.J.R.), Department of Pediatrics, Texas Children's Hospital, Baylor College of Medicine, Houston; Divisions of Neurology (R.A., K.P.) and Pediatric Neurology (T.A.G.), Cincinnati Children's Hospital Medical Center, OH; Department of Neurology and Pediatrics (J.N.B., H.P.G.), University of Virginia Health System, Charlottesville; Center for Neuroscience (J.L.C., W.D.G.), Children's National Medical Center, George Washington University School of Medicine and Health Sciences, Washington, DC; Departments of Pediatrics and Neurology (K.E.C.), Children's Hospital Colorado, University of Colorado School of Medicine, Aurora; Department of Pediatrics (T.A.G.), University of Cincinnati College of Medicine, OH; Ruth D. & Ken M. Davee Pediatric Neurocritical Care Program (J.L.G., M.S.W.), Northwestern University Feinberg School of Medicine, Chicago, IL; Division of Pediatric Neurology (A.R.H., M.A.M., D.T.), Duke University Medical Center, Duke University, Durham, NC; Division of Child Neurology (T.L.M.), Department of Neurology, Columbia University Medical Center, Columbia University, New York, NY; Barrow Neurological Institute (A.W., K.W.), Phoenix Children's Hospital, AZ; and Department of Pediatrics (A.W., K.W.), University of Arizona School of Medicine, Phoenix
| | - J Clark
- From the Division of Epilepsy and Clinical Neurophysiology, Department of Neurology (I.S.F., M.G.-L., J.C., M.C.J., K.K., T.L.), and Division of Critical Care, Departments of Neurology, Anesthesiology, and Perioperative and Pain Medicine (R.C.T.), Boston Children's Hospital, Harvard Medical School, MA; Department of Child Neurology (I.S.F.), Hospital Sant Joan de Déu, Universidad de Barcelona, Spain; Facultad de Medicina (M.G.-L.), Universidad Austral de Chile, Valdivia; Divisions of Neurology (N.S.A.) and Critical Care Medicine (A.A.T.), The Children's Hospital of Philadelphia, The Perelman School of Medicine at the University of Pennsylvania, Philadelphia; Section of Neurology and Developmental Neuroscience (A.E.A., Y.-C.L., A.N., J.J.R.), Department of Pediatrics, Texas Children's Hospital, Baylor College of Medicine, Houston; Divisions of Neurology (R.A., K.P.) and Pediatric Neurology (T.A.G.), Cincinnati Children's Hospital Medical Center, OH; Department of Neurology and Pediatrics (J.N.B., H.P.G.), University of Virginia Health System, Charlottesville; Center for Neuroscience (J.L.C., W.D.G.), Children's National Medical Center, George Washington University School of Medicine and Health Sciences, Washington, DC; Departments of Pediatrics and Neurology (K.E.C.), Children's Hospital Colorado, University of Colorado School of Medicine, Aurora; Department of Pediatrics (T.A.G.), University of Cincinnati College of Medicine, OH; Ruth D. & Ken M. Davee Pediatric Neurocritical Care Program (J.L.G., M.S.W.), Northwestern University Feinberg School of Medicine, Chicago, IL; Division of Pediatric Neurology (A.R.H., M.A.M., D.T.), Duke University Medical Center, Duke University, Durham, NC; Division of Child Neurology (T.L.M.), Department of Neurology, Columbia University Medical Center, Columbia University, New York, NY; Barrow Neurological Institute (A.W., K.W.), Phoenix Children's Hospital, AZ; and Department of Pediatrics (A.W., K.W.), University of Arizona School of Medicine, Phoenix
| | - W D Gaillard
- From the Division of Epilepsy and Clinical Neurophysiology, Department of Neurology (I.S.F., M.G.-L., J.C., M.C.J., K.K., T.L.), and Division of Critical Care, Departments of Neurology, Anesthesiology, and Perioperative and Pain Medicine (R.C.T.), Boston Children's Hospital, Harvard Medical School, MA; Department of Child Neurology (I.S.F.), Hospital Sant Joan de Déu, Universidad de Barcelona, Spain; Facultad de Medicina (M.G.-L.), Universidad Austral de Chile, Valdivia; Divisions of Neurology (N.S.A.) and Critical Care Medicine (A.A.T.), The Children's Hospital of Philadelphia, The Perelman School of Medicine at the University of Pennsylvania, Philadelphia; Section of Neurology and Developmental Neuroscience (A.E.A., Y.-C.L., A.N., J.J.R.), Department of Pediatrics, Texas Children's Hospital, Baylor College of Medicine, Houston; Divisions of Neurology (R.A., K.P.) and Pediatric Neurology (T.A.G.), Cincinnati Children's Hospital Medical Center, OH; Department of Neurology and Pediatrics (J.N.B., H.P.G.), University of Virginia Health System, Charlottesville; Center for Neuroscience (J.L.C., W.D.G.), Children's National Medical Center, George Washington University School of Medicine and Health Sciences, Washington, DC; Departments of Pediatrics and Neurology (K.E.C.), Children's Hospital Colorado, University of Colorado School of Medicine, Aurora; Department of Pediatrics (T.A.G.), University of Cincinnati College of Medicine, OH; Ruth D. & Ken M. Davee Pediatric Neurocritical Care Program (J.L.G., M.S.W.), Northwestern University Feinberg School of Medicine, Chicago, IL; Division of Pediatric Neurology (A.R.H., M.A.M., D.T.), Duke University Medical Center, Duke University, Durham, NC; Division of Child Neurology (T.L.M.), Department of Neurology, Columbia University Medical Center, Columbia University, New York, NY; Barrow Neurological Institute (A.W., K.W.), Phoenix Children's Hospital, AZ; and Department of Pediatrics (A.W., K.W.), University of Arizona School of Medicine, Phoenix
| | - T A Glauser
- From the Division of Epilepsy and Clinical Neurophysiology, Department of Neurology (I.S.F., M.G.-L., J.C., M.C.J., K.K., T.L.), and Division of Critical Care, Departments of Neurology, Anesthesiology, and Perioperative and Pain Medicine (R.C.T.), Boston Children's Hospital, Harvard Medical School, MA; Department of Child Neurology (I.S.F.), Hospital Sant Joan de Déu, Universidad de Barcelona, Spain; Facultad de Medicina (M.G.-L.), Universidad Austral de Chile, Valdivia; Divisions of Neurology (N.S.A.) and Critical Care Medicine (A.A.T.), The Children's Hospital of Philadelphia, The Perelman School of Medicine at the University of Pennsylvania, Philadelphia; Section of Neurology and Developmental Neuroscience (A.E.A., Y.-C.L., A.N., J.J.R.), Department of Pediatrics, Texas Children's Hospital, Baylor College of Medicine, Houston; Divisions of Neurology (R.A., K.P.) and Pediatric Neurology (T.A.G.), Cincinnati Children's Hospital Medical Center, OH; Department of Neurology and Pediatrics (J.N.B., H.P.G.), University of Virginia Health System, Charlottesville; Center for Neuroscience (J.L.C., W.D.G.), Children's National Medical Center, George Washington University School of Medicine and Health Sciences, Washington, DC; Departments of Pediatrics and Neurology (K.E.C.), Children's Hospital Colorado, University of Colorado School of Medicine, Aurora; Department of Pediatrics (T.A.G.), University of Cincinnati College of Medicine, OH; Ruth D. & Ken M. Davee Pediatric Neurocritical Care Program (J.L.G., M.S.W.), Northwestern University Feinberg School of Medicine, Chicago, IL; Division of Pediatric Neurology (A.R.H., M.A.M., D.T.), Duke University Medical Center, Duke University, Durham, NC; Division of Child Neurology (T.L.M.), Department of Neurology, Columbia University Medical Center, Columbia University, New York, NY; Barrow Neurological Institute (A.W., K.W.), Phoenix Children's Hospital, AZ; and Department of Pediatrics (A.W., K.W.), University of Arizona School of Medicine, Phoenix
| | - J L Goldstein
- From the Division of Epilepsy and Clinical Neurophysiology, Department of Neurology (I.S.F., M.G.-L., J.C., M.C.J., K.K., T.L.), and Division of Critical Care, Departments of Neurology, Anesthesiology, and Perioperative and Pain Medicine (R.C.T.), Boston Children's Hospital, Harvard Medical School, MA; Department of Child Neurology (I.S.F.), Hospital Sant Joan de Déu, Universidad de Barcelona, Spain; Facultad de Medicina (M.G.-L.), Universidad Austral de Chile, Valdivia; Divisions of Neurology (N.S.A.) and Critical Care Medicine (A.A.T.), The Children's Hospital of Philadelphia, The Perelman School of Medicine at the University of Pennsylvania, Philadelphia; Section of Neurology and Developmental Neuroscience (A.E.A., Y.-C.L., A.N., J.J.R.), Department of Pediatrics, Texas Children's Hospital, Baylor College of Medicine, Houston; Divisions of Neurology (R.A., K.P.) and Pediatric Neurology (T.A.G.), Cincinnati Children's Hospital Medical Center, OH; Department of Neurology and Pediatrics (J.N.B., H.P.G.), University of Virginia Health System, Charlottesville; Center for Neuroscience (J.L.C., W.D.G.), Children's National Medical Center, George Washington University School of Medicine and Health Sciences, Washington, DC; Departments of Pediatrics and Neurology (K.E.C.), Children's Hospital Colorado, University of Colorado School of Medicine, Aurora; Department of Pediatrics (T.A.G.), University of Cincinnati College of Medicine, OH; Ruth D. & Ken M. Davee Pediatric Neurocritical Care Program (J.L.G., M.S.W.), Northwestern University Feinberg School of Medicine, Chicago, IL; Division of Pediatric Neurology (A.R.H., M.A.M., D.T.), Duke University Medical Center, Duke University, Durham, NC; Division of Child Neurology (T.L.M.), Department of Neurology, Columbia University Medical Center, Columbia University, New York, NY; Barrow Neurological Institute (A.W., K.W.), Phoenix Children's Hospital, AZ; and Department of Pediatrics (A.W., K.W.), University of Arizona School of Medicine, Phoenix
| | - H P Goodkin
- From the Division of Epilepsy and Clinical Neurophysiology, Department of Neurology (I.S.F., M.G.-L., J.C., M.C.J., K.K., T.L.), and Division of Critical Care, Departments of Neurology, Anesthesiology, and Perioperative and Pain Medicine (R.C.T.), Boston Children's Hospital, Harvard Medical School, MA; Department of Child Neurology (I.S.F.), Hospital Sant Joan de Déu, Universidad de Barcelona, Spain; Facultad de Medicina (M.G.-L.), Universidad Austral de Chile, Valdivia; Divisions of Neurology (N.S.A.) and Critical Care Medicine (A.A.T.), The Children's Hospital of Philadelphia, The Perelman School of Medicine at the University of Pennsylvania, Philadelphia; Section of Neurology and Developmental Neuroscience (A.E.A., Y.-C.L., A.N., J.J.R.), Department of Pediatrics, Texas Children's Hospital, Baylor College of Medicine, Houston; Divisions of Neurology (R.A., K.P.) and Pediatric Neurology (T.A.G.), Cincinnati Children's Hospital Medical Center, OH; Department of Neurology and Pediatrics (J.N.B., H.P.G.), University of Virginia Health System, Charlottesville; Center for Neuroscience (J.L.C., W.D.G.), Children's National Medical Center, George Washington University School of Medicine and Health Sciences, Washington, DC; Departments of Pediatrics and Neurology (K.E.C.), Children's Hospital Colorado, University of Colorado School of Medicine, Aurora; Department of Pediatrics (T.A.G.), University of Cincinnati College of Medicine, OH; Ruth D. & Ken M. Davee Pediatric Neurocritical Care Program (J.L.G., M.S.W.), Northwestern University Feinberg School of Medicine, Chicago, IL; Division of Pediatric Neurology (A.R.H., M.A.M., D.T.), Duke University Medical Center, Duke University, Durham, NC; Division of Child Neurology (T.L.M.), Department of Neurology, Columbia University Medical Center, Columbia University, New York, NY; Barrow Neurological Institute (A.W., K.W.), Phoenix Children's Hospital, AZ; and Department of Pediatrics (A.W., K.W.), University of Arizona School of Medicine, Phoenix
| | - A R Helseth
- From the Division of Epilepsy and Clinical Neurophysiology, Department of Neurology (I.S.F., M.G.-L., J.C., M.C.J., K.K., T.L.), and Division of Critical Care, Departments of Neurology, Anesthesiology, and Perioperative and Pain Medicine (R.C.T.), Boston Children's Hospital, Harvard Medical School, MA; Department of Child Neurology (I.S.F.), Hospital Sant Joan de Déu, Universidad de Barcelona, Spain; Facultad de Medicina (M.G.-L.), Universidad Austral de Chile, Valdivia; Divisions of Neurology (N.S.A.) and Critical Care Medicine (A.A.T.), The Children's Hospital of Philadelphia, The Perelman School of Medicine at the University of Pennsylvania, Philadelphia; Section of Neurology and Developmental Neuroscience (A.E.A., Y.-C.L., A.N., J.J.R.), Department of Pediatrics, Texas Children's Hospital, Baylor College of Medicine, Houston; Divisions of Neurology (R.A., K.P.) and Pediatric Neurology (T.A.G.), Cincinnati Children's Hospital Medical Center, OH; Department of Neurology and Pediatrics (J.N.B., H.P.G.), University of Virginia Health System, Charlottesville; Center for Neuroscience (J.L.C., W.D.G.), Children's National Medical Center, George Washington University School of Medicine and Health Sciences, Washington, DC; Departments of Pediatrics and Neurology (K.E.C.), Children's Hospital Colorado, University of Colorado School of Medicine, Aurora; Department of Pediatrics (T.A.G.), University of Cincinnati College of Medicine, OH; Ruth D. & Ken M. Davee Pediatric Neurocritical Care Program (J.L.G., M.S.W.), Northwestern University Feinberg School of Medicine, Chicago, IL; Division of Pediatric Neurology (A.R.H., M.A.M., D.T.), Duke University Medical Center, Duke University, Durham, NC; Division of Child Neurology (T.L.M.), Department of Neurology, Columbia University Medical Center, Columbia University, New York, NY; Barrow Neurological Institute (A.W., K.W.), Phoenix Children's Hospital, AZ; and Department of Pediatrics (A.W., K.W.), University of Arizona School of Medicine, Phoenix
| | - M C Jackson
- From the Division of Epilepsy and Clinical Neurophysiology, Department of Neurology (I.S.F., M.G.-L., J.C., M.C.J., K.K., T.L.), and Division of Critical Care, Departments of Neurology, Anesthesiology, and Perioperative and Pain Medicine (R.C.T.), Boston Children's Hospital, Harvard Medical School, MA; Department of Child Neurology (I.S.F.), Hospital Sant Joan de Déu, Universidad de Barcelona, Spain; Facultad de Medicina (M.G.-L.), Universidad Austral de Chile, Valdivia; Divisions of Neurology (N.S.A.) and Critical Care Medicine (A.A.T.), The Children's Hospital of Philadelphia, The Perelman School of Medicine at the University of Pennsylvania, Philadelphia; Section of Neurology and Developmental Neuroscience (A.E.A., Y.-C.L., A.N., J.J.R.), Department of Pediatrics, Texas Children's Hospital, Baylor College of Medicine, Houston; Divisions of Neurology (R.A., K.P.) and Pediatric Neurology (T.A.G.), Cincinnati Children's Hospital Medical Center, OH; Department of Neurology and Pediatrics (J.N.B., H.P.G.), University of Virginia Health System, Charlottesville; Center for Neuroscience (J.L.C., W.D.G.), Children's National Medical Center, George Washington University School of Medicine and Health Sciences, Washington, DC; Departments of Pediatrics and Neurology (K.E.C.), Children's Hospital Colorado, University of Colorado School of Medicine, Aurora; Department of Pediatrics (T.A.G.), University of Cincinnati College of Medicine, OH; Ruth D. & Ken M. Davee Pediatric Neurocritical Care Program (J.L.G., M.S.W.), Northwestern University Feinberg School of Medicine, Chicago, IL; Division of Pediatric Neurology (A.R.H., M.A.M., D.T.), Duke University Medical Center, Duke University, Durham, NC; Division of Child Neurology (T.L.M.), Department of Neurology, Columbia University Medical Center, Columbia University, New York, NY; Barrow Neurological Institute (A.W., K.W.), Phoenix Children's Hospital, AZ; and Department of Pediatrics (A.W., K.W.), University of Arizona School of Medicine, Phoenix
| | - K Kapur
- From the Division of Epilepsy and Clinical Neurophysiology, Department of Neurology (I.S.F., M.G.-L., J.C., M.C.J., K.K., T.L.), and Division of Critical Care, Departments of Neurology, Anesthesiology, and Perioperative and Pain Medicine (R.C.T.), Boston Children's Hospital, Harvard Medical School, MA; Department of Child Neurology (I.S.F.), Hospital Sant Joan de Déu, Universidad de Barcelona, Spain; Facultad de Medicina (M.G.-L.), Universidad Austral de Chile, Valdivia; Divisions of Neurology (N.S.A.) and Critical Care Medicine (A.A.T.), The Children's Hospital of Philadelphia, The Perelman School of Medicine at the University of Pennsylvania, Philadelphia; Section of Neurology and Developmental Neuroscience (A.E.A., Y.-C.L., A.N., J.J.R.), Department of Pediatrics, Texas Children's Hospital, Baylor College of Medicine, Houston; Divisions of Neurology (R.A., K.P.) and Pediatric Neurology (T.A.G.), Cincinnati Children's Hospital Medical Center, OH; Department of Neurology and Pediatrics (J.N.B., H.P.G.), University of Virginia Health System, Charlottesville; Center for Neuroscience (J.L.C., W.D.G.), Children's National Medical Center, George Washington University School of Medicine and Health Sciences, Washington, DC; Departments of Pediatrics and Neurology (K.E.C.), Children's Hospital Colorado, University of Colorado School of Medicine, Aurora; Department of Pediatrics (T.A.G.), University of Cincinnati College of Medicine, OH; Ruth D. & Ken M. Davee Pediatric Neurocritical Care Program (J.L.G., M.S.W.), Northwestern University Feinberg School of Medicine, Chicago, IL; Division of Pediatric Neurology (A.R.H., M.A.M., D.T.), Duke University Medical Center, Duke University, Durham, NC; Division of Child Neurology (T.L.M.), Department of Neurology, Columbia University Medical Center, Columbia University, New York, NY; Barrow Neurological Institute (A.W., K.W.), Phoenix Children's Hospital, AZ; and Department of Pediatrics (A.W., K.W.), University of Arizona School of Medicine, Phoenix
| | - Y-C Lai
- From the Division of Epilepsy and Clinical Neurophysiology, Department of Neurology (I.S.F., M.G.-L., J.C., M.C.J., K.K., T.L.), and Division of Critical Care, Departments of Neurology, Anesthesiology, and Perioperative and Pain Medicine (R.C.T.), Boston Children's Hospital, Harvard Medical School, MA; Department of Child Neurology (I.S.F.), Hospital Sant Joan de Déu, Universidad de Barcelona, Spain; Facultad de Medicina (M.G.-L.), Universidad Austral de Chile, Valdivia; Divisions of Neurology (N.S.A.) and Critical Care Medicine (A.A.T.), The Children's Hospital of Philadelphia, The Perelman School of Medicine at the University of Pennsylvania, Philadelphia; Section of Neurology and Developmental Neuroscience (A.E.A., Y.-C.L., A.N., J.J.R.), Department of Pediatrics, Texas Children's Hospital, Baylor College of Medicine, Houston; Divisions of Neurology (R.A., K.P.) and Pediatric Neurology (T.A.G.), Cincinnati Children's Hospital Medical Center, OH; Department of Neurology and Pediatrics (J.N.B., H.P.G.), University of Virginia Health System, Charlottesville; Center for Neuroscience (J.L.C., W.D.G.), Children's National Medical Center, George Washington University School of Medicine and Health Sciences, Washington, DC; Departments of Pediatrics and Neurology (K.E.C.), Children's Hospital Colorado, University of Colorado School of Medicine, Aurora; Department of Pediatrics (T.A.G.), University of Cincinnati College of Medicine, OH; Ruth D. & Ken M. Davee Pediatric Neurocritical Care Program (J.L.G., M.S.W.), Northwestern University Feinberg School of Medicine, Chicago, IL; Division of Pediatric Neurology (A.R.H., M.A.M., D.T.), Duke University Medical Center, Duke University, Durham, NC; Division of Child Neurology (T.L.M.), Department of Neurology, Columbia University Medical Center, Columbia University, New York, NY; Barrow Neurological Institute (A.W., K.W.), Phoenix Children's Hospital, AZ; and Department of Pediatrics (A.W., K.W.), University of Arizona School of Medicine, Phoenix
| | - T L McDonough
- From the Division of Epilepsy and Clinical Neurophysiology, Department of Neurology (I.S.F., M.G.-L., J.C., M.C.J., K.K., T.L.), and Division of Critical Care, Departments of Neurology, Anesthesiology, and Perioperative and Pain Medicine (R.C.T.), Boston Children's Hospital, Harvard Medical School, MA; Department of Child Neurology (I.S.F.), Hospital Sant Joan de Déu, Universidad de Barcelona, Spain; Facultad de Medicina (M.G.-L.), Universidad Austral de Chile, Valdivia; Divisions of Neurology (N.S.A.) and Critical Care Medicine (A.A.T.), The Children's Hospital of Philadelphia, The Perelman School of Medicine at the University of Pennsylvania, Philadelphia; Section of Neurology and Developmental Neuroscience (A.E.A., Y.-C.L., A.N., J.J.R.), Department of Pediatrics, Texas Children's Hospital, Baylor College of Medicine, Houston; Divisions of Neurology (R.A., K.P.) and Pediatric Neurology (T.A.G.), Cincinnati Children's Hospital Medical Center, OH; Department of Neurology and Pediatrics (J.N.B., H.P.G.), University of Virginia Health System, Charlottesville; Center for Neuroscience (J.L.C., W.D.G.), Children's National Medical Center, George Washington University School of Medicine and Health Sciences, Washington, DC; Departments of Pediatrics and Neurology (K.E.C.), Children's Hospital Colorado, University of Colorado School of Medicine, Aurora; Department of Pediatrics (T.A.G.), University of Cincinnati College of Medicine, OH; Ruth D. & Ken M. Davee Pediatric Neurocritical Care Program (J.L.G., M.S.W.), Northwestern University Feinberg School of Medicine, Chicago, IL; Division of Pediatric Neurology (A.R.H., M.A.M., D.T.), Duke University Medical Center, Duke University, Durham, NC; Division of Child Neurology (T.L.M.), Department of Neurology, Columbia University Medical Center, Columbia University, New York, NY; Barrow Neurological Institute (A.W., K.W.), Phoenix Children's Hospital, AZ; and Department of Pediatrics (A.W., K.W.), University of Arizona School of Medicine, Phoenix
| | - M A Mikati
- From the Division of Epilepsy and Clinical Neurophysiology, Department of Neurology (I.S.F., M.G.-L., J.C., M.C.J., K.K., T.L.), and Division of Critical Care, Departments of Neurology, Anesthesiology, and Perioperative and Pain Medicine (R.C.T.), Boston Children's Hospital, Harvard Medical School, MA; Department of Child Neurology (I.S.F.), Hospital Sant Joan de Déu, Universidad de Barcelona, Spain; Facultad de Medicina (M.G.-L.), Universidad Austral de Chile, Valdivia; Divisions of Neurology (N.S.A.) and Critical Care Medicine (A.A.T.), The Children's Hospital of Philadelphia, The Perelman School of Medicine at the University of Pennsylvania, Philadelphia; Section of Neurology and Developmental Neuroscience (A.E.A., Y.-C.L., A.N., J.J.R.), Department of Pediatrics, Texas Children's Hospital, Baylor College of Medicine, Houston; Divisions of Neurology (R.A., K.P.) and Pediatric Neurology (T.A.G.), Cincinnati Children's Hospital Medical Center, OH; Department of Neurology and Pediatrics (J.N.B., H.P.G.), University of Virginia Health System, Charlottesville; Center for Neuroscience (J.L.C., W.D.G.), Children's National Medical Center, George Washington University School of Medicine and Health Sciences, Washington, DC; Departments of Pediatrics and Neurology (K.E.C.), Children's Hospital Colorado, University of Colorado School of Medicine, Aurora; Department of Pediatrics (T.A.G.), University of Cincinnati College of Medicine, OH; Ruth D. & Ken M. Davee Pediatric Neurocritical Care Program (J.L.G., M.S.W.), Northwestern University Feinberg School of Medicine, Chicago, IL; Division of Pediatric Neurology (A.R.H., M.A.M., D.T.), Duke University Medical Center, Duke University, Durham, NC; Division of Child Neurology (T.L.M.), Department of Neurology, Columbia University Medical Center, Columbia University, New York, NY; Barrow Neurological Institute (A.W., K.W.), Phoenix Children's Hospital, AZ; and Department of Pediatrics (A.W., K.W.), University of Arizona School of Medicine, Phoenix
| | - A Nayak
- From the Division of Epilepsy and Clinical Neurophysiology, Department of Neurology (I.S.F., M.G.-L., J.C., M.C.J., K.K., T.L.), and Division of Critical Care, Departments of Neurology, Anesthesiology, and Perioperative and Pain Medicine (R.C.T.), Boston Children's Hospital, Harvard Medical School, MA; Department of Child Neurology (I.S.F.), Hospital Sant Joan de Déu, Universidad de Barcelona, Spain; Facultad de Medicina (M.G.-L.), Universidad Austral de Chile, Valdivia; Divisions of Neurology (N.S.A.) and Critical Care Medicine (A.A.T.), The Children's Hospital of Philadelphia, The Perelman School of Medicine at the University of Pennsylvania, Philadelphia; Section of Neurology and Developmental Neuroscience (A.E.A., Y.-C.L., A.N., J.J.R.), Department of Pediatrics, Texas Children's Hospital, Baylor College of Medicine, Houston; Divisions of Neurology (R.A., K.P.) and Pediatric Neurology (T.A.G.), Cincinnati Children's Hospital Medical Center, OH; Department of Neurology and Pediatrics (J.N.B., H.P.G.), University of Virginia Health System, Charlottesville; Center for Neuroscience (J.L.C., W.D.G.), Children's National Medical Center, George Washington University School of Medicine and Health Sciences, Washington, DC; Departments of Pediatrics and Neurology (K.E.C.), Children's Hospital Colorado, University of Colorado School of Medicine, Aurora; Department of Pediatrics (T.A.G.), University of Cincinnati College of Medicine, OH; Ruth D. & Ken M. Davee Pediatric Neurocritical Care Program (J.L.G., M.S.W.), Northwestern University Feinberg School of Medicine, Chicago, IL; Division of Pediatric Neurology (A.R.H., M.A.M., D.T.), Duke University Medical Center, Duke University, Durham, NC; Division of Child Neurology (T.L.M.), Department of Neurology, Columbia University Medical Center, Columbia University, New York, NY; Barrow Neurological Institute (A.W., K.W.), Phoenix Children's Hospital, AZ; and Department of Pediatrics (A.W., K.W.), University of Arizona School of Medicine, Phoenix
| | - K Peariso
- From the Division of Epilepsy and Clinical Neurophysiology, Department of Neurology (I.S.F., M.G.-L., J.C., M.C.J., K.K., T.L.), and Division of Critical Care, Departments of Neurology, Anesthesiology, and Perioperative and Pain Medicine (R.C.T.), Boston Children's Hospital, Harvard Medical School, MA; Department of Child Neurology (I.S.F.), Hospital Sant Joan de Déu, Universidad de Barcelona, Spain; Facultad de Medicina (M.G.-L.), Universidad Austral de Chile, Valdivia; Divisions of Neurology (N.S.A.) and Critical Care Medicine (A.A.T.), The Children's Hospital of Philadelphia, The Perelman School of Medicine at the University of Pennsylvania, Philadelphia; Section of Neurology and Developmental Neuroscience (A.E.A., Y.-C.L., A.N., J.J.R.), Department of Pediatrics, Texas Children's Hospital, Baylor College of Medicine, Houston; Divisions of Neurology (R.A., K.P.) and Pediatric Neurology (T.A.G.), Cincinnati Children's Hospital Medical Center, OH; Department of Neurology and Pediatrics (J.N.B., H.P.G.), University of Virginia Health System, Charlottesville; Center for Neuroscience (J.L.C., W.D.G.), Children's National Medical Center, George Washington University School of Medicine and Health Sciences, Washington, DC; Departments of Pediatrics and Neurology (K.E.C.), Children's Hospital Colorado, University of Colorado School of Medicine, Aurora; Department of Pediatrics (T.A.G.), University of Cincinnati College of Medicine, OH; Ruth D. & Ken M. Davee Pediatric Neurocritical Care Program (J.L.G., M.S.W.), Northwestern University Feinberg School of Medicine, Chicago, IL; Division of Pediatric Neurology (A.R.H., M.A.M., D.T.), Duke University Medical Center, Duke University, Durham, NC; Division of Child Neurology (T.L.M.), Department of Neurology, Columbia University Medical Center, Columbia University, New York, NY; Barrow Neurological Institute (A.W., K.W.), Phoenix Children's Hospital, AZ; and Department of Pediatrics (A.W., K.W.), University of Arizona School of Medicine, Phoenix
| | - J J Riviello
- From the Division of Epilepsy and Clinical Neurophysiology, Department of Neurology (I.S.F., M.G.-L., J.C., M.C.J., K.K., T.L.), and Division of Critical Care, Departments of Neurology, Anesthesiology, and Perioperative and Pain Medicine (R.C.T.), Boston Children's Hospital, Harvard Medical School, MA; Department of Child Neurology (I.S.F.), Hospital Sant Joan de Déu, Universidad de Barcelona, Spain; Facultad de Medicina (M.G.-L.), Universidad Austral de Chile, Valdivia; Divisions of Neurology (N.S.A.) and Critical Care Medicine (A.A.T.), The Children's Hospital of Philadelphia, The Perelman School of Medicine at the University of Pennsylvania, Philadelphia; Section of Neurology and Developmental Neuroscience (A.E.A., Y.-C.L., A.N., J.J.R.), Department of Pediatrics, Texas Children's Hospital, Baylor College of Medicine, Houston; Divisions of Neurology (R.A., K.P.) and Pediatric Neurology (T.A.G.), Cincinnati Children's Hospital Medical Center, OH; Department of Neurology and Pediatrics (J.N.B., H.P.G.), University of Virginia Health System, Charlottesville; Center for Neuroscience (J.L.C., W.D.G.), Children's National Medical Center, George Washington University School of Medicine and Health Sciences, Washington, DC; Departments of Pediatrics and Neurology (K.E.C.), Children's Hospital Colorado, University of Colorado School of Medicine, Aurora; Department of Pediatrics (T.A.G.), University of Cincinnati College of Medicine, OH; Ruth D. & Ken M. Davee Pediatric Neurocritical Care Program (J.L.G., M.S.W.), Northwestern University Feinberg School of Medicine, Chicago, IL; Division of Pediatric Neurology (A.R.H., M.A.M., D.T.), Duke University Medical Center, Duke University, Durham, NC; Division of Child Neurology (T.L.M.), Department of Neurology, Columbia University Medical Center, Columbia University, New York, NY; Barrow Neurological Institute (A.W., K.W.), Phoenix Children's Hospital, AZ; and Department of Pediatrics (A.W., K.W.), University of Arizona School of Medicine, Phoenix
| | - R C Tasker
- From the Division of Epilepsy and Clinical Neurophysiology, Department of Neurology (I.S.F., M.G.-L., J.C., M.C.J., K.K., T.L.), and Division of Critical Care, Departments of Neurology, Anesthesiology, and Perioperative and Pain Medicine (R.C.T.), Boston Children's Hospital, Harvard Medical School, MA; Department of Child Neurology (I.S.F.), Hospital Sant Joan de Déu, Universidad de Barcelona, Spain; Facultad de Medicina (M.G.-L.), Universidad Austral de Chile, Valdivia; Divisions of Neurology (N.S.A.) and Critical Care Medicine (A.A.T.), The Children's Hospital of Philadelphia, The Perelman School of Medicine at the University of Pennsylvania, Philadelphia; Section of Neurology and Developmental Neuroscience (A.E.A., Y.-C.L., A.N., J.J.R.), Department of Pediatrics, Texas Children's Hospital, Baylor College of Medicine, Houston; Divisions of Neurology (R.A., K.P.) and Pediatric Neurology (T.A.G.), Cincinnati Children's Hospital Medical Center, OH; Department of Neurology and Pediatrics (J.N.B., H.P.G.), University of Virginia Health System, Charlottesville; Center for Neuroscience (J.L.C., W.D.G.), Children's National Medical Center, George Washington University School of Medicine and Health Sciences, Washington, DC; Departments of Pediatrics and Neurology (K.E.C.), Children's Hospital Colorado, University of Colorado School of Medicine, Aurora; Department of Pediatrics (T.A.G.), University of Cincinnati College of Medicine, OH; Ruth D. & Ken M. Davee Pediatric Neurocritical Care Program (J.L.G., M.S.W.), Northwestern University Feinberg School of Medicine, Chicago, IL; Division of Pediatric Neurology (A.R.H., M.A.M., D.T.), Duke University Medical Center, Duke University, Durham, NC; Division of Child Neurology (T.L.M.), Department of Neurology, Columbia University Medical Center, Columbia University, New York, NY; Barrow Neurological Institute (A.W., K.W.), Phoenix Children's Hospital, AZ; and Department of Pediatrics (A.W., K.W.), University of Arizona School of Medicine, Phoenix
| | - D Tchapyjnikov
- From the Division of Epilepsy and Clinical Neurophysiology, Department of Neurology (I.S.F., M.G.-L., J.C., M.C.J., K.K., T.L.), and Division of Critical Care, Departments of Neurology, Anesthesiology, and Perioperative and Pain Medicine (R.C.T.), Boston Children's Hospital, Harvard Medical School, MA; Department of Child Neurology (I.S.F.), Hospital Sant Joan de Déu, Universidad de Barcelona, Spain; Facultad de Medicina (M.G.-L.), Universidad Austral de Chile, Valdivia; Divisions of Neurology (N.S.A.) and Critical Care Medicine (A.A.T.), The Children's Hospital of Philadelphia, The Perelman School of Medicine at the University of Pennsylvania, Philadelphia; Section of Neurology and Developmental Neuroscience (A.E.A., Y.-C.L., A.N., J.J.R.), Department of Pediatrics, Texas Children's Hospital, Baylor College of Medicine, Houston; Divisions of Neurology (R.A., K.P.) and Pediatric Neurology (T.A.G.), Cincinnati Children's Hospital Medical Center, OH; Department of Neurology and Pediatrics (J.N.B., H.P.G.), University of Virginia Health System, Charlottesville; Center for Neuroscience (J.L.C., W.D.G.), Children's National Medical Center, George Washington University School of Medicine and Health Sciences, Washington, DC; Departments of Pediatrics and Neurology (K.E.C.), Children's Hospital Colorado, University of Colorado School of Medicine, Aurora; Department of Pediatrics (T.A.G.), University of Cincinnati College of Medicine, OH; Ruth D. & Ken M. Davee Pediatric Neurocritical Care Program (J.L.G., M.S.W.), Northwestern University Feinberg School of Medicine, Chicago, IL; Division of Pediatric Neurology (A.R.H., M.A.M., D.T.), Duke University Medical Center, Duke University, Durham, NC; Division of Child Neurology (T.L.M.), Department of Neurology, Columbia University Medical Center, Columbia University, New York, NY; Barrow Neurological Institute (A.W., K.W.), Phoenix Children's Hospital, AZ; and Department of Pediatrics (A.W., K.W.), University of Arizona School of Medicine, Phoenix
| | - A A Topjian
- From the Division of Epilepsy and Clinical Neurophysiology, Department of Neurology (I.S.F., M.G.-L., J.C., M.C.J., K.K., T.L.), and Division of Critical Care, Departments of Neurology, Anesthesiology, and Perioperative and Pain Medicine (R.C.T.), Boston Children's Hospital, Harvard Medical School, MA; Department of Child Neurology (I.S.F.), Hospital Sant Joan de Déu, Universidad de Barcelona, Spain; Facultad de Medicina (M.G.-L.), Universidad Austral de Chile, Valdivia; Divisions of Neurology (N.S.A.) and Critical Care Medicine (A.A.T.), The Children's Hospital of Philadelphia, The Perelman School of Medicine at the University of Pennsylvania, Philadelphia; Section of Neurology and Developmental Neuroscience (A.E.A., Y.-C.L., A.N., J.J.R.), Department of Pediatrics, Texas Children's Hospital, Baylor College of Medicine, Houston; Divisions of Neurology (R.A., K.P.) and Pediatric Neurology (T.A.G.), Cincinnati Children's Hospital Medical Center, OH; Department of Neurology and Pediatrics (J.N.B., H.P.G.), University of Virginia Health System, Charlottesville; Center for Neuroscience (J.L.C., W.D.G.), Children's National Medical Center, George Washington University School of Medicine and Health Sciences, Washington, DC; Departments of Pediatrics and Neurology (K.E.C.), Children's Hospital Colorado, University of Colorado School of Medicine, Aurora; Department of Pediatrics (T.A.G.), University of Cincinnati College of Medicine, OH; Ruth D. & Ken M. Davee Pediatric Neurocritical Care Program (J.L.G., M.S.W.), Northwestern University Feinberg School of Medicine, Chicago, IL; Division of Pediatric Neurology (A.R.H., M.A.M., D.T.), Duke University Medical Center, Duke University, Durham, NC; Division of Child Neurology (T.L.M.), Department of Neurology, Columbia University Medical Center, Columbia University, New York, NY; Barrow Neurological Institute (A.W., K.W.), Phoenix Children's Hospital, AZ; and Department of Pediatrics (A.W., K.W.), University of Arizona School of Medicine, Phoenix
| | - M S Wainwright
- From the Division of Epilepsy and Clinical Neurophysiology, Department of Neurology (I.S.F., M.G.-L., J.C., M.C.J., K.K., T.L.), and Division of Critical Care, Departments of Neurology, Anesthesiology, and Perioperative and Pain Medicine (R.C.T.), Boston Children's Hospital, Harvard Medical School, MA; Department of Child Neurology (I.S.F.), Hospital Sant Joan de Déu, Universidad de Barcelona, Spain; Facultad de Medicina (M.G.-L.), Universidad Austral de Chile, Valdivia; Divisions of Neurology (N.S.A.) and Critical Care Medicine (A.A.T.), The Children's Hospital of Philadelphia, The Perelman School of Medicine at the University of Pennsylvania, Philadelphia; Section of Neurology and Developmental Neuroscience (A.E.A., Y.-C.L., A.N., J.J.R.), Department of Pediatrics, Texas Children's Hospital, Baylor College of Medicine, Houston; Divisions of Neurology (R.A., K.P.) and Pediatric Neurology (T.A.G.), Cincinnati Children's Hospital Medical Center, OH; Department of Neurology and Pediatrics (J.N.B., H.P.G.), University of Virginia Health System, Charlottesville; Center for Neuroscience (J.L.C., W.D.G.), Children's National Medical Center, George Washington University School of Medicine and Health Sciences, Washington, DC; Departments of Pediatrics and Neurology (K.E.C.), Children's Hospital Colorado, University of Colorado School of Medicine, Aurora; Department of Pediatrics (T.A.G.), University of Cincinnati College of Medicine, OH; Ruth D. & Ken M. Davee Pediatric Neurocritical Care Program (J.L.G., M.S.W.), Northwestern University Feinberg School of Medicine, Chicago, IL; Division of Pediatric Neurology (A.R.H., M.A.M., D.T.), Duke University Medical Center, Duke University, Durham, NC; Division of Child Neurology (T.L.M.), Department of Neurology, Columbia University Medical Center, Columbia University, New York, NY; Barrow Neurological Institute (A.W., K.W.), Phoenix Children's Hospital, AZ; and Department of Pediatrics (A.W., K.W.), University of Arizona School of Medicine, Phoenix
| | - A Wilfong
- From the Division of Epilepsy and Clinical Neurophysiology, Department of Neurology (I.S.F., M.G.-L., J.C., M.C.J., K.K., T.L.), and Division of Critical Care, Departments of Neurology, Anesthesiology, and Perioperative and Pain Medicine (R.C.T.), Boston Children's Hospital, Harvard Medical School, MA; Department of Child Neurology (I.S.F.), Hospital Sant Joan de Déu, Universidad de Barcelona, Spain; Facultad de Medicina (M.G.-L.), Universidad Austral de Chile, Valdivia; Divisions of Neurology (N.S.A.) and Critical Care Medicine (A.A.T.), The Children's Hospital of Philadelphia, The Perelman School of Medicine at the University of Pennsylvania, Philadelphia; Section of Neurology and Developmental Neuroscience (A.E.A., Y.-C.L., A.N., J.J.R.), Department of Pediatrics, Texas Children's Hospital, Baylor College of Medicine, Houston; Divisions of Neurology (R.A., K.P.) and Pediatric Neurology (T.A.G.), Cincinnati Children's Hospital Medical Center, OH; Department of Neurology and Pediatrics (J.N.B., H.P.G.), University of Virginia Health System, Charlottesville; Center for Neuroscience (J.L.C., W.D.G.), Children's National Medical Center, George Washington University School of Medicine and Health Sciences, Washington, DC; Departments of Pediatrics and Neurology (K.E.C.), Children's Hospital Colorado, University of Colorado School of Medicine, Aurora; Department of Pediatrics (T.A.G.), University of Cincinnati College of Medicine, OH; Ruth D. & Ken M. Davee Pediatric Neurocritical Care Program (J.L.G., M.S.W.), Northwestern University Feinberg School of Medicine, Chicago, IL; Division of Pediatric Neurology (A.R.H., M.A.M., D.T.), Duke University Medical Center, Duke University, Durham, NC; Division of Child Neurology (T.L.M.), Department of Neurology, Columbia University Medical Center, Columbia University, New York, NY; Barrow Neurological Institute (A.W., K.W.), Phoenix Children's Hospital, AZ; and Department of Pediatrics (A.W., K.W.), University of Arizona School of Medicine, Phoenix
| | - K Williams
- From the Division of Epilepsy and Clinical Neurophysiology, Department of Neurology (I.S.F., M.G.-L., J.C., M.C.J., K.K., T.L.), and Division of Critical Care, Departments of Neurology, Anesthesiology, and Perioperative and Pain Medicine (R.C.T.), Boston Children's Hospital, Harvard Medical School, MA; Department of Child Neurology (I.S.F.), Hospital Sant Joan de Déu, Universidad de Barcelona, Spain; Facultad de Medicina (M.G.-L.), Universidad Austral de Chile, Valdivia; Divisions of Neurology (N.S.A.) and Critical Care Medicine (A.A.T.), The Children's Hospital of Philadelphia, The Perelman School of Medicine at the University of Pennsylvania, Philadelphia; Section of Neurology and Developmental Neuroscience (A.E.A., Y.-C.L., A.N., J.J.R.), Department of Pediatrics, Texas Children's Hospital, Baylor College of Medicine, Houston; Divisions of Neurology (R.A., K.P.) and Pediatric Neurology (T.A.G.), Cincinnati Children's Hospital Medical Center, OH; Department of Neurology and Pediatrics (J.N.B., H.P.G.), University of Virginia Health System, Charlottesville; Center for Neuroscience (J.L.C., W.D.G.), Children's National Medical Center, George Washington University School of Medicine and Health Sciences, Washington, DC; Departments of Pediatrics and Neurology (K.E.C.), Children's Hospital Colorado, University of Colorado School of Medicine, Aurora; Department of Pediatrics (T.A.G.), University of Cincinnati College of Medicine, OH; Ruth D. & Ken M. Davee Pediatric Neurocritical Care Program (J.L.G., M.S.W.), Northwestern University Feinberg School of Medicine, Chicago, IL; Division of Pediatric Neurology (A.R.H., M.A.M., D.T.), Duke University Medical Center, Duke University, Durham, NC; Division of Child Neurology (T.L.M.), Department of Neurology, Columbia University Medical Center, Columbia University, New York, NY; Barrow Neurological Institute (A.W., K.W.), Phoenix Children's Hospital, AZ; and Department of Pediatrics (A.W., K.W.), University of Arizona School of Medicine, Phoenix
| | - T Loddenkemper
- From the Division of Epilepsy and Clinical Neurophysiology, Department of Neurology (I.S.F., M.G.-L., J.C., M.C.J., K.K., T.L.), and Division of Critical Care, Departments of Neurology, Anesthesiology, and Perioperative and Pain Medicine (R.C.T.), Boston Children's Hospital, Harvard Medical School, MA; Department of Child Neurology (I.S.F.), Hospital Sant Joan de Déu, Universidad de Barcelona, Spain; Facultad de Medicina (M.G.-L.), Universidad Austral de Chile, Valdivia; Divisions of Neurology (N.S.A.) and Critical Care Medicine (A.A.T.), The Children's Hospital of Philadelphia, The Perelman School of Medicine at the University of Pennsylvania, Philadelphia; Section of Neurology and Developmental Neuroscience (A.E.A., Y.-C.L., A.N., J.J.R.), Department of Pediatrics, Texas Children's Hospital, Baylor College of Medicine, Houston; Divisions of Neurology (R.A., K.P.) and Pediatric Neurology (T.A.G.), Cincinnati Children's Hospital Medical Center, OH; Department of Neurology and Pediatrics (J.N.B., H.P.G.), University of Virginia Health System, Charlottesville; Center for Neuroscience (J.L.C., W.D.G.), Children's National Medical Center, George Washington University School of Medicine and Health Sciences, Washington, DC; Departments of Pediatrics and Neurology (K.E.C.), Children's Hospital Colorado, University of Colorado School of Medicine, Aurora; Department of Pediatrics (T.A.G.), University of Cincinnati College of Medicine, OH; Ruth D. & Ken M. Davee Pediatric Neurocritical Care Program (J.L.G., M.S.W.), Northwestern University Feinberg School of Medicine, Chicago, IL; Division of Pediatric Neurology (A.R.H., M.A.M., D.T.), Duke University Medical Center, Duke University, Durham, NC; Division of Child Neurology (T.L.M.), Department of Neurology, Columbia University Medical Center, Columbia University, New York, NY; Barrow Neurological Institute (A.W., K.W.), Phoenix Children's Hospital, AZ; and Department of Pediatrics (A.W., K.W.), University of Arizona School of Medicine, Phoenix.
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Lai YC, Li N, Lawrence W, Wang S, Levine A, Burchhardt DM, Pautler RG, Valderrábano M, Wehrens XH, Anderson AE. Myocardial remodeling and susceptibility to ventricular tachycardia in a model of chronic epilepsy. Epilepsia Open 2018; 3:213-223. [PMID: 29881800 PMCID: PMC5983128 DOI: 10.1002/epi4.12107] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/02/2018] [Indexed: 01/08/2023] Open
Abstract
Objective Sympathetic predominance and ventricular repolarization abnormalities represent epilepsy‐associated cardiac alterations and may underlie seizure‐induced ventricular arrhythmias. Myocardial ion channel and electrical remodeling have been described early in epilepsy development and may contribute to ventricular repolarization abnormalities and excitability. Using the pilocarpine‐induced acquired epilepsy model we sought to examine whether altered myocardial ion channel levels and electrophysiological changes also occur in animals with long‐standing epilepsy. Methods We examined myocardial adrenergic receptor and ion channel protein levels of epileptic and age‐matched sham rats (9–20 months old) using western blotting. Cardiac electrical properties were examined using optical mapping ex vivo and electrophysiology in vivo. We investigated the propensity for ventricular tachycardia (VT) and the effects of β‐adrenergic blockade on ventricular electrical properties and excitability in vivo. Results In animals with long‐standing epilepsy, we observed decreased myocardial voltage‐gated K+ channels Kv4.2 and Kv4.3, which are known to underlie early ventricular repolarization in rodents. Decreased β1 and increased α1A adrenergic receptor protein levels occurred in the myocardium of chronically epileptic animals consistent with elevated sympathetic tone. These animals exhibited many cardiac electrophysiological abnormalities, represented by longer QRS and corrected QT (QTc) intervals in vivo, slower conduction velocity ex vivo, and stimulation‐induced VT. Administration of a β‐adrenergic antagonist late in epilepsy was beneficial, as the therapy shortened the QTc interval and decreased stimulation‐induced VT. Significance Our findings demonstrate that myocardial ion channel remodeling and sympathetic predominance, risk factors for increased ventricular excitability and arrhythmias, persist in chronic epilepsy. The beneficial effects of β‐adrenergic antagonist treatment late in the course of epilepsy suggest that attenuating elevated sympathetic tone may represent a therapeutic target for ameliorating epilepsy‐associated cardiac morbidity.
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Affiliation(s)
- Yi-Chen Lai
- Department of Pediatrics Baylor College of Medicine Houston Texas U.S.A
| | - Na Li
- Department of Molecular Physiology and Biophysics Baylor College of Medicine Houston Texas U.S.A
| | - William Lawrence
- Department of Molecular Physiology and Biophysics Baylor College of Medicine Houston Texas U.S.A
| | - Sufen Wang
- DeBakey Heart and Vascular Center Methodist Hospital Research Institute Houston Texas U.S.A
| | - Amber Levine
- Department of Neuroscience Baylor College of Medicine Houston Texas U.S.A
| | | | - Robia G Pautler
- Department of Molecular Physiology and Biophysics Baylor College of Medicine Houston Texas U.S.A
| | - Miguel Valderrábano
- DeBakey Heart and Vascular Center Methodist Hospital Research Institute Houston Texas U.S.A
| | - Xander H Wehrens
- Department of Molecular Physiology and Biophysics Baylor College of Medicine Houston Texas U.S.A
| | - Anne E Anderson
- Department of Pediatrics Baylor College of Medicine Houston Texas U.S.A.,Department of Neuroscience Baylor College of Medicine Houston Texas U.S.A.,Department of Neurology Baylor College of Medicine Houston Texas U.S.A
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Hussain S, Egbenya DL, Lai YC, Dosa ZJ, Sørensen JB, Anderson AE, Davanger S. Cover Image, Volume 27, Issue 11. Hippocampus 2017. [DOI: 10.1002/hipo.22645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Suleman Hussain
- Division of Anatomy; Department of Molecular Medicine, Institute of Basic Medical Sciences, University of Oslo; Norway
| | - Daniel Lawer Egbenya
- Division of Anatomy; Department of Molecular Medicine, Institute of Basic Medical Sciences, University of Oslo; Norway
| | - Yi-Chen Lai
- Jan and Dan Duncan Neurological Research Institute; Baylor College of Medicine; Houston Texas USA
| | - Zita J. Dosa
- Department of Neuroscience and Pharmacology; Faculty of Health and Medical Sciences, Lundbeck Foundation Center for Biomembranes in Nanomedicine, University of Copenhagen; Denmark
| | - Jakob B. Sørensen
- Department of Neuroscience and Pharmacology; Faculty of Health and Medical Sciences, Lundbeck Foundation Center for Biomembranes in Nanomedicine, University of Copenhagen; Denmark
| | - Anne E. Anderson
- Jan and Dan Duncan Neurological Research Institute; Baylor College of Medicine; Houston Texas USA
| | - Svend Davanger
- Division of Anatomy; Department of Molecular Medicine, Institute of Basic Medical Sciences, University of Oslo; Norway
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Ali W, Bubolz BA, Nguyen L, Castro D, Coss-Bu J, Quach MM, Kennedy CE, Anderson AE, Lai YC. Epilepsy is associated with ventricular alterations following convulsive status epilepticus in children. Epilepsia Open 2017; 2:432-440. [PMID: 29430560 PMCID: PMC5800777 DOI: 10.1002/epi4.12074] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Objective Convulsive status epilepticus can exert profound cardiovascular effects in adults, including ventricular depolarization–repolarization abnormalities. Whether status epilepticus adversely affects ventricular electrical properties in children is less understood. Therefore, we sought to characterize ventricular alterations and the associated clinical factors in children following convulsive status epilepticus. Methods We conducted a 2‐year retrospective case–control study. Children between 1 month and 21 years of age were included if they were admitted to the pediatric intensive care unit with primary diagnosis of convulsive status epilepticus and had 12‐lead electrocardiogram (ECG) within 24 h of admission. Children with heart disease or ion channelopathy, or who were on vasoactive medications were excluded. Age‐matched control subjects had no history of seizures or epilepsy. The primary outcome was ventricular abnormalities represented by ST segment changes, abnormal T wave, QRS axis deviation, and corrected QT (QTc) interval prolongation. The secondary outcomes included QT/RR relationship, beat‐to‐beat QTc interval variability, ECG interval measurement between groups, and clinical factors associated with ECG abnormalities. Results Of 317 eligible children, 59 met the inclusion criteria. History of epilepsy was present in 31 children (epileptic) and absent in 28 children (nonepileptic). Compared with the control subjects (n = 31), the status epilepticus groups were more likely to have an abnormal ECG, with overall odds ratios of 3.8 and 7.0 for the nonepileptic and the epileptic groups, respectively. Simple linear regression analysis demonstrated that children with epilepsy exhibited impaired dependence and adaptation of the QT interval on heart rate. Beat‐to‐beat QTc interval variability, a marker of ventricular repolarization instability, was increased in children with epilepsy. Significance Convulsive status epilepticus can adversely affect ventricular electrical properties and stability in children, especially those with epilepsy. These findings suggest that children with epilepsy may be particularly vulnerable to seizure‐induced arrhythmias. Therefore, postictal cardiac surveillance may be warranted in this population.
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Affiliation(s)
- Wail Ali
- Section of Pediatric Critical Care Medicine, Department of Pediatrics, West Virginia University, Morgantown, WV
| | - Beth A Bubolz
- Section of Pediatric Emergency Medicine, Department of Pediatrics, Nationwide Children's Hospital, Columbus, Ohio
| | - Linh Nguyen
- Section of Pediatric Critical Care Medicine, Department of Pediatrics, Baylor College of Medicine, Houston, TX
| | - Danny Castro
- Section of Pediatric Critical Care Medicine, Department of Pediatrics, Baylor College of Medicine, Houston, TX
| | - Jorge Coss-Bu
- Section of Pediatric Critical Care Medicine, Department of Pediatrics, Baylor College of Medicine, Houston, TX
| | - Michael M Quach
- Section of Pediatric Neurology and Developmental Neuroscience; Department of Pediatrics, Baylor College of Medicine, Houston, TX
| | - Curtis E Kennedy
- Section of Pediatric Critical Care Medicine, Department of Pediatrics, Baylor College of Medicine, Houston, TX
| | - Anne E Anderson
- Section of Pediatric Neurology and Developmental Neuroscience; Department of Pediatrics, Baylor College of Medicine, Houston, TX
| | - Yi-Chen Lai
- Section of Pediatric Critical Care Medicine, Department of Pediatrics, Baylor College of Medicine, Houston, TX
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Hussain S, Egbenya DL, Lai YC, Dosa ZJ, Sørensen JB, Anderson AE, Davanger S. The calcium sensor synaptotagmin 1 is expressed and regulated in hippocampal postsynaptic spines. Hippocampus 2017; 27:1168-1177. [PMID: 28686803 DOI: 10.1002/hipo.22761] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [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: 02/24/2017] [Revised: 05/31/2017] [Accepted: 06/29/2017] [Indexed: 11/07/2022]
Abstract
Synaptotagmin 1 is a presynaptic calcium sensor, regulating SNARE-mediated vesicle exocytosis of transmitter. Increasing evidence indicate roles of SNARE proteins in postsynaptic glutamate receptor trafficking. However, a possible postsynaptic expression of synaptotagmin 1 has not been demonstrated previously. Here, we used postembedding immunogold electron microscopy to determine the subsynaptic localization of synaptotagmin 1 in rat hippocampal CA1 Schaffer collateral synapses. We report for the first time that synaptotagmin 1 is present in rat hippocampal postsynaptic spines, both on cytoplasmic vesicles and at the postsynaptic density. We further investigated whether postsynaptic synaptotagmin 1 is regulated during synaptic plasticity. In a rat model of chronic temporal lobe epilepsy, we found that presynaptic and postsynaptic concentrations of the protein are reduced compared to control animals. This downregulation may possibly be an adaptive measure to decrease both presynaptic and postsynaptic calcium sensitivity in excitotoxic conditions.
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Affiliation(s)
- Suleman Hussain
- Division of Anatomy, Department of Molecular Medicine, Institute of Basic Medical Sciences, University of Oslo, Norway
| | - Daniel Lawer Egbenya
- Division of Anatomy, Department of Molecular Medicine, Institute of Basic Medical Sciences, University of Oslo, Norway
| | - Yi-Chen Lai
- Jan and Dan Duncan Neurological Research Institute, Baylor College of Medicine, Houston, Texas, USA
| | - Zita J Dosa
- Department of Neuroscience and Pharmacology, Faculty of Health and Medical Sciences, Lundbeck Foundation Center for Biomembranes in Nanomedicine, University of Copenhagen, Denmark
| | - Jakob B Sørensen
- Department of Neuroscience and Pharmacology, Faculty of Health and Medical Sciences, Lundbeck Foundation Center for Biomembranes in Nanomedicine, University of Copenhagen, Denmark
| | - Anne E Anderson
- Jan and Dan Duncan Neurological Research Institute, Baylor College of Medicine, Houston, Texas, USA
| | - Svend Davanger
- Division of Anatomy, Department of Molecular Medicine, Institute of Basic Medical Sciences, University of Oslo, Norway
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Lai YC, Baker JS, Donti T, Graham BH, Craigen WJ, Anderson AE. Mitochondrial Dysfunction Mediated by Poly(ADP-Ribose) Polymerase-1 Activation Contributes to Hippocampal Neuronal Damage Following Status Epilepticus. Int J Mol Sci 2017; 18:ijms18071502. [PMID: 28704930 PMCID: PMC5535992 DOI: 10.3390/ijms18071502] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Revised: 07/06/2017] [Accepted: 07/10/2017] [Indexed: 11/16/2022] Open
Abstract
Mitochondrial dysfunction plays a central role in the neuropathology associated with status epilepticus (SE) and is implicated in the development of epilepsy. While excitotoxic mechanisms are well-known mediators affecting mitochondrial health following SE, whether hyperactivation of poly(ADP-ribose) polymerase-1 (PARP-1) also contributes to SE-induced mitochondrial dysfunction remains to be examined. Here we first evaluated the temporal evolution of poly-ADP-ribosylated protein levels in hippocampus following kainic acid-induced SE as a marker for PARP-1 activity, and found that PARP-1 was hyperactive at 24 h following SE. We evaluated oxidative metabolism and found decreased NAD+ levels by enzymatic cycling, and impaired NAD+-dependent mitochondrial respiration as measured by polarography at 24 h following SE. Stereological estimation showed significant cell loss in the hippocampal CA1 and CA3 subregions 72 h following SE. PARP-1 inhibition using N-(6-Oxo-5,6-dihydro-phenanthridin-2-yl)- N,N-dimethylacetamide (PJ-34) in vivo administration was associated with preserved NAD+ levels and NAD+-dependent mitochondrial respiration, and improved CA1 neuronal survival. These findings suggest that PARP-1 hyperactivation contributes to SE-associated mitochondrial dysfunction and CA1 hippocampal damage. The deleterious effects of PARP-1 hyperactivation on mitochondrial respiration are in part mediated through intracellular NAD+ depletion. Therefore, modulating PARP-1 activity may represent a potential therapeutic target to preserve intracellular energetics and mitochondrial function following SE.
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Affiliation(s)
- Yi-Chen Lai
- Departments of Pediatrics, Baylor College of Medicine, Houston, TX 77030, USA.
| | - J Scott Baker
- Departments of Pediatrics, Baylor College of Medicine, Houston, TX 77030, USA.
| | - Taraka Donti
- Departments of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX 77030, USA.
| | - Brett H Graham
- Departments of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX 77030, USA.
| | - William J Craigen
- Departments of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX 77030, USA.
| | - Anne E Anderson
- Departments of Pediatrics, Baylor College of Medicine, Houston, TX 77030, USA.
- Departments of Neurology, Baylor College of Medicine, Houston, TX 77030, USA.
- Departments of Neuroscience, Baylor College of Medicine, Houston, TX 77030, USA.
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Anderson AE, Swan DJ, Wong OY, Buck M, Eltherington O, Harry RA, Patterson AM, Pratt AG, Reynolds G, Doran JP, Kirby JA, Isaacs JD, Hilkens CMU. Tolerogenic dendritic cells generated with dexamethasone and vitamin D3 regulate rheumatoid arthritis CD4 + T cells partly via transforming growth factor-β1. Clin Exp Immunol 2016; 187:113-123. [PMID: 27667787 DOI: 10.1111/cei.12870] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [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: 03/14/2016] [Revised: 09/09/2016] [Accepted: 09/21/2016] [Indexed: 12/28/2022] Open
Abstract
Tolerogenic dendritic cells (tolDC) are a new immunotherapeutic tool for the treatment of rheumatoid arthritis (RA) and other autoimmune disorders. We have established a method to generate stable tolDC by pharmacological modulation of human monocyte-derived DC. These tolDC exert potent pro-tolerogenic actions on CD4+ T cells. Lack of interleukin (IL)-12p70 production is a key immunoregulatory attribute of tolDC but does not explain their action fully. Here we show that tolDC express transforming growth factor (TGF)-β1 at both mRNA and protein levels, and that expression of this immunoregulatory cytokine is significantly higher in tolDC than in mature monocyte-derived DC. By inhibiting TGF-β1 signalling we demonstrate that tolDC regulate CD4+ T cell responses in a manner that is at least partly dependent upon this cytokine. Crucially, we also show that while there is no significant difference in expression of TGF-βRII on CD4+ T cells from RA patients and healthy controls, RA patient CD4+ T cells are measurably less responsive to TGF-β1 than healthy control CD4+ T cells [reduced TGF-β-induced mothers against decapentaplegic homologue (Smad)2/3 phosphorylation, forkhead box protein 3 (FoxP3) expression and suppression of (IFN)-γ secretion]. However, CD4+ T cells from RA patients can, nonetheless, be regulated efficiently by tolDC in a TGF-β1-dependent manner. This work is important for the design and development of future studies investigating the potential use of tolDC as a novel immunotherapy for the treatment of RA.
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Affiliation(s)
- A E Anderson
- Musculoskeletal Research Group.,Arthritis Research UK Rheumatoid Arthritis Centre of Excellence (RACE)
| | | | | | - M Buck
- Musculoskeletal Research Group
| | - O Eltherington
- Musculoskeletal Research Group.,Arthritis Research UK Rheumatoid Arthritis Centre of Excellence (RACE)
| | - R A Harry
- Musculoskeletal Research Group.,Arthritis Research UK Rheumatoid Arthritis Centre of Excellence (RACE)
| | | | - A G Pratt
- Musculoskeletal Research Group.,Arthritis Research UK Rheumatoid Arthritis Centre of Excellence (RACE)
| | - G Reynolds
- Musculoskeletal Research Group.,Arthritis Research UK Rheumatoid Arthritis Centre of Excellence (RACE)
| | | | - J A Kirby
- Applied Immunobiology and Transplantation Research Group, Institute of Cellular Medicine at the Newcastle NIHR Biomedical Research Centre, Newcastle University and Newcastle upon Tyne NHS Trust, Newcastle upon Tyne, UK
| | - J D Isaacs
- Musculoskeletal Research Group.,Arthritis Research UK Rheumatoid Arthritis Centre of Excellence (RACE)
| | - C M U Hilkens
- Musculoskeletal Research Group.,Arthritis Research UK Rheumatoid Arthritis Centre of Excellence (RACE)
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Abiega O, Beccari S, Diaz-Aparicio I, Nadjar A, Layé S, Leyrolle Q, Gómez-Nicola D, Domercq M, Pérez-Samartín A, Sánchez-Zafra V, Paris I, Valero J, Savage JC, Hui CW, Tremblay MÈ, Deudero JJP, Brewster AL, Anderson AE, Zaldumbide L, Galbarriatu L, Marinas A, Vivanco MDM, Matute C, Maletic-Savatic M, Encinas JM, Sierra A. Correction: Neuronal Hyperactivity Disturbs ATP Microgradients, Impairs Microglial Motility, and Reduces Phagocytic Receptor Expression Triggering Apoptosis/Microglial Phagocytosis Uncoupling. PLoS Biol 2016; 14:e1002554. [PMID: 27649285 PMCID: PMC5029941 DOI: 10.1371/journal.pbio.1002554] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Brewster AL, Marzec K, Hairston A, Ho M, Anderson AE, Lai YC. Early cardiac electrographic and molecular remodeling in a model of status epilepticus and acquired epilepsy. Epilepsia 2016; 57:1907-1915. [PMID: 27555091 DOI: 10.1111/epi.13516] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/03/2016] [Indexed: 01/08/2023]
Abstract
OBJECTIVES A myriad of acute and chronic cardiac alterations are associated with status epilepticus (SE) including increased sympathetic tone, rhythm and ventricular repolarization disturbances. Despite these observations, the molecular processes underlying SE-associated myocardial remodeling remain to be identified. Here we determined early SE-associated myocardial electrical and molecular alterations using a model of SE and acquired epilepsy. METHODS We performed electrocardiography (ECG) assessments in rats beginning at 2 weeks following kainate-induced SE, and calculated short-term variability (STV) of the corrected QT intervals (QTc) as a marker of ventricular stability. Using western blotting, we quantified myocardial β1-adrenergic receptors (β1-AR) and ventricular gap junction protein connexin 43 (Cx43) levels as makers of increased sympathetic tone. We determined the activation status of three kinases associated with sympathetic stimulation and their downstream ion channel targets: extracellular signal-regulated kinase (ERK), protein kinase A (PKA), Ca2+ /calmodulin-dependent protein kinase II (CamKII), hyperpolarization-activated cyclic nucleotide-gated channel subunit 2 (HCN2), and voltage-gated potassium channels 4.2 (Kv4.2 ). We investigated whether SE was associated with altered Ca2+ homeostasis by determining select Ca2+ -handling protein levels using western blotting. RESULTS Compared with the sham group, SE animals exhibited higher heart rate, longer QTc interval, and higher STV beginning at 2 weeks following SE. Concurrently, the myocardium of SE rats showed lower β1-AR and higher Cx43 protein levels, higher levels of phosphorylated ERK, PKA, and CamKII along with decreased HCN2 and Kv4.2 channel levels. In addition, the SE rats had altered proteins levels of Ca2+ -handling proteins, with decreased Na+ /Ca2+ exchanger-1 and increased calreticulin. SIGNIFICANCE SE triggers early molecular alterations in the myocardium consistent with increased sympathetic tone and altered Ca2+ homeostasis. These changes, coupled with early and persistent ECG abnormalities, suggest that the observed molecular alterations may contribute to SE-associated cardiac remodeling. Additional mechanistic studies are needed to determine potential causal roles.
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Affiliation(s)
- Amy L Brewster
- Department of Psychological Sciences, Purdue University, West Lafayette, Indiana, U.S.A.,Weldon School of Biomedical Engineering, Purdue University, West Lafayette, Indiana, U.S.A
| | - Kyle Marzec
- Department of Psychological Sciences, Purdue University, West Lafayette, Indiana, U.S.A
| | - Alexandria Hairston
- Department of Psychological Sciences, Purdue University, West Lafayette, Indiana, U.S.A
| | - Marvin Ho
- Department of Pediatrics, Baylor College of Medicine, Houston, Texas, U.S.A
| | - Anne E Anderson
- Department of Pediatrics, Baylor College of Medicine, Houston, Texas, U.S.A.,Department of Neurology, Baylor College of Medicine, Houston, Texas, U.S.A
| | - Yi-Chen Lai
- Department of Pediatrics, Baylor College of Medicine, Houston, Texas, U.S.A
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Abiega O, Beccari S, Diaz-Aparicio I, Nadjar A, Layé S, Leyrolle Q, Gómez-Nicola D, Domercq M, Pérez-Samartín A, Sánchez-Zafra V, Paris I, Valero J, Savage JC, Hui CW, Tremblay MÈ, Deudero JJP, Brewster AL, Anderson AE, Zaldumbide L, Galbarriatu L, Marinas A, Vivanco MDM, Matute C, Maletic-Savatic M, Encinas JM, Sierra A. Neuronal Hyperactivity Disturbs ATP Microgradients, Impairs Microglial Motility, and Reduces Phagocytic Receptor Expression Triggering Apoptosis/Microglial Phagocytosis Uncoupling. PLoS Biol 2016; 14:e1002466. [PMID: 27228556 PMCID: PMC4881984 DOI: 10.1371/journal.pbio.1002466] [Citation(s) in RCA: 114] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Accepted: 04/21/2016] [Indexed: 12/24/2022] Open
Abstract
Phagocytosis is essential to maintain tissue homeostasis in a large number of inflammatory and autoimmune diseases, but its role in the diseased brain is poorly explored. Recent findings suggest that in the adult hippocampal neurogenic niche, where the excess of newborn cells undergo apoptosis in physiological conditions, phagocytosis is efficiently executed by surveillant, ramified microglia. To test whether microglia are efficient phagocytes in the diseased brain as well, we confronted them with a series of apoptotic challenges and discovered a generalized response. When challenged with excitotoxicity in vitro (via the glutamate agonist NMDA) or inflammation in vivo (via systemic administration of bacterial lipopolysaccharides or by omega 3 fatty acid deficient diets), microglia resorted to different strategies to boost their phagocytic efficiency and compensate for the increased number of apoptotic cells, thus maintaining phagocytosis and apoptosis tightly coupled. Unexpectedly, this coupling was chronically lost in a mouse model of mesial temporal lobe epilepsy (MTLE) as well as in hippocampal tissue resected from individuals with MTLE, a major neurological disorder characterized by seizures, excitotoxicity, and inflammation. Importantly, the loss of phagocytosis/apoptosis coupling correlated with the expression of microglial proinflammatory, epileptogenic cytokines, suggesting its contribution to the pathophysiology of epilepsy. The phagocytic blockade resulted from reduced microglial surveillance and apoptotic cell recognition receptor expression and was not directly mediated by signaling through microglial glutamate receptors. Instead, it was related to the disruption of local ATP microgradients caused by the hyperactivity of the hippocampal network, at least in the acute phase of epilepsy. Finally, the uncoupling led to an accumulation of apoptotic newborn cells in the neurogenic niche that was due not to decreased survival but to delayed cell clearance after seizures. These results demonstrate that the efficiency of microglial phagocytosis critically affects the dynamics of apoptosis and urge to routinely assess the microglial phagocytic efficiency in neurodegenerative disorders. Phagocytosis by microglia is tightly coupled to apoptosis, swiftly removing apoptotic cells and actively maintaining tissue homeostasis, but the neuronal hyperactivity associated with epilepsy disrupts the ATP gradients that drive phagocytosis, leading to the accumulation of apoptotic cells and inflammation. Phagocytosis, the engulfment and digestion of cellular debris, is at the core of the regenerative response of the damaged tissue, because it prevents the spillover of toxic intracellular contents and is actively anti-inflammatory. In the brain, the professional phagocytes are microglia, whose dynamic processes rapidly engulf and degrade cells undergoing apoptosis—programmed cell death—in physiological conditions. Thus, microglia hold the key to brain regeneration, but their efficiency as phagocytes in the diseased brain is only presumed. Here, we have discovered a generalized response of microglia to apoptotic challenge induced by excitotoxicity and inflammation, in which they boost their phagocytic efficiency to account for the increase in apoptosis. To our surprise, this apoptosis/microglial phagocytosis coupling was lost in the hippocampus from human and experimental mesial temporal lobe epilepsy (MTLE), a major neurodegenerative disorder characterized by excitotoxicity, inflammation, and seizures. This uncoupling was due to widespread ATP release during neuronal hyperactivity, which “blinded” microglia to the ATP microgradients released by apoptotic cells as “find-me” signals. The impairment of phagocytosis led to the accumulation of apoptotic cells and the build-up of a detrimental inflammatory reaction. Our data advocates for systematic assessment of the efficiency of microglial phagocytosis in brain disorders.
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Affiliation(s)
- Oihane Abiega
- Achucarro Basque Center for Neuroscience, Bizkaia Science and Technology Park, Zamudio, Spain
- University of the Basque Country, Leioa, Spain
| | - Sol Beccari
- Achucarro Basque Center for Neuroscience, Bizkaia Science and Technology Park, Zamudio, Spain
- University of the Basque Country, Leioa, Spain
| | - Irune Diaz-Aparicio
- Achucarro Basque Center for Neuroscience, Bizkaia Science and Technology Park, Zamudio, Spain
- University of the Basque Country, Leioa, Spain
| | | | - Sophie Layé
- Université Bordeaux Segalen, Bordeaux, France
| | | | - Diego Gómez-Nicola
- Centre for Biological Sciences, University of Southampton, Southampton, United Kingdom
| | - María Domercq
- Achucarro Basque Center for Neuroscience, Bizkaia Science and Technology Park, Zamudio, Spain
- University of the Basque Country, Leioa, Spain
| | - Alberto Pérez-Samartín
- Achucarro Basque Center for Neuroscience, Bizkaia Science and Technology Park, Zamudio, Spain
- University of the Basque Country, Leioa, Spain
| | - Víctor Sánchez-Zafra
- Achucarro Basque Center for Neuroscience, Bizkaia Science and Technology Park, Zamudio, Spain
- University of the Basque Country, Leioa, Spain
| | - Iñaki Paris
- Achucarro Basque Center for Neuroscience, Bizkaia Science and Technology Park, Zamudio, Spain
- University of the Basque Country, Leioa, Spain
| | - Jorge Valero
- Achucarro Basque Center for Neuroscience, Bizkaia Science and Technology Park, Zamudio, Spain
- University of the Basque Country, Leioa, Spain
- Ikerbasque Foundation, Bilbao, Spain
| | - Julie C. Savage
- Centre de recherche du CHU de Québec, Axe Neurosciences, Québec, Canada
- Université Laval, Département de médecine moléculaire, Québec, Canada
| | - Chin-Wai Hui
- Centre de recherche du CHU de Québec, Axe Neurosciences, Québec, Canada
- Université Laval, Département de médecine moléculaire, Québec, Canada
| | - Marie-Ève Tremblay
- Centre de recherche du CHU de Québec, Axe Neurosciences, Québec, Canada
- Université Laval, Département de médecine moléculaire, Québec, Canada
| | - Juan J. P. Deudero
- Baylor College of Medicine, The Jan and Dan Duncan Neurological Research Institute at Texas Children’s Hospital, Houston, Texas, United States of America
| | - Amy L. Brewster
- Baylor College of Medicine, The Jan and Dan Duncan Neurological Research Institute at Texas Children’s Hospital, Houston, Texas, United States of America
| | - Anne E. Anderson
- Baylor College of Medicine, The Jan and Dan Duncan Neurological Research Institute at Texas Children’s Hospital, Houston, Texas, United States of America
| | | | | | | | | | - Carlos Matute
- Achucarro Basque Center for Neuroscience, Bizkaia Science and Technology Park, Zamudio, Spain
- University of the Basque Country, Leioa, Spain
| | | | - Juan M. Encinas
- Achucarro Basque Center for Neuroscience, Bizkaia Science and Technology Park, Zamudio, Spain
- University of the Basque Country, Leioa, Spain
- Baylor College of Medicine, The Jan and Dan Duncan Neurological Research Institute at Texas Children’s Hospital, Houston, Texas, United States of America
| | - Amanda Sierra
- Achucarro Basque Center for Neuroscience, Bizkaia Science and Technology Park, Zamudio, Spain
- University of the Basque Country, Leioa, Spain
- Baylor College of Medicine, The Jan and Dan Duncan Neurological Research Institute at Texas Children’s Hospital, Houston, Texas, United States of America
- * E-mail:
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Bell GM, Anderson AE, Diboll J, Reece R, Eltherington O, Harry RA, Fouweather T, MacDonald C, Chadwick T, McColl E, Dunn J, Dickinson AM, Hilkens CMU, Isaacs JD. Autologous tolerogenic dendritic cells for rheumatoid and inflammatory arthritis. Ann Rheum Dis 2016; 76:227-234. [PMID: 27117700 PMCID: PMC5264217 DOI: 10.1136/annrheumdis-2015-208456] [Citation(s) in RCA: 194] [Impact Index Per Article: 24.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Revised: 02/29/2016] [Accepted: 03/24/2016] [Indexed: 11/28/2022]
Abstract
Objectives To assess the safety of intra-articular (IA) autologous tolerogenic dendritic cells (tolDC) in patients with inflammatory arthritis and an inflamed knee; to assess the feasibility and acceptability of the approach and to assess potential effects on local and systemic disease activities. Methods An unblinded, randomised, controlled, dose escalation Phase I trial. TolDC were differentiated from CD14+ monocytes and loaded with autologous synovial fluid as a source of autoantigens. Cohorts of three participants received 1×106, 3×106 or 10×106 tolDC arthroscopically following saline irrigation of an inflamed (target) knee. Control participants received saline irrigation only. Primary outcome was flare of disease in the target knee within 5 days of treatment. Feasibility was assessed by successful tolDC manufacture and acceptability via patient questionnaire. Potential effects on disease activity were assessed by arthroscopic synovitis score, disease activity score (DAS)28 and Health Assessment Questionnaire (HAQ). Immunomodulatory effects were sought in peripheral blood. Results There were no target knee flares within 5 days of treatment. At day 14, arthroscopic synovitis was present in all participants except for one who received 10×106 tolDC; a further participant in this cohort declined day 14 arthroscopy because symptoms had remitted; both remained stable throughout 91 days of observation. There were no trends in DAS28 or HAQ score or consistent immunomodulatory effects in peripheral blood. 9 of 10 manufactured products met quality control release criteria; acceptability of the protocol by participants was high. Conclusion IA tolDC therapy appears safe, feasible and acceptable. Knee symptoms stabilised in two patients who received 10×106 tolDC but no systemic clinical or immunomodulatory effects were detectable. Trial registration number NCT01352858.
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Affiliation(s)
- G M Bell
- Arthritis Research UK Rheumatoid Arthritis Pathogenesis Centre of Excellence (RACE), Musculoskeletal Research Group, Institute of Cellular Medicine, Newcastle upon Tyne, UK
| | - A E Anderson
- Arthritis Research UK Rheumatoid Arthritis Pathogenesis Centre of Excellence (RACE), Musculoskeletal Research Group, Institute of Cellular Medicine, Newcastle upon Tyne, UK
| | - J Diboll
- Arthritis Research UK Rheumatoid Arthritis Pathogenesis Centre of Excellence (RACE), Musculoskeletal Research Group, Institute of Cellular Medicine, Newcastle upon Tyne, UK
| | - R Reece
- Arthritis Research UK Rheumatoid Arthritis Pathogenesis Centre of Excellence (RACE), Musculoskeletal Research Group, Institute of Cellular Medicine, Newcastle upon Tyne, UK
| | - O Eltherington
- Arthritis Research UK Rheumatoid Arthritis Pathogenesis Centre of Excellence (RACE), Musculoskeletal Research Group, Institute of Cellular Medicine, Newcastle upon Tyne, UK
| | - R A Harry
- Arthritis Research UK Rheumatoid Arthritis Pathogenesis Centre of Excellence (RACE), Musculoskeletal Research Group, Institute of Cellular Medicine, Newcastle upon Tyne, UK
| | - T Fouweather
- Institute of Health and Society, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - C MacDonald
- Institute of Health and Society, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - T Chadwick
- Institute of Health and Society, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - E McColl
- Institute of Health and Society, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK.,Clinical Trials Unit, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - J Dunn
- Haematological Sciences, Institute of Cellular Medicine, Newcastle upon Tyne, UK
| | - A M Dickinson
- Haematological Sciences, Institute of Cellular Medicine, Newcastle upon Tyne, UK
| | - C M U Hilkens
- Arthritis Research UK Rheumatoid Arthritis Pathogenesis Centre of Excellence (RACE), Musculoskeletal Research Group, Institute of Cellular Medicine, Newcastle upon Tyne, UK
| | - John D Isaacs
- Arthritis Research UK Rheumatoid Arthritis Pathogenesis Centre of Excellence (RACE), Musculoskeletal Research Group, Institute of Cellular Medicine, Newcastle upon Tyne, UK
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Cooles FAH, Anderson AE, Hilkens CMU, Isaacs JD. A1.13 The prevalence of a raised interferon gene signature is increased in early ra and is associated with worse disease activity. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-209124.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Pratt AG, Massey J, Anderson AE, Nair N, Diboll J, Skelton A, Lendrem DW, Reynard LN, Cordell HJ, Eyre S, Barton A, Isaacs JD. A6.13 Identification of novel expression quantitative trait loci in CD4 +T cells of untreated early arthritis patients. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-209124.125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Patil VV, Guzman M, Carter AN, Rathore G, Yoshor D, Curry D, Wilfong A, Agadi S, Swann JW, Adesina AM, Bhattacharjee MB, Anderson AE. Activation of extracellular regulated kinase and mechanistic target of rapamycin pathway in focal cortical dysplasia. Neuropathology 2015; 36:146-56. [PMID: 26381727 DOI: 10.1111/neup.12242] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [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: 05/05/2015] [Revised: 07/31/2015] [Accepted: 08/01/2015] [Indexed: 12/26/2022]
Abstract
Neuropathology of resected brain tissue has revealed an association of focal cortical dysplasia (FCD) with drug-resistant epilepsy (DRE). Recent studies have shown that the mechanistic target of rapamycin (mTOR) pathway is hyperactivated in FCD as evidenced by increased phosphorylation of the ribosomal protein S6 (S6) at serine 240/244 (S(240/244) ), a downstream target of mTOR. Moreover, extracellular regulated kinase (ERK) has been shown to phosphorylate S6 at serine 235/236 (S(235/236) ) and tuberous sclerosis complex 2 (TSC2) at serine 664 (S(664) ) leading to hyperactive mTOR signaling. We evaluated ERK phosphorylation of S6 and TSC2 in two types of FCD (FCD I and FCD II) as a candidate mechanism contributing to mTOR pathway dysregulation. Tissue samples from patients with tuberous sclerosis (TS) served as a positive control. Immunostaining for phospho-S6 (pS6(240/244) and pS6(235/236) ), phospho-ERK (pERK), and phospho-TSC2 (pTSC2) was performed on resected brain tissue with FCD and TS. We found increased pS6(240/244) and pS6(235/236) staining in FCD I, FCD II and TS compared to normal-appearing tissue, while pERK and pTSC2 staining was increased only in FCD IIb and TS tissue. Our results suggest that both the ERK and mTOR pathways are dysregulated in FCD and TS; however, the signaling alterations are different for FCD I as compared to FCD II and TS.
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Affiliation(s)
- Vinit V Patil
- Program in Translational Biology and Molecular Medicine, Texas Children's Hospital, Houston, Texas, USA.,Cain Foundation Laboratories, Texas Children's Hospital, Houston, Texas, USA.,Jan and Dan Duncan Neurological Research Institute, Texas Children's Hospital, Houston, Texas, USA.,Department of Pathology, Saint Louis University, Saint Louis, Missouri
| | - Miguel Guzman
- Department of Pathology, Saint Louis University, Saint Louis, Missouri
| | - Angela N Carter
- Department of Neuroscience, Texas Children's Hospital, Houston, Texas, USA.,Cain Foundation Laboratories, Texas Children's Hospital, Houston, Texas, USA.,Jan and Dan Duncan Neurological Research Institute, Texas Children's Hospital, Houston, Texas, USA
| | - Geetanjali Rathore
- Department of Pediatrics, Texas Children's Hospital, Houston, Texas, USA
| | - Daniel Yoshor
- Department of Neurosurgery, Texas Children's Hospital, Houston, Texas, USA
| | - Daniel Curry
- Department of Neurosurgery, Texas Children's Hospital, Houston, Texas, USA
| | - Angus Wilfong
- Department of Neurology, Texas Children's Hospital, Houston, Texas, USA.,Department of Pediatrics, Texas Children's Hospital, Houston, Texas, USA
| | - Satish Agadi
- Department of Neurology, Texas Children's Hospital, Houston, Texas, USA.,Department of Pediatrics, Texas Children's Hospital, Houston, Texas, USA
| | - John W Swann
- Department of Neuroscience, Texas Children's Hospital, Houston, Texas, USA.,Department of Pediatrics, Texas Children's Hospital, Houston, Texas, USA.,Program in Translational Biology and Molecular Medicine, Texas Children's Hospital, Houston, Texas, USA.,Cain Foundation Laboratories, Texas Children's Hospital, Houston, Texas, USA.,Jan and Dan Duncan Neurological Research Institute, Texas Children's Hospital, Houston, Texas, USA
| | | | - Meenakshi B Bhattacharjee
- Department of Pathology and Laboratory Medicine, University of Texas Medical School, Houston, Texas, USA
| | - Anne E Anderson
- Department of Neurology, Texas Children's Hospital, Houston, Texas, USA.,Department of Neuroscience, Texas Children's Hospital, Houston, Texas, USA.,Department of Pediatrics, Texas Children's Hospital, Houston, Texas, USA.,Program in Translational Biology and Molecular Medicine, Texas Children's Hospital, Houston, Texas, USA.,Cain Foundation Laboratories, Texas Children's Hospital, Houston, Texas, USA.,Jan and Dan Duncan Neurological Research Institute, Texas Children's Hospital, Houston, Texas, USA
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Erramuzpe A, Encinas JM, Sierra A, Maletic-Savatic M, Brewster AL, Anderson AE, Stramaglia S, Cortes JM. Longitudinal variations of brain functional connectivity: A case report study based on a mouse model of epilepsy. F1000Res 2015; 4:144. [PMID: 26167275 PMCID: PMC4482210 DOI: 10.12688/f1000research.6570.2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/15/2015] [Indexed: 11/20/2022] Open
Abstract
Brain Functional Connectivity (FC) quantifies statistical dependencies between areas of the brain. FC has been widely used to address altered function of brain circuits in control conditions compared to different pathological states, including epilepsy, a major neurological disorder. However, FC also has the as yet unexplored potential to help us understand the pathological transformation of the brain circuitry. Our hypothesis is that FC can differentiate global brain interactions across a time-scale of days. To this end, we present a case report study based on a mouse model for epilepsy and analyze longitudinal intracranial electroencephalography data of epilepsy to calculate FC changes from the initial insult (status epilepticus) and over the latent period, when epileptogenic networks emerge, and at chronic epilepsy, when unprovoked seizures occur as spontaneous events. We found that the overall network FC at low frequency bands decreased immediately after status epilepticus was provoked, and increased monotonously later on during the latent period. Overall, our results demonstrate the capacity of FC to address longitudinal variations of brain connectivity across the establishment of pathological states.
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Affiliation(s)
- A Erramuzpe
- Biocruces Health Research Institute, Cruces University Hospital, Barakaldo, 48903, Spain
| | - J M Encinas
- Achucarro Basque Center for Neuroscience, Zamudio, 48170, Spain.,University of the Basque Country (UPV/EHU), Leioa, 48940, Spain.,Ikerbasque: The Basque Foundation for Science, Bilbao, 48013, Spain
| | - A Sierra
- Achucarro Basque Center for Neuroscience, Zamudio, 48170, Spain.,University of the Basque Country (UPV/EHU), Leioa, 48940, Spain.,Ikerbasque: The Basque Foundation for Science, Bilbao, 48013, Spain
| | - M Maletic-Savatic
- Neurological Research Institute, Baylor College of Medicine, Houston, Texas, 77030, USA
| | - A L Brewster
- Neurological Research Institute, Baylor College of Medicine, Houston, Texas, 77030, USA
| | - Anne E Anderson
- Neurological Research Institute, Baylor College of Medicine, Houston, Texas, 77030, USA
| | - S Stramaglia
- Dipartimento di Fisica, Universita degla Studi di Bari and INFN, Bari, 70125, Italy.,BCAM, Basque Center for Applied Mathematics, Bilbao, 48009, Spain
| | - Jesus M Cortes
- Biocruces Health Research Institute, Cruces University Hospital, Barakaldo, 48903, Spain.,University of the Basque Country (UPV/EHU), Leioa, 48940, Spain.,Ikerbasque: The Basque Foundation for Science, Bilbao, 48013, Spain
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Hethorn WR, Ciarlone SL, Filonova I, Rogers JT, Aguirre D, Ramirez RA, Grieco JC, Peters MM, Gulick D, Anderson AE, L Banko J, Lussier AL, Weeber EJ. Reelin supplementation recovers synaptic plasticity and cognitive deficits in a mouse model for Angelman syndrome. Eur J Neurosci 2015; 41:1372-80. [PMID: 25864922 PMCID: PMC4676289 DOI: 10.1111/ejn.12893] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Revised: 03/09/2015] [Accepted: 03/12/2015] [Indexed: 01/21/2023]
Abstract
The Reelin signaling pathway is implicated in processes controlling synaptic plasticity and hippocampus-dependent learning and memory. A single direct in vivo application of Reelin enhances long-term potentiation, increases dendritic spine density and improves associative and spatial learning and memory. Angelman syndrome (AS) is a neurological disorder that presents with an overall defect in synaptic function, including decreased long-term potentiation, reduced dendritic spine density, and deficits in learning and memory, making it an attractive model in which to examine the ability of Reelin to recover synaptic function and cognitive deficits. In this study, we investigated the effects of Reelin administration on synaptic plasticity and cognitive function in a mouse model of AS and demonstrated that bilateral, intraventricular injections of Reelin recover synaptic function and corresponding hippocampus-dependent associative and spatial learning and memory. Additionally, we describe alteration of the Reelin profile in tissue from both the AS mouse and post-mortem human brain.
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Affiliation(s)
- Whitney R Hethorn
- USF Health Byrd Alzheimer's Institute, 4001 East Fletcher Avenue, Tampa, FL, 33613, USA.,Department of Molecular Pharmacology and Physiology, University of South Florida, Tampa, FL, USA
| | - Stephanie L Ciarlone
- USF Health Byrd Alzheimer's Institute, 4001 East Fletcher Avenue, Tampa, FL, 33613, USA.,Department of Molecular Pharmacology and Physiology, University of South Florida, Tampa, FL, USA
| | - Irina Filonova
- USF Health Byrd Alzheimer's Institute, 4001 East Fletcher Avenue, Tampa, FL, 33613, USA.,Department of Molecular Pharmacology and Physiology, University of South Florida, Tampa, FL, USA
| | - Justin T Rogers
- USF Health Byrd Alzheimer's Institute, 4001 East Fletcher Avenue, Tampa, FL, 33613, USA.,Department of Molecular Pharmacology and Physiology, University of South Florida, Tampa, FL, USA
| | - Daniela Aguirre
- Department of Molecular Pharmacology and Physiology, University of South Florida, Tampa, FL, USA
| | - Raquel A Ramirez
- USF Health Byrd Alzheimer's Institute, 4001 East Fletcher Avenue, Tampa, FL, 33613, USA.,Department of Molecular Pharmacology and Physiology, University of South Florida, Tampa, FL, USA
| | - Joseph C Grieco
- USF Health Byrd Alzheimer's Institute, 4001 East Fletcher Avenue, Tampa, FL, 33613, USA.,Department of Molecular Pharmacology and Physiology, University of South Florida, Tampa, FL, USA
| | - Melinda M Peters
- USF Health Byrd Alzheimer's Institute, 4001 East Fletcher Avenue, Tampa, FL, 33613, USA.,Department of Molecular Pharmacology and Physiology, University of South Florida, Tampa, FL, USA
| | - Danielle Gulick
- USF Health Byrd Alzheimer's Institute, 4001 East Fletcher Avenue, Tampa, FL, 33613, USA.,Department of Molecular Medicine, University of South Florida, Tampa, FL, USA
| | - Anne E Anderson
- Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - Jessica L Banko
- USF Health Byrd Alzheimer's Institute, 4001 East Fletcher Avenue, Tampa, FL, 33613, USA.,Department of Molecular Medicine, University of South Florida, Tampa, FL, USA
| | - April L Lussier
- USF Health Byrd Alzheimer's Institute, 4001 East Fletcher Avenue, Tampa, FL, 33613, USA.,Department of Molecular Pharmacology and Physiology, University of South Florida, Tampa, FL, USA
| | - Edwin J Weeber
- USF Health Byrd Alzheimer's Institute, 4001 East Fletcher Avenue, Tampa, FL, 33613, USA.,Department of Molecular Pharmacology and Physiology, University of South Florida, Tampa, FL, USA
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Nguyen LH, Brewster AL, Clark ME, Regnier-Golanov A, Sunnen CN, Patil VV, D'Arcangelo G, Anderson AE. mTOR inhibition suppresses established epilepsy in a mouse model of cortical dysplasia. Epilepsia 2015; 56:636-46. [PMID: 25752454 DOI: 10.1111/epi.12946] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/21/2015] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Hyperactivation of the mechanistic target of rapamycin (mTOR; also known as mammalian target of rapamycin) pathway has been demonstrated in human cortical dysplasia (CD) as well as in animal models of epilepsy. Although inhibition of mTOR signaling early in epileptogenesis suppressed epileptiform activity in the neuron subset-specific Pten knockout (NS-Pten KO) mouse model of CD, the effects of mTOR inhibition after epilepsy is fully established were not previously examined in this model. Here, we investigated whether mTOR inhibition suppresses epileptiform activity and other neuropathological correlates in adult NS-Pten KO mice with severe and well-established epilepsy. METHODS The progression of epileptiform activity, mTOR pathway dysregulation, and associated neuropathology with age in NS-Pten KO mice were evaluated using video-electroencephalography (EEG) recordings, Western blotting, and immunohistochemistry. A cohort of NS-Pten KO mice was treated with the mTOR inhibitor rapamycin (10 mg/kg i.p., 5 days/week) starting at postnatal week 9 and video-EEG monitored for epileptiform activity. Western blotting and immunohistochemistry were performed to evaluate the effects of rapamycin on the associated pathology. RESULTS Epileptiform activity worsened with age in NS-Pten KO mice, with parallel increases in the extent of hippocampal mTOR complex 1 and 2 (mTORC1 and mTORC2, respectively) dysregulation and progressive astrogliosis and microgliosis. Rapamycin treatment suppressed epileptiform activity, improved baseline EEG activity, and increased survival in severely epileptic NS-Pten KO mice. At the molecular level, rapamycin treatment was associated with a reduction in both mTORC1 and mTORC2 signaling and decreased astrogliosis and microgliosis. SIGNIFICANCE These findings reveal a wide temporal window for successful therapeutic intervention with rapamycin in the NS-Pten KO mouse model, and they support mTOR inhibition as a candidate therapy for established, late-stage epilepsy associated with CD and genetic dysregulation of the mTOR pathway.
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Affiliation(s)
- Lena H Nguyen
- Department of Neuroscience, Baylor College of Medicine, Houston, Texas, U.S.A; The Jan and Dan Duncan Neurological Research Institute, Texas Children's Hospital, Houston, Texas, U.S.A; The Gordon and Mary Cain Pediatric Neurology Research Foundation Laboratories, Texas Children's Hospital, Houston, Texas, U.S.A
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Pratt AG, Anderson AE, Diboll J, Nair N, Skelton A, Lendrem D, Hargreaves B, Routledge C, Brown P, Stocks P, Barton A, Isaacs JD. A2.3 STAT3-regulated gene expression in circulating CD4 +T cells discriminates RA patients independently of clinical parameters in early arthritis: a validation study. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-207259.38] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Cooles FAH, Anderson AE, Hilkens CMU, Isaacs JD. A5.15 Heterogeneity in plasmacytoid dendritic cell response to HIV-GP120 as a putative cause for variability in HIV musculoskeletal co-morbidity. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-207259.121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Barg K, Wiewiorski M, Anderson AE, Schneider SW, Wimmer MD, Wirtz DC, Valderrabano V, Barg A, Pagenstert G. Total ankle replacement in patients with von Willebrand disease: mid-term results of 18 procedures. Haemophilia 2015; 21:e389-401. [PMID: 25688467 DOI: 10.1111/hae.12561] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/19/2014] [Indexed: 12/28/2022]
Abstract
von Willebrand disease (VWD) is a recognized cause of secondary ankle osteoarthritis (OA). Few studies have examined orthopaedic complications and outcomes in VWD patients treated for end-stage ankle OA with total ankle replacement (TAR). To determine the clinical presentation, intraoperative and postoperative complications and evaluate the mid-term outcome in VWD patients treated with TAR. Eighteen patients with VWD with mean age 47.3 years (range = 34.0-68.7) were treated for end-stage ankle OA with TAR. The mean duration of follow-up was 7.5 years (range = 2.9-13.2). Intraoperative and perioperative complications were recorded. Component stability was assessed with weight-bearing radiographs. Clinical evaluation included range of motion (ROM) tests using a goniometer and under fluoroscopy using a lateral view. Clinical outcomes were analysed by a visual analogue scale, the American Orthopaedic Foot and Ankle Society hindfoot score and Short Form (36) Health Survey (SF-36) health survey. One patient sustained an intraoperative medial malleolar fracture. In two patients delayed wound healing was observed. Two secondary major surgeries were performed. Pain level decreased from 8.2 ± 0.9 (range = 7-10) preoperatively to 1.1 ± 1.2 (range = 0-4) postoperatively. Significant functional improvement including ROM was observed. All categories of SF-36 score showed significant improvement in quality of life. Mid-term results of TAR in patients with VWD are encouraging. The total rate of intraoperative and postoperative complications was 33.3%. However, longer term outcomes are necessary to fully understand the clinical benefit of TAR in patients with VWD.
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Affiliation(s)
- K Barg
- Orthopaedic Department, University Hospital of Basel, Basel, Switzerland
| | - M Wiewiorski
- Orthopaedic Department, University Hospital of Basel, Basel, Switzerland
| | - A E Anderson
- Department of Orthopaedics, Harold K. Dunn Orthopaedic Research Laboratory, University of Utah, Salt Lake City, UT, USA
| | - S W Schneider
- Department of Dermatology Venerology and Allergology, University Medical Center and Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - M D Wimmer
- Department of Orthopaedics and Trauma Surgery, University of Bonn, Bonn, Germany
| | - D C Wirtz
- Department of Orthopaedics and Trauma Surgery, University of Bonn, Bonn, Germany
| | - V Valderrabano
- Orthopaedic Department, University Hospital of Basel, Basel, Switzerland
| | - A Barg
- Orthopaedic Department, University Hospital of Basel, Basel, Switzerland
| | - G Pagenstert
- Orthopaedic Department, University Hospital of Basel, Basel, Switzerland
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Horisberger M, Barg A, Wiewiorski M, Anderson AE, Valderrabano V. Ankle joint-preserving surgery in a patient with severe haemophilia and Noonan syndrome: case report and literature review. Haemophilia 2014; 21:e105-8. [PMID: 25471311 DOI: 10.1111/hae.12583] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/18/2014] [Indexed: 11/28/2022]
Affiliation(s)
- M Horisberger
- Orthopaedic Department, University Hospital of Basel, Basel, Switzerland
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Henak CR, Abraham CL, Peters CL, Sanders RK, Weiss JA, Anderson AE. Computed tomography arthrography with traction in the human hip for three-dimensional reconstruction of cartilage and the acetabular labrum. Clin Radiol 2014; 69:e381-91. [PMID: 25070373 DOI: 10.1016/j.crad.2014.06.009] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2014] [Revised: 05/20/2014] [Accepted: 06/03/2014] [Indexed: 11/16/2022]
Abstract
AIM To develop and demonstrate the efficacy of a computed tomography arthrography (CTA) protocol for the hip that enables accurate three-dimensional reconstructions of cartilage and excellent visualization of the acetabular labrum. MATERIALS AND METHODS Ninety-three subjects were imaged (104 scans); 68 subjects with abnormal anatomy, 11 patients after periacetabular osteotomy surgery, and 25 subjects with normal anatomy. Fifteen to 25 ml of contrast agent diluted with lidocaine was injected using a lateral oblique approach. A Hare traction splint applied traction during CT. The association between traction force and intra-articular joint space was assessed qualitatively under fluoroscopy. Cartilage geometry was reconstructed from the CTA images for 30 subjects; the maximum joint space under traction was measured. RESULTS Using the Hare traction splint, the intra-articular space and boundaries of cartilage could be clearly delineated throughout the joint; the acetabular labrum was also visible. Dysplastic hips required less traction (∼5 kg) than normal and retroverted hips required (>10 kg) to separate the cartilage. An increase in traction force produced a corresponding widening of the intra-articular joint space. Under traction, the maximum width of the intra-articular joint space during CT ranged from 0.98-6.7 mm (2.46 ± 1.16 mm). CONCLUSIONS When applied to subjects with normal and abnormal hip anatomy, the CTA protocol presented yields clear delineation of the cartilage and the acetabular labrum. Use of a Hare traction splint provides a simple, cost-effective method to widen the intra-articular joint space during CT, and provides flexibility to vary the traction as required.
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Affiliation(s)
- C R Henak
- Department of Bioengineering, and Scientific Computing and Imaging Institute, University of Utah, Salt Lake City, UT, USA
| | - C L Abraham
- Department of Bioengineering, and Scientific Computing and Imaging Institute, University of Utah, Salt Lake City, UT, USA; Department of Orthopaedics, University of Utah, Salt Lake City, UT, USA
| | - C L Peters
- Department of Orthopaedics, University of Utah, Salt Lake City, UT, USA
| | - R K Sanders
- Department of Radiology, University of Utah, Salt Lake City, UT, USA
| | - J A Weiss
- Department of Bioengineering, and Scientific Computing and Imaging Institute, University of Utah, Salt Lake City, UT, USA; Department of Orthopaedics, University of Utah, Salt Lake City, UT, USA
| | - A E Anderson
- Department of Bioengineering, and Scientific Computing and Imaging Institute, University of Utah, Salt Lake City, UT, USA; Department of Orthopaedics, University of Utah, Salt Lake City, UT, USA; Department of Physical Therapy, University of Utah, Salt Lake City, UT, USA.
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Lugo JN, Swann JW, Anderson AE. Early-life seizures result in deficits in social behavior and learning. Exp Neurol 2014; 256:74-80. [PMID: 24685665 DOI: 10.1016/j.expneurol.2014.03.014] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [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: 12/19/2013] [Revised: 03/14/2014] [Accepted: 03/20/2014] [Indexed: 12/30/2022]
Abstract
Children with epilepsy show a high co-morbidity with psychiatric disorders and autism. One of the critical determinants of a child's behavioral outcome with autism and cognitive dysfunction is the age of onset of seizures. In order to examine whether seizures during postnatal days 7-11 result in learning and memory deficits and behavioral features of autism we administered the inhalant flurothyl to induce seizures in C57BL/6J mice. Mice received three seizures per day for five days starting on postnatal day 7. Parallel control groups consisted of similarly handled animals that were not exposed to flurothyl and naïve mice. Subjects were then processed through a battery of behavioral tests in adulthood: elevated-plus maze, nose-poke assay, marble burying, social partition, social chamber, fear conditioning, and Morris water maze. Mice with early-life seizures had learning and memory deficits in the training portion of the Morris water maze (p<0.05) and probe trial (p<0.01). Mice with seizures showed no differences in marble burying, the nose-poke assay, or elevated plus-maze testing compared to controls. However, they showed a significant difference in the social chamber and social partition tests. Mice with seizures during postnatal days 7-11 showed a significant decrease in social interaction in the social chamber test and had a significant impairment in social behavior in the social partition test. Together, these results indicate that early life seizures result in deficits in hippocampal-dependent memory tasks and produce long-term disruptions in social behavior.
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Affiliation(s)
- Joaquin N Lugo
- Department of Psychology and Neuroscience, Baylor University, Waco, TX 76798, USA; Cain Foundation Laboratories, Jan and Dan Duncan Neurological Research Institute at Texas Children's Hospital, USA; Department of Pediatrics, Baylor College of Medicine, Houston, TX 77030, USA.
| | - John W Swann
- Cain Foundation Laboratories, Jan and Dan Duncan Neurological Research Institute at Texas Children's Hospital, USA; Department of Pediatrics, Baylor College of Medicine, Houston, TX 77030, USA; Department of Neurology, Baylor College of Medicine, Houston, TX 77030, USA
| | - Anne E Anderson
- Cain Foundation Laboratories, Jan and Dan Duncan Neurological Research Institute at Texas Children's Hospital, USA; Department of Pediatrics, Baylor College of Medicine, Houston, TX 77030, USA; Department of Neurology, Baylor College of Medicine, Houston, TX 77030, USA; Department of Neuroscience, Baylor College of Medicine, Houston, TX 77030, USA
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Anderson AE, Flores KG, Boonyasiriwat W, Gammon A, Kohlmann W, Birmingham WC, Schwartz MD, Samadder J, Boucher K, Kinney AY. Interest and informational preferences regarding genomic testing for modest increases in colorectal cancer risk. Public Health Genomics 2014; 17:48-60. [PMID: 24435063 DOI: 10.1159/000356567] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2013] [Accepted: 10/21/2013] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND/AIMS This study explored the interest in genomic testing for modest changes in colorectal cancer risk and preferences for receiving genomic risk communications among individuals with intermediate disease risk due to a family history of colorectal cancer. METHODS Surveys were conducted on 272 men and women at intermediate risk for colorectal cancer enrolled in a randomized trial comparing a remote personalized risk communication intervention (TeleCARE) aimed at promoting colonoscopy to a generic print control condition. Guided by Leventhal's Common Sense Model of Self-Regulation, we examined demographic and psychosocial factors possibly associated with interest in SNP testing. Descriptive statistics and logistic regression models were used to identify factors associated with interest in SNP testing and preferences for receiving genomic risk communications. RESULTS Three-fourths of participants expressed interest in SNP testing for colorectal cancer risk. Testing interest did not markedly change across behavior modifier scenarios. Participants preferred to receive genomic risk communications from a variety of sources: printed materials (69.5%), oncologists (54.8%), primary-care physicians (58.4%), and the web (58.1%). Overall, persons who were unmarried (p = 0.029), younger (p = 0.003) and with greater cancer-related fear (p = 0.019) were more likely to express interest in predictive genomic testing for colorectal cancer risk. In a stratified analysis, cancer-related fear was associated with the interest in predictive genomic testing in the intervention group (p = 0.017), but not the control group. CONCLUSIONS Individuals with intermediate familial risk for colorectal cancer are highly interested in genomic testing for modest increases in disease risk, specifically unmarried persons, younger age groups and those with greater cancer fear.
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Affiliation(s)
- A E Anderson
- Huntsman Cancer Institute, University of Utah, Utah, USA
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Krueger DA, Wilfong AA, Holland-Bouley K, Anderson AE, Agricola K, Tudor C, Mays M, Lopez CM, Kim MO, Franz DN. Everolimus treatment of refractory epilepsy in tuberous sclerosis complex. Ann Neurol 2013; 74:679-87. [PMID: 23798472 DOI: 10.1002/ana.23960] [Citation(s) in RCA: 303] [Impact Index Per Article: 27.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2013] [Revised: 05/28/2013] [Accepted: 06/07/2013] [Indexed: 01/14/2023]
Abstract
OBJECTIVE Epilepsy is a major manifestation of tuberous sclerosis complex (TSC). Everolimus is an mammalian target of rapamycin complex 1 inhibitor with demonstrated benefit in several aspects of TSC. We report the first prospective human clinical trial to directly assess whether everolimus will also benefit epilepsy in TSC patients. METHODS The effect of everolimus on seizure control was assessed using a prospective, multicenter, open-label, phase I/II clinical trial. Patients≥2 years of age with confirmed diagnosis of TSC and medically refractory epilepsy were treated for a total of 12 weeks. The primary endpoint was percentage of patients with a ≥50% reduction in seizure frequency over a 4-week period before and after treatment. Secondary endpoints assessed impact on electroencephalography (EEG), behavior, and quality of life. RESULTS Twenty-three patients were enrolled, and 20 patients were treated with everolimus. Seizure frequency was reduced by ≥50% in 12 of 20 subjects. Overall, seizures were reduced in 17 of the 20 by a median reduction of 73% (p<0.001). Seizure frequency was also reduced during 23-hour EEG monitoring (p=0.007). Significant reductions in seizure duration and improvement in parent-reported behavior and quality of life were also observed. There were 83 reported adverse events that were thought to be treatment-related, all of which were mild or moderate in severity. INTERPRETATION Seizure control improved in the majority of TSC patients with medically refractory epilepsy following treatment with everolimus. Everolimus demonstrated additional benefits on behavior and quality of life. Treatment was safe and well tolerated. Everolimus may be a therapeutic option for refractory epilepsy in this population.
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Affiliation(s)
- Darcy A Krueger
- Departments of Pediatrics and Neurology, University of Cincinnati College of Medicine and Division of Child Neurology Cincinnati Children's Hospital Medical Center, Cincinnati, OH
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Anderson AE, Hure AJ, Forder P, Powers JR, Kay-Lambkin FJ, Loxton DJ. Predictors of antenatal alcohol use among Australian women: a prospective cohort study. BJOG 2013; 120:1366-74. [DOI: 10.1111/1471-0528.12356] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/12/2013] [Indexed: 11/28/2022]
Affiliation(s)
- AE Anderson
- Priority Research Centre for Gender, Health and Ageing; University of Newcastle; Callaghan NSW Australia
| | - AJ Hure
- Priority Research Centre for Gender, Health and Ageing; University of Newcastle; Callaghan NSW Australia
| | - P Forder
- Priority Research Centre for Gender, Health and Ageing; University of Newcastle; Callaghan NSW Australia
| | - JR Powers
- Priority Research Centre for Gender, Health and Ageing; University of Newcastle; Callaghan NSW Australia
| | - FJ Kay-Lambkin
- Priority Research Centre for Translational Neuroscience and Mental Health Research; University of Newcastle; Callaghan NSW Australia
- National Drug and Alcohol Research Centre; University of New South Wales; Randwick NSW Australia
| | - DJ Loxton
- Priority Research Centre for Gender, Health and Ageing; University of Newcastle; Callaghan NSW Australia
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Brewster AL, Lugo JN, Patil VV, Lee WL, Qian Y, Vanegas F, Anderson AE. Rapamycin reverses status epilepticus-induced memory deficits and dendritic damage. PLoS One 2013; 8:e57808. [PMID: 23536771 PMCID: PMC3594232 DOI: 10.1371/journal.pone.0057808] [Citation(s) in RCA: 82] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2012] [Accepted: 01/26/2013] [Indexed: 12/27/2022] Open
Abstract
Cognitive impairments are prominent sequelae of prolonged continuous seizures (status epilepticus; SE) in humans and animal models. While often associated with dendritic injury, the underlying mechanisms remain elusive. The mammalian target of rapamycin complex 1 (mTORC1) pathway is hyperactivated following SE. This pathway modulates learning and memory and is associated with regulation of neuronal, dendritic, and glial properties. Thus, in the present study we tested the hypothesis that SE-induced mTORC1 hyperactivation is a candidate mechanism underlying cognitive deficits and dendritic pathology seen following SE. We examined the effects of rapamycin, an mTORC1 inhibitor, on the early hippocampal-dependent spatial learning and memory deficits associated with an episode of pilocarpine-induced SE. Rapamycin-treated SE rats performed significantly better than the vehicle-treated rats in two spatial memory tasks, the Morris water maze and the novel object recognition test. At the molecular level, we found that the SE-induced increase in mTORC1 signaling was localized in neurons and microglia. Rapamycin decreased the SE-induced mTOR activation and attenuated microgliosis which was mostly localized within the CA1 area. These findings paralleled a reversal of the SE-induced decreases in dendritic Map2 and ion channels levels as well as improved dendritic branching and spine density in area CA1 following rapamycin treatment. Taken together, these findings suggest that mTORC1 hyperactivity contributes to early hippocampal-dependent spatial learning and memory deficits and dendritic dysregulation associated with SE.
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Affiliation(s)
- Amy L. Brewster
- Cain Foundation Laboratories, Jan and Dan Duncan Neurological Research Institute at Texas Children’s Hospital and Department of Pediatrics, Baylor College of Medicine, Houston, Texas, United States of America
| | - Joaquin N. Lugo
- Cain Foundation Laboratories, Jan and Dan Duncan Neurological Research Institute at Texas Children’s Hospital and Department of Pediatrics, Baylor College of Medicine, Houston, Texas, United States of America
| | - Vinit V. Patil
- Cain Foundation Laboratories, Jan and Dan Duncan Neurological Research Institute at Texas Children’s Hospital and Department of Pediatrics, Baylor College of Medicine, Houston, Texas, United States of America
| | - Wai L. Lee
- Cain Foundation Laboratories, Jan and Dan Duncan Neurological Research Institute at Texas Children’s Hospital and Department of Pediatrics, Baylor College of Medicine, Houston, Texas, United States of America
| | - Yan Qian
- Cain Foundation Laboratories, Jan and Dan Duncan Neurological Research Institute at Texas Children’s Hospital and Department of Pediatrics, Baylor College of Medicine, Houston, Texas, United States of America
| | - Fabiola Vanegas
- Cain Foundation Laboratories, Jan and Dan Duncan Neurological Research Institute at Texas Children’s Hospital and Department of Pediatrics, Baylor College of Medicine, Houston, Texas, United States of America
| | - Anne E. Anderson
- Cain Foundation Laboratories, Jan and Dan Duncan Neurological Research Institute at Texas Children’s Hospital and Department of Pediatrics, Baylor College of Medicine, Houston, Texas, United States of America
- Department of Neurology, Baylor College of Medicine, Houston, Texas, United States of America
- Department of Neuroscience, Baylor College of Medicine, Houston, Texas, United States of America
- * E-mail:
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McNeil JJ, Anderson AE, Louis WJ, Morgan DJ. Pharmacokinetics and pharmacodynamic studies of labetalol in hypertensive subjects. Br J Clin Pharmacol 2012; 8 Suppl 2:157S-61S. [DOI: 10.1111/j.1365-2125.1979.tb04773.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Kazdoba TM, Sunnen CN, Crowell B, Lee GH, Anderson AE, D'Arcangelo G. Development and characterization of NEX- Pten, a novel forebrain excitatory neuron-specific knockout mouse. Dev Neurosci 2012; 34:198-209. [PMID: 22572802 DOI: 10.1159/000337229] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2011] [Accepted: 02/13/2012] [Indexed: 01/15/2023] Open
Abstract
The phosphatase and tensin homolog located on chromosome 10 (PTEN) suppresses the activity of the phosphoinositide-3-kinase/Akt/mammalian target of rapamycin (mTOR) pathway, a signaling cascade critically involved in the regulation of cell proliferation and growth. Human patients carrying germ line PTEN mutations have an increased predisposition to tumors, and also display a variety of neurological symptoms and increased risk of epilepsy and autism, implicating PTEN in neuronal development and function. Consistently, loss of Pten in mouse neural cells results in ataxia, seizures, cognitive abnormalities, increased soma size and synaptic abnormalities. To better understand how Pten regulates the excitability of principal forebrain neurons, a factor that is likely to be altered in cognitive disorders, epilepsy and autism, we generated a novel conditional knockout mouse line (NEX-Pten) in which Cre, under the control of the NEX promoter, drives the deletion of Pten specifically in early postmitotic, excitatory neurons of the developing forebrain. Homozygous mutant mice exhibited a massive enlargement of the forebrain, and died shortly after birth due to excessive mTOR activation. Analysis of the neonatal cerebral cortex further identified molecular defects resulting from Pten deletion that likely affect several aspects of neuronal development and excitability.
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Affiliation(s)
- Tatiana M Kazdoba
- Department of Cell Biology and Neuroscience, The State University of New Jersey, Piscataway, NJ 08854, USA
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Marcelin B, Lugo JN, Brewster AL, Liu Z, Lewis AS, McClelland S, Chetkovich DM, Baram TZ, Anderson AE, Becker A, Esclapez M, Bernard C. Differential dorso-ventral distributions of Kv4.2 and HCN proteins confer distinct integrative properties to hippocampal CA1 pyramidal cell distal dendrites. J Biol Chem 2012; 287:17656-17661. [PMID: 22511771 DOI: 10.1074/jbc.c112.367110] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
The dorsal and ventral regions of the hippocampus perform different functions. Whether the integrative properties of hippocampal cells reflect this heterogeneity is unknown. We focused on dendrites where most synaptic input integration takes place. We report enhanced backpropagation and theta resonance and decreased summation of synaptic inputs in ventral versus dorsal CA1 pyramidal cell distal dendrites. Transcriptional Kv4.2 down-regulation and post-transcriptional hyperpolarization-activated cyclic AMP-gated channel (HCN1/2) up-regulation may underlie these differences, respectively. Our results reveal differential dendritic integrative properties along the dorso-ventral axis, reflecting diverse computational needs.
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Affiliation(s)
- Béatrice Marcelin
- INSERM, U1106, F-13385 Marseille, France; Aix Marseille Université, F-13385 Marseille, France
| | - Joaquin N Lugo
- Cain Foundation Laboratories, Section of Neurology, Department of Pediatrics, Baylor College of Medicine, Houston, Texas 77030
| | - Amy L Brewster
- Cain Foundation Laboratories, Section of Neurology, Department of Pediatrics, Baylor College of Medicine, Houston, Texas 77030
| | - Zhiqiang Liu
- Davee Department of Neurology and Clinical Neurosciences, Northwestern University, Chicago, Illinois 60611
| | - Alan S Lewis
- Davee Department of Neurology and Clinical Neurosciences, Northwestern University, Chicago, Illinois 60611
| | - Shawn McClelland
- Departments of Anatomy/Neurobiology and Pediatrics, University of California, Irvine, California 92697-4475
| | - Dane M Chetkovich
- Davee Department of Neurology and Clinical Neurosciences, Northwestern University, Chicago, Illinois 60611; Department of Physiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois 60611
| | - Tallie Z Baram
- Departments of Anatomy/Neurobiology and Pediatrics, University of California, Irvine, California 92697-4475
| | - Anne E Anderson
- Cain Foundation Laboratories, Section of Neurology, Department of Pediatrics, Baylor College of Medicine, Houston, Texas 77030; Department of Neurology and Department of Neuroscience, Baylor College of Medicine, Houston, Texas 77030
| | - Albert Becker
- Department of Neuropathology, University of Bonn Medical Center, Sigmund Freud Strasse 25, 53105 Bonn, Germany
| | - Monique Esclapez
- INSERM, U1106, F-13385 Marseille, France; Aix Marseille Université, F-13385 Marseille, France
| | - Christophe Bernard
- INSERM, U1106, F-13385 Marseille, France; Aix Marseille Université, F-13385 Marseille, France.
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Abstract
Kv4.2 channels contribute to the transient, outward K(+) current (A-type current) in hippocampal dendrites, and modulation of this current substantially alters dendritic excitability. Using Kv4.2 knockout (KO) mice, we examined the role of Kv4.2 in hippocampal-dependent learning and memory. We found that Kv4.2 KO mice showed a deficit in the learning phase of the Morris water maze (MWM) and significant impairment in the probe trial compared with wild type (WT). Kv4.2 KO mice also demonstrated a specific deficit in contextual learning in the fear-conditioning test, without impairment in the conditioned stimulus or new context condition. Kv4.2 KO mice had normal activity, anxiety levels, and prepulse inhibition compared with WT mice. A compensatory increase in tonic inhibition has been previously described in hippocampal slice recordings from Kv4.2 KO mice. In an attempt to decipher whether increased tonic inhibition contributed to the learning and memory deficits in Kv4.2 KO mice, we administered picrotoxin to block GABA(A) receptors (GABA(A)R), and thereby tonic inhibition. This manipulation had no effect on behavior in the WT or KO mice. Furthermore, total protein levels of the α5 or δ GABA(A)R subunits, which contribute to tonic inhibition, were unchanged in hippocampus. Overall, our findings add to the growing body of evidence, suggesting an important role for Kv4.2 channels in hippocampal-dependent learning and memory.
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Affiliation(s)
- Joaquin N Lugo
- Cain Foundation Laboratories, Jan and Dan Duncan Neurological Research Institute at Texas Children's Hospital, Houston, Texas 77030, USA
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Sunnen CN, Brewster AL, Lugo JN, Vanegas F, Turcios E, Mukhi S, Parghi D, D'Arcangelo G, Anderson AE. Inhibition of the mammalian target of rapamycin blocks epilepsy progression in NS-Pten conditional knockout mice. Epilepsia 2011; 52:2065-75. [PMID: 21973019 DOI: 10.1111/j.1528-1167.2011.03280.x] [Citation(s) in RCA: 90] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
PURPOSE Increased activity of mTOR Complex 1 (mTORC1) has been demonstrated in cortical dysplasia and tuberous sclerosis complex, as well as in animal models of epilepsy. Recent studies in such models revealed that inhibiting mTORC1 with rapamycin effectively suppressed seizure activity. However, seizures can recur after treatment cessation, and continuous rapamycin exposure can adversely affect animal growth and health. Here, we evaluated the efficacy of an intermittent rapamycin treatment protocol on epilepsy progression using neuron subset-specific-Pten (NS-Pten) conditional knockout mice. METHODS NS-Pten knockouts were treated with a single course of rapamycin during postnatal weeks 4 and 5, or intermittently over a period of 5 months. Epileptiform activity was monitored using video-electroencephalography (EEG) recordings, and mossy fiber sprouting was evaluated using Timm staining. Survival and body weight were assessed in parallel. KEY FINDINGS NS-Pten knockouts treated with a single course of rapamycin had recurrence of epilepsy 4-7 weeks after treatment ended. In contrast, epileptiform activity remained suppressed, and survival increased if knockout mice received additional rapamycin during weeks 10-11 and 16-17. Aberrant mossy fiber sprouting, present by 4 weeks of age and progressing in parallel with epileptiform activity, was also blocked by rapamycin. SIGNIFICANCE These findings demonstrate that a single course of rapamycin treatment suppresses epileptiform activity and mossy fiber sprouting for several weeks before epilepsy recurs. However, additional intermittent treatments with rapamycin prevented this recurrence and enhanced survival without compromising growth. Therefore, these studies add to the growing body of evidence implicating an important role for mTORC1 signaling in epilepsy.
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Affiliation(s)
- C Nicole Sunnen
- The Cain Foundation Laboratories and The Jan and Dan Duncan Neurological Research Institute, Texas Children's Hospital, Houston, Texas 77030, USA
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Brodlie M, McKean MC, Johnson GE, Anderson AE, Hilkens CMU, Fisher AJ, Corris PA, Lordan JL, Ward C. Raised interleukin-17 is immunolocalised to neutrophils in cystic fibrosis lung disease. Eur Respir J 2011; 37:1378-85. [PMID: 21109552 DOI: 10.1183/09031936.00067110] [Citation(s) in RCA: 69] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Interleukin (IL)-17 is pivotal in orchestrating the activity of neutrophils. Neutrophilic inflammation is the dominant pathology in cystic fibrosis (CF) lung disease. We investigated IL-17 protein expression in the lower airway in CF, its cellular immunolocalisation and the effects of IL-17 on CF primary bronchial epithelial cells. Immunohistochemistry was performed on explanted CF lungs and compared with the non-suppurative condition pulmonary hypertension (PH). Airway lavages and epithelial cultures were generated from explanted CF lungs. Immunoreactivity for IL-17 was significantly increased in the lower airway epithelium in CF (median 14.1%) compared with PH (2.95%, p=0.0001). The number of cells staining positive for IL-17 in the lower airway mucosa was also increased (64 cells·mm(-1) compared with 9 cells·mm(-1) basement membrane, p=0.0005) and included both neutrophils in addition to mononuclear cells. IL-17 was detectable in airway lavages from explanted CF lungs. Treatment of epithelial cultures with IL-17 increased production of IL-8, IL-6 and granulocyte macrophage colony-stimulating factor. In conclusion, immunoreactive IL-17 is raised in the lower airway of people with CF and localises to both neutrophils and mononuclear cells. IL-17 increases production of pro-neutrophilic mediators by CF epithelial cells, suggesting potential for a positive feedback element in airway inflammation.
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Affiliation(s)
- M Brodlie
- Applied Immunobiology and Transplantation Group, Institute of Cellular Medicine, Newcastle University, and Department of Cardiopulmonary Transplantation, Newcastle Upon Tyne Hospitals NHS Foundation Trust, Sir William Leech Centre For Lung Research, Freeman Hospital, Newcastle Upon Tyne, NE7 7DN, UK.
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Lodhi AK, Krishnamurthy S, Bhattacharyya A, Hall CS, Anderson AE, Jackson SA, Singh B, Lucci A. Abstract P3-02-01: Is Ethnicity a Predictor of Micrometastatic Disease in Early Stage Breast Cancer Patients? Cancer Res 2010. [DOI: 10.1158/0008-5472.sabcs10-p3-02-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Ethnicity plays a role in breast cancer (BC) outcome, highlighted by the fact that African-American women have a higher BC mortality rate than do Caucasian women. Microscopic disease, including disseminated tumor cells (DTCs) in bone marrow and circulating tumor cells (CTCs) in peripheral blood, has been shown to predict worse outcomes as well. We sought to determine whether ethnicity was a significant predictor for the presence of DTCs and/or CTCs in stage I-III BC patients.
Methods: Patients provided informed consent to participate in an IRB-approved study involving collection of blood and bone marrow at the time of surgery for their primary BC. CTCs (per 7.5 ml blood) were detected using the Cell SearchTM system (Veridex) and were defined as nucleated cells lacking CD45 but expressing cytokeratins (CK) 8, 18, or 19; for this study we considered one or more positive cells meeting these criteria a positive result. DTCs were assessed using an anti-CK antibody cocktail (AE1/AE3, CAM5.2, MNF116, CK8 and 18) following cytospin. A positive result for DTCs was defined by presence of one or more CK positive cells meeting morphologic criteria for malignancy. Information on clinicopathological factors including ethnicity was obtained from a prospective database. Statistical analyses used Chi-square test on STATA IC11.
Results: We prospectively evaluated 224 patients undergoing surgery for stage I-III BC. Median follow-up was 22 months and mean age was 53 years. One hundred sixty seven patients (75%) were Caucasians, 22 (10%) were African-American (AA), 30 (14%) were Hispanic and 3 (1%) belonged to other ethnicities. CTCs were found in 25% (57/224) and DTCs in 30% (67/224) of patients. Patients of AA ethnicity were significantly more likely to have CTCs (50%, (11/22)) compared to the other ethnic groups (22%, (43/194)); {O.R. = 2.5, 95% C.I. = 1.35- 7.80, P = 0.002}, and had significantly higher numbers of CTCs (≥2 CTCs or ≥3 CTCs/7.5mL blood) than other ethnic groups (P = 0.001 and P < 0.001, respectively). No statistically significant correlation was observed between other ethnic groups and CTCs. Patients of Hispanic origin were more likely to have DTCs (60%, (18/30)) as compared to other ethnic groups (25%, (49/194)); {O.R. = 4.4, 95% C.I. = 1.85- 10.80, P < 0.0001}, while DTCs were less likely to be found in Caucasians (26%, (44/167)) as compared to the other ethnicities (40%, (23/57)); {O.R. = 0.52, 95% C.I. = 0.27 — 1.05, P = 0.046}. No significant association was found between occurrence of DTCs and AA ethnicity. In a multivariate analysis considering lymph node status, tumor size and tumor markers, ethnic origin was an independent predictor of microscopic disease.
Conclusions: Nearly one-third of primary BC patients have CTCs and/or DTCs. African-American women were much more likely to have CTCs and Hispanic patients had significantly more DTCs than did patients of other ethnicities. Ethnicity was an independent predictor of microscopic disease. These findings may shed some light on the higher BC mortality rates found in certain ethnic groups.
Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P3-02-01.
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Affiliation(s)
- AK Lodhi
- University of Texas MD Anderson Cancer Center, Houston
| | | | | | - CS Hall
- University of Texas MD Anderson Cancer Center, Houston
| | - AE Anderson
- University of Texas MD Anderson Cancer Center, Houston
| | - SA Jackson
- University of Texas MD Anderson Cancer Center, Houston
| | - B Singh
- University of Texas MD Anderson Cancer Center, Houston
| | - A. Lucci
- University of Texas MD Anderson Cancer Center, Houston
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Lodhi AK, Krishnamurthy S, Bhattacharyya A, Hall CS, Anderson AE, Singh B, Lucci A. Abstract P3-02-02: Influence of Body Mass Index on Presence of Disseminated Tumor Cells in Clinical Stage I-III Breast Cancer Patients. Cancer Res 2010. [DOI: 10.1158/0008-5472.sabcs10-p3-02-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Disseminated tumor cells (DTCs) are found in approximately one third of clinical stage I-III breast cancer (BC) patients, and published reports show that presence of DTCs is an independent predictor of outcome. While higher body mass index (BMI) is associated with increased risk of breast cancer recurrence and lower survival rates in BC patients, women with lower BMIs may have lower bone density and higher bone turnover. We hypothesized that increases in bone turnover may result in the release of bone growth and “homing” factors that facilitate BC metastasis to bone and provide a “pre-metastatic niche” for BC cells. The purpose of this study was to determine if a correlation existed between DTCs and BMI in early stage BC patients.
Methods: We obtained informed consent and collected bone marrow samples from 262 clinical stage I-III BC patients who were participants in an IRB-approved clinical study from 2/2005- 2/2010. All marrow samples were collected at the time of surgery for the primary tumor. DTCs were assessed using anti-pancytokeratin (CK) antibody cocktail (AE1/AE3, CAM5.2, MNF116, CK8 and 18) following cytospin. The presence of one or more CK positive cells meeting morphologic criteria for malignancy was considered a positive result for DTC. Patients with a BMI of (18.5 — 24.9) kg/m2 were considered “normal weight”, those with a BMI of (25 - 29.9) kg/m2 “overweight” and a BMI greater than 30 kg/m2 was used to designate them as “obese”. Information on clinicopathological factors including BMI (measured on initial presentation) was obtained from a prospective database. Statistical analyses used Chi-square and non-parametric tests for trend.
Results: Median follow-up was 19 months and mean age was 53 (25-80) years. Eighty-four patients (32%) were normal weight, 85 (32%) were overweight and 91 (35%) were obese. Seventy-eight (30%) patients had DTCs present at the time of assessment. Obese patients were significantly less likely to show presence of DTCs as compared to those who had a BMI < 30 kg/m2 (20/78; 26% vs. 71/184; 39%) {O.R. = 0.55, 95% C.I. = 0.29- 0.96, P = 0.03}. DTCs were also less likely to be found in patients with BMI ≥25 kg/m2 as compared to those with BMI < 25 kg/m2 (40/78; 51% vs. 136/184; 74%); {O.R. = 0.42, 95% C.I. = 0.04- 1.02, P = 0.03}. No statistically significant correlation was observed between primary tumor characteristics (ER, PR, HER2, lymph node status, tumor grade) and presence of DTCs. Finally, a non-parametric analysis demonstrated a trend in occurrence of DTCs across the ordered levels of patients’ BMI values (P= 0.013).
Conclusions: DTCs were much more common in patients with lower BMI. Further studies are needed to determine if patients with low BMI have unique microenvironmental factors within the bone that predisposes them to tumor cell dissemination.
Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P3-02-02.
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Affiliation(s)
- AK Lodhi
- University of Texas M. D. Anderson Cancer Center, Houston
| | | | | | - CS Hall
- University of Texas M. D. Anderson Cancer Center, Houston
| | - AE Anderson
- University of Texas M. D. Anderson Cancer Center, Houston
| | - B Singh
- University of Texas M. D. Anderson Cancer Center, Houston
| | - A. Lucci
- University of Texas M. D. Anderson Cancer Center, Houston
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