Bertram E H, Mangan P S, Zhang D, Scott C A, Williamson J M
Department of Neurology, University of Virginia, Charlottesville, Virginia 22908, USA.
Epilepsia. 2001 Aug;42(8):967-78. doi: 10.1046/j.1528-1157.2001.042008967.x.
In limbic or mesial temporal lobe epilepsy, much attention has been given to specific regions or cell populations (e.g., the hippocampus or dentate granule cells). Epileptic seizures may involve broader changes in neural circuits, and evidence suggests that subcortical regions may play a role. In this study we examined the midline thalamic regions for involvement in limbic seizures, changes in anatomy and physiology, and the potential role for this region in limbic seizures and epilepsy.
Using two rat models for limbic epilepsy (hippocampal kindled and chronic spontaneous limbic epilepsy) we examined the midline thalamus for evidence of involvement in seizure activity, alterations in structure, changes in the basic in vitro physiology of the thalamic neurons. We also explored how this region may influence limbic seizures.
The midline thalamus was consistently involved with seizure activity from the onset, and there was significant neuronal loss in the medial dorsal and reuniens/rhomboid nuclei. In addition, thalamic neurons had changes in synaptically mediated and voltage-gated responses. Infusion of lidocaine into the midline thalamus significantly shortened afterdischarge duration.
These observations suggest that this thalamic region is part of the neural circuitry of limbic epilepsy and may play a significant role in seizure modulation. Local neuronal changes can enhance the excitability of the thalamolimbic circuits.
在边缘叶或内侧颞叶癫痫中,人们已对特定区域或细胞群(如海马体或齿状颗粒细胞)给予了大量关注。癫痫发作可能涉及神经回路更广泛的变化,且有证据表明皮质下区域可能发挥作用。在本研究中,我们检查了中线丘脑区域是否参与边缘叶癫痫发作、解剖学和生理学变化,以及该区域在边缘叶癫痫发作和癫痫中的潜在作用。
使用两种边缘叶癫痫大鼠模型(海马体点燃模型和慢性自发性边缘叶癫痫模型),我们检查了中线丘脑是否有参与癫痫活动的证据、结构改变、丘脑神经元基本体外生理学变化。我们还探究了该区域如何影响边缘叶癫痫发作。
从中线丘脑区域一开始就持续参与癫痫活动,内侧背核和中央正中核/菱形核存在明显的神经元丢失。此外,丘脑神经元在突触介导反应和电压门控反应方面有变化。向中线丘脑注入利多卡因可显著缩短放电后持续时间。
这些观察结果表明,该丘脑区域是边缘叶癫痫神经回路的一部分,可能在癫痫发作调节中发挥重要作用。局部神经元变化可增强丘脑边缘叶回路的兴奋性。