Hill M W, Wong M, Amarakone A, Rothman S M
Department of Neurology, Washington University School of Medicine, St. Louis, Missouri, USA.
Epilepsia. 2000 Oct;41(10):1241-8. doi: 10.1111/j.1528-1157.2000.tb04601.x.
As a preliminary step in the development of an implantable Peltier device to abort focal neocortical seizures in vivo, we have examined the effect of rapid cooling on seizures in rodent hippocampal-entorhinal slices.
Seizure-like discharges were induced by exposing the slices to extracellular saline containing 4-aminopyridine (50 micromol/L).
When we manually activated a Peltier device that was in direct contact with the slice, seizures terminated within seconds of the onset of cooling, sometimes preceding a detectable decrease in temperature measured near the top of the slice. However, activation of the Peltier device did not stop seizures when slices were no longer in direct physical contact with the device, indicating that this was not a field effect. When cooling was shut off and temperature returned to 33 degrees C, bursting sometimes returned, but a longer-term suppressive effect on seizure activity could be observed. In two of our experiments, a custom computer program automatically detected seizure discharges and triggered a transistor-transistor logic pulse to activate the Peltier device. In these experiments, the Peltier device automatically terminated the slice bursting in less than 4 seconds. When the Peltier device was placed in contact with the normal, exposed cortex of a newborn pig, we found that the cortical temperature decreased rapidly from 36 degrees C to as low as 26 degrees C at a depth of 1.7 mm below the cooling unit.
These experiments show that local cooling may rapidly terminate focal paroxysmal discharges and might be adapted for clinical practice.
作为开发用于在体内中止局灶性新皮质癫痫发作的植入式珀耳帖装置的初步步骤,我们研究了快速冷却对啮齿动物海马-内嗅皮层切片癫痫发作的影响。
通过将切片暴露于含有4-氨基吡啶(50微摩尔/升)的细胞外盐水中诱导癫痫样放电。
当我们手动激活与切片直接接触的珀耳帖装置时,癫痫发作在冷却开始后的几秒钟内终止,有时在切片顶部附近测得的温度出现可检测到的下降之前就已终止。然而,当切片不再与该装置直接物理接触时,激活珀耳帖装置并不能阻止癫痫发作,这表明这不是一种场效应。当冷却停止且温度恢复到33摄氏度时,爆发有时会再次出现,但可以观察到对癫痫活动有长期抑制作用。在我们的两个实验中,一个定制的计算机程序自动检测癫痫放电并触发晶体管-晶体管逻辑脉冲来激活珀耳帖装置。在这些实验中,珀耳帖装置在不到4秒的时间内自动终止了切片爆发。当将珀耳帖装置与新生猪正常暴露的皮层接触时,我们发现在冷却单元下方1.7毫米深处,皮层温度从36摄氏度迅速降至低至26摄氏度。
这些实验表明局部冷却可能迅速终止局灶性阵发性放电,并可能适用于临床实践。