Sutula Thomas P, Dudek F Edward
Department of Neurology H6/570 CSC, University of Wisconsin, 600 Highland Avenue, Madison, WI 53792, USA.
Prog Brain Res. 2007;163:541-63. doi: 10.1016/S0079-6123(07)63029-5.
Seizure-induced sprouting of the mossy fiber pathway in the dentate gyrus has been observed nearly universally in experimental models of limbic epilepsy and in the epileptic human hippocampus. The observation of progressive mossy fiber sprouting induced by kindling demonstrated that even a few repeated seizures are sufficient to alter synaptic connectivity and circuit organization. As it is now recognized that seizures induce synaptic reorganization in hippocampal and cortical pathways, the implications of seizure-induced synaptic reorganization for circuit properties and function have been subjects of intense interest. Detailed anatomical characterization of the sprouted mossy fiber pathway has revealed that the overwhelming majority of sprouted synapses in the inner molecular layer of the dentate gyrus form recurrent excitatory connections, and are thus likely to contribute to recurrent excitation and potentially to enhanced susceptibility to seizures. Nevertheless, difficulties in detecting functional abnormalities in circuits reorganized by mossy fiber sprouting and the fact that some sprouted axons appear to form synapses with inhibitory interneurons have been cited as evidence that sprouting may not contribute to seizure susceptibility, but could form recurrent inhibitory circuits and be a compensatory response to prevent seizures. Quantitative analysis of the synaptic connections of the sprouted mossy fiber pathway, assessment of the functional features of sprouted circuitry using reliable physiological measures, and the perspective of complex systems analysis of neural circuits strongly support the view that the functional effects of the recurrent excitatory circuits formed by mossy fiber sprouting after seizures or injury emerge only conditionally and intermittently, as observed with spontaneous seizures in human epilepsy. The recognition that mossy fiber sprouting is induced after hippocampal injury and seizures and contributes conditionally to emergence of recurrent excitation has provided a conceptual framework for understanding how injury and seizure-induced circuit reorganization may contribute to paroxysmal network synchronization, epileptogenesis, and the consequences of repeated seizures, and thus has had a major influence on understanding of fundamental aspects of the epilepsies.
在边缘性癫痫的实验模型以及癫痫患者的海马体中,几乎普遍观察到癫痫发作诱导齿状回苔藓纤维通路的发芽。点燃诱导的渐进性苔藓纤维发芽的观察表明,即使是几次反复的癫痫发作也足以改变突触连接和电路组织。由于现在已经认识到癫痫发作会诱导海马体和皮质通路中的突触重组,癫痫发作诱导的突触重组对电路特性和功能的影响一直是人们密切关注的课题。对发芽的苔藓纤维通路的详细解剖学特征表明,齿状回内分子层中绝大多数发芽的突触形成了反复的兴奋性连接,因此可能有助于反复兴奋,并可能增加癫痫发作的易感性。然而,检测由苔藓纤维发芽重组的电路中的功能异常存在困难,并且一些发芽的轴突似乎与抑制性中间神经元形成突触这一事实被引为证据,表明发芽可能不会导致癫痫易感性增加,而是可能形成反复的抑制性电路,并作为预防癫痫发作的一种代偿反应。对发芽的苔藓纤维通路的突触连接进行定量分析,使用可靠的生理测量方法评估发芽电路的功能特征,以及对神经电路进行复杂系统分析的观点,都有力地支持了这样一种观点,即癫痫发作或损伤后苔藓纤维发芽形成的反复兴奋性电路的功能效应仅在特定条件下和间歇性地出现,就像在人类癫痫的自发发作中观察到的那样。认识到海马体损伤和癫痫发作后会诱导苔藓纤维发芽,并在一定条件下促成反复兴奋的出现,为理解损伤和癫痫发作诱导的电路重组如何导致阵发性网络同步、癫痫发生以及反复癫痫发作的后果提供了一个概念框架,因此对理解癫痫的基本方面产生了重大影响。