Gentsch K, Heinemann U, Schmitz B, Behr J
Department of Neurophysiology, Institute of Physiology, University Hospital Charité, Humboldt University Berlin, Germany.
Epilepsia. 2000 Aug;41(8):925-8. doi: 10.1111/j.1528-1157.2000.tb00273.x.
The entorhinal cortex (EC) represents the main input structure to the hippocampus and seems to be critically involved in temporal lobe epilepsy. Considering that the EC receives a strong serotonergic projection from the raphe nuclei and expresses a high density of serotonin (5-HT) receptors, the effect of the 5-HT-releasing drug fenfluramine (FFA) on epileptiform activity generated in the EC was investigated in an in vitro model of epilepsy.
The experiments were performed on 43 horizontal slices containing the EC, the subiculum, and the hippocampal formation obtained from 230-250 g adult Wistar rats. Using extracellular recording techniques, we investigated the effect of bath-applied FFA (200 micromol/L to 1 mmol/L) on epileptiform activity induced by omitting MgSO4 from the artificial cerebrospinal fluid.
We demonstrate that FFA reversibly blocks epileptiform activity in the EC. Surprisingly, in the presence of the 5-HT uptake blocker paroxetine, the FFA-induced effect was diminished. Coapplication of the 5-HT1A receptor antagonist WAY100635 prevented the FFA-induced anticonvulsive effect, suggesting that (a) the FFA-induced suppression of epileptiform activity is mediated by the release of 5-HT from synaptic terminals within the EC rather than by an unspecific effect of FFA and (b) released 5-HT most likely blocks the activity by activation of 5-HT1A receptors.
FFA, which is primarily used because of its anorectic activity, might get an additional therapeutic value in the treatment of temporal lobe epilepsy with parahippocampal involvement.
内嗅皮质(EC)是海马体的主要输入结构,似乎在颞叶癫痫中起关键作用。鉴于EC接受来自中缝核的强烈5-羟色胺能投射并表达高密度的5-羟色胺(5-HT)受体,我们在癫痫体外模型中研究了5-HT释放药物芬氟拉明(FFA)对EC中产生的癫痫样活动的影响。
实验采用从230 - 250 g成年Wistar大鼠获取的43个包含EC、下托和海马结构的水平切片进行。使用细胞外记录技术,我们研究了浴加FFA(200 μmol/L至1 mmol/L)对通过从人工脑脊液中省略MgSO4诱导的癫痫样活动的影响。
我们证明FFA可逆转EC中的癫痫样活动。令人惊讶的是,在5-HT摄取阻断剂帕罗西汀存在的情况下,FFA诱导的效应减弱。共同应用5-HT1A受体拮抗剂WAY100635可防止FFA诱导的抗惊厥作用,这表明(a)FFA诱导的癫痫样活动抑制是由EC内突触末端释放5-HT介导的,而非FFA的非特异性作用;(b)释放的5-HT最有可能通过激活5-HT1A受体来阻断活动。
主要因其食欲抑制活性而使用的FFA,在治疗伴有海马旁参与的颞叶癫痫时可能具有额外的治疗价值。