D'Ambrosio Raimondo, Fender Jason S, Fairbanks Jared P, Simon Ednea A, Born Donald E, Doyle Dana L, Miller John W
Department of Neurological Surgery, Center on Human Development and Disability, University of Washington, School of Medicine, Harborview Medical Center, Box 359915, 325 Ninth Avenue, Seattle, WA 98104, USA.
Brain. 2005 Jan;128(Pt 1):174-88. doi: 10.1093/brain/awh337. Epub 2004 Nov 24.
We recently described an in vivo model of post-traumatic epilepsy (PTE) in the rat where chronic spontaneous recurrent seizures appear following a single episode of fluid percussion injury (FPI). PTE, studied during the first 2 months post-injury, was focal and seizures originated predominantly from the frontal-parietal neocortex at or around the injury site. However, rarer bilateral seizures originating from a different and undefined focus were also observed. To shed light on the Posttraumatic Epileptogenic mechanisms and on the generation of bilateral seizures, we studied rats up to 7 months post-injury. In vivo paired epidural and depth-electrode recordings indicated that the anterior hippocampus evolves into an epileptic focus which initiates bilateral seizures. The rate of frontal-parietal seizures remained constant over time after 2 weeks post-injury, while the rate of hippocampal seizures greatly increased over time, suggesting that different mechanisms mediate neocortical and hippocampal post-traumatic epileptogenesis. Because of different temporal evolution of these foci, the epileptic syndrome was characterized by predominant frontal-parietal seizures early after injury, but by predominant mesio-temporal seizures at later time points. Pathological analysis demonstrated progressive hippocampal and temporal cortex pathology that paralleled the increase in frequency and duration of bilateral seizures. These results demonstrate that FPI-induced frontal-parietal epilepsy (FPE) progresses to mesial-temporal lobe epilepsy (MTLE) with dual pathology. These observations establish numerous similarities between FPI-induced and human PTE and further validate it as a clinically relevant model of PTE.
我们最近描述了一种大鼠创伤后癫痫(PTE)的体内模型,在单次液体冲击伤(FPI)后会出现慢性自发性反复癫痫发作。在损伤后的前2个月进行研究,PTE为局灶性,癫痫发作主要起源于损伤部位或其周围的额顶叶新皮层。然而,也观察到了罕见的源自不同且未明确的病灶的双侧癫痫发作。为了阐明创伤后癫痫的发病机制以及双侧癫痫发作的产生,我们对损伤后长达7个月的大鼠进行了研究。体内成对的硬膜外和深部电极记录表明,前海马体演变成一个癫痫病灶,引发双侧癫痫发作。损伤后2周后,额顶叶癫痫发作的发生率随时间保持恒定,而海马体癫痫发作的发生率随时间大幅增加,这表明不同的机制介导了新皮层和海马体的创伤后癫痫发生。由于这些病灶的时间演变不同,癫痫综合征在损伤早期以额顶叶癫痫发作为主,而在后期以颞叶内侧癫痫发作为主。病理分析显示海马体和颞叶皮质的病理变化逐渐进展,与双侧癫痫发作的频率和持续时间增加平行。这些结果表明,FPI诱导的额顶叶癫痫(FPE)进展为具有双重病理的颞叶内侧癫痫(MTLE)。这些观察结果在FPI诱导的癫痫与人类PTE之间建立了许多相似之处,并进一步验证了它作为PTE的临床相关模型。
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