Hamani Clement, Hodaie Mojgan, Chiang Jason, del Campo Martin, Andrade Danielle M, Sherman David, Mirski Marek, Mello Luiz E, Lozano Andres M
Division of Neurosurgery, Toronto Western Hospital and University Health Network, University of Toronto, Toronto, Ontario, Canada.
Epilepsy Res. 2008 Feb;78(2-3):117-23. doi: 10.1016/j.eplepsyres.2007.09.010. Epub 2007 Dec 20.
Electrical stimulation of the anterior nucleus of the thalamus appears to be effective against seizures in animals and humans. As the optimal stimulation settings remain elusive, we studied the effects of different stimulation parameters against pilocarpine induced seizures and status epilepticus (SE).
Adult rats had electrodes implanted bilaterally into the AN. Five days later, different groups of animals were stimulated with 1000 microA, 500 microA, or 200 microA and frequencies of either 20 Hz or 130 Hz. Pilocarpine (350 mg/kg i.p.) was injected 5 min after stimulation onset and seizures were monitored. Sham-treated controls had electrodes implanted but did not receive stimulation until they developed SE. After SE, these animals had the electrodes turned on to assess whether AN stimulation could arrest ongoing ictal activity.
Compared to sham-treated controls (n=8), stimulation at 500 microA (n=13) significantly increased the latency for seizures and SE by 1.9-2.2-fold. In contrast, stimulation at 1000 microA (n=8) produced a non-significant decrease in the latencies to these events. No major effect was observed with stimulation at 200 microA (n=11). Similar results were obtained for each current intensity, regardless of the stimulation frequency used (20 Hz and 130 Hz). In sham-treated controls that had the electrodes turned on after SE, stimulation was not able to arrest ongoing ictal activity.
The anticonvulsant effects of AN stimulation against pilocarpine-induced seizures were mainly determined by the current and not the frequency of stimulation. AN stimulation initiated after SE onset was ineffective.
丘脑前核的电刺激似乎对动物和人类的癫痫发作有效。由于最佳刺激设置仍不明确,我们研究了不同刺激参数对毛果芸香碱诱发的癫痫发作和癫痫持续状态(SE)的影响。
成年大鼠双侧植入电极至丘脑前核。五天后,不同组的动物分别用1000微安、500微安或200微安,频率为20赫兹或130赫兹进行刺激。刺激开始5分钟后注射毛果芸香碱(350毫克/千克腹腔注射),并监测癫痫发作情况。假手术对照组植入电极,但在出现癫痫持续状态之前不接受刺激。在出现癫痫持续状态后,这些动物打开电极以评估丘脑前核电刺激是否能阻止正在进行的发作活动。
与假手术对照组(n = 8)相比,500微安(n = 13)刺激显著使癫痫发作和癫痫持续状态的潜伏期延长1.9至2.2倍。相比之下,1000微安(n = 8)刺激使这些事件的潜伏期有不显著的缩短。200微安(n = 11)刺激未观察到主要影响。无论使用的刺激频率(20赫兹和130赫兹)如何,每种电流强度均获得类似结果。在癫痫持续状态后打开电极的假手术对照组中,刺激无法阻止正在进行的发作活动。
丘脑前核电刺激对毛果芸香碱诱发癫痫发作的抗惊厥作用主要由电流而非刺激频率决定。癫痫持续状态发作后开始的丘脑前核电刺激无效。