Karnam Havisha B, Zhao Qian, Shatskikh Tatiana, Holmes Gregory L
Department of Neurology, Neuroscience Center at Dartmouth, Dartmouth Medical School, Hanover, New Hampshire 03756, United States.
Epilepsy Res. 2009 Aug;85(2-3):221-30. doi: 10.1016/j.eplepsyres.2009.03.008. Epub 2009 Apr 22.
Clinical studies have suggested that seizures in newborns are more damaging than seizures occurring in older children. However, these studies are difficult to interpret for a variety of factors including differing etiologies of seizures across ages. Animal studies can provide insights into the question of whether age of seizure onset in children is a factor in cognitive outcome.
To evaluate the effect of age on seizure-induced cognitive impairment we subjected rats to 50 seizures from postnatal days P0-P10 or P15-P25. As adults the rats were studied in the Morris water maze, radial-arm water maze, open field, and active avoidance. To assess synaptic strength and network excitatory and inhibitory function animals were evaluated with long-term potentiation (LTP) and paired-pulse facilitation/inhibition.
Compared to controls, both groups of rats with recurrent seizures were impaired in spatial memory in both water maze tests, had altered activity in the open field, and did not differ from controls in active avoidance. Rats with recurrent seizures had impaired LTP but showed no deficits in paired-pulse facilitation or inhibition. While rats with later onset showed a trend to worse performance than rats with earlier seizures, the differences were not substantial.
Recurrent seizures during development are associated with long-term behavioral deficits in learning, memory and activity level as well as impaired synaptic efficiency. Age of seizure onset was not a strong predictor of outcome.
临床研究表明,新生儿癫痫发作比大龄儿童癫痫发作的损害更大。然而,由于包括各年龄段癫痫发作病因不同等多种因素,这些研究难以解读。动物研究可以为儿童癫痫发作起始年龄是否是认知结果的一个因素这一问题提供见解。
为了评估年龄对癫痫发作所致认知障碍的影响,我们使出生后第0至10天或第15至25天的大鼠经历50次癫痫发作。成年后,在莫里斯水迷宫、放射状臂水迷宫、旷场和主动回避实验中对大鼠进行研究。为了评估突触强度以及网络兴奋性和抑制性功能,采用长时程增强(LTP)和双脉冲易化/抑制对动物进行评估。
与对照组相比,两组反复癫痫发作的大鼠在两项水迷宫测试中的空间记忆均受损,在旷场中的活动发生改变,在主动回避实验中与对照组无差异。反复癫痫发作的大鼠LTP受损,但在双脉冲易化或抑制方面无缺陷。虽然癫痫发作较晚的大鼠表现出比癫痫发作较早的大鼠更差的趋势,但差异并不显著。
发育期间的反复癫痫发作与学习、记忆和活动水平的长期行为缺陷以及突触效率受损有关。癫痫发作起始年龄并非结果的有力预测指标。