Kadam Shilpa D, Dudek F Edward
Department of Biomedical Sciences, Neurosciences Division, Colorado State University, Fort Collins, Colorado 80523, USA.
J Comp Neurol. 2007 Dec 20;505(6):716-37. doi: 10.1002/cne.21533.
Hypoxic-ischemic (HI) encephalopathy is an important neurological problem of the perinatal period. Little is known of the long-term progression of HI insults or the maladaptive changes that lead to epilepsy. Using rats with unilateral carotid occlusion followed by hypoxia at postnatal day 7, this study provides an initial analysis of the epilepsy caused by a perinatal HI insult with chronic and continuous behavioral monitoring. The histopathology was investigated at postnatal day 30 and later at > or =6 months of age using cresyl violet, Timm, and rapid Golgi staining and immunocytochemistry. The resultant epilepsy showed an increase in seizure frequency over time, with a preponderance for seizure clusters and behavioral features of an ipsilateral cerebral syndrome. In addition to parasagittal infarcts and porencephalic cysts in severe lesions, columnar neuronal death was found with cytomegaly in isolated groups of dysmorphic cortical neurons. Cortical dysgenesis was seen in the form of deep laminar cell loss, microgyri, white matter hypercellularity, and blurring of the white and gray matter junction. Mossy fiber sprouting was not only detected in the atrophied ipsilateral dorsal hippocampus of HI rats with chronic epilepsy, but was also found in comparable grades in spared ipsi- and contralateral ventral hippocampi. The cortical lesions in this animal model show histological similarities with those found in humans after perinatal HI. The occurrence of cortical abnormalities that are associated with epilepsy in humans correlates with the consequent detection of spontaneous recurrent seizures.
缺氧缺血性(HI)脑病是围生期重要的神经学问题。对于HI损伤的长期进展或导致癫痫的适应性不良变化,人们了解甚少。本研究采用出生后第7天单侧颈动脉闭塞并继以缺氧的大鼠,通过长期持续的行为监测,对围生期HI损伤所致癫痫进行了初步分析。在出生后第30天以及≥6月龄时,使用甲酚紫、Timm、快速高尔基染色和免疫细胞化学方法对组织病理学进行了研究。所导致的癫痫表现为发作频率随时间增加,以发作簇和同侧脑综合征的行为特征为主。除严重病变中的矢状旁梗死和脑穿通性囊肿外,在形态异常的皮质神经元孤立组中发现柱状神经元死亡并伴有细胞肿大。皮质发育异常表现为深层细胞丢失、微小脑回、白质细胞增多以及白质与灰质交界处模糊。苔藓纤维发芽不仅在患有慢性癫痫的HI大鼠同侧萎缩的背侧海马中被检测到,在同侧和对侧腹侧海马的相应部位也有类似程度的发现。该动物模型中的皮质病变在组织学上与围生期HI后人类发现的病变相似。人类中与癫痫相关的皮质异常的出现与随后检测到的自发性反复癫痫发作相关。