Department of Pharmacology and Physiology, Georgetown University, Washington, District of Columbia, United States of America.
PLoS One. 2013 Dec 4;8(12):e81401. doi: 10.1371/journal.pone.0081401. eCollection 2013.
Neurosurgical therapeutic interventions include components that are presumed to be therapeutically inert, such as craniotomy and electrode implantation. Because these procedures may themselves exert neuroactive actions, with anecdotal evidence suggesting that craniotomy and electrode placement may have a particularly significant impact on epileptic seizures, the importance of their inclusion in sham control groups has become more compelling. Here we set out to test the hypothesis that craniotomy alone is sufficient to alter experimental seizures in rats. We tested adult male rats for seizures evoked by pentylenetetrazole (70 mg/kg) between 3 and 20 days following placement of bilateral craniotomies (either 2.5 or 3.5 mm in diameter) in the parietal bone of the skull, without penetrating the dura. Control (sham-operated) animals underwent anesthesia and surgery without craniotomy. We found that craniotomy significantly decreased the severity of experimental seizures on postoperative days 3, 6, and 10; this effect was dependent on the size of craniotomy. Animals with craniotomies returned to control seizure severity by 20 days post-craniotomy. These data support the hypothesis that damage to the skull is sufficient to cause a significant alteration in seizure susceptibility over an extended postoperative period, and indicate that this damage should not be considered neurologically inert.
神经外科治疗干预包括被认为具有治疗惰性的成分，例如开颅术和电极植入。由于这些手术本身可能会产生神经活性作用，并且有传闻证据表明开颅术和电极放置可能对癫痫发作有特别显著的影响，因此将这些手术纳入假手术对照组的重要性变得更加迫切。在这里，我们着手测试这样一个假设，即单纯开颅术足以改变大鼠的实验性癫痫发作。我们在颅骨顶骨上进行双侧开颅术（直径为 2.5 或 3.5 毫米）后 3 至 20 天，用戊四氮（70mg/kg）诱发成年雄性大鼠癫痫发作，而不穿透硬脑膜。对照（假手术）动物接受麻醉和手术，但不开颅。我们发现开颅术显著降低了术后第 3、6 和 10 天实验性癫痫发作的严重程度；这种效果取决于开颅术的大小。开颅术的动物在开颅术后 20 天恢复到对照性癫痫发作严重程度。这些数据支持这样一个假设，即颅骨损伤足以导致在延长的术后期间癫痫易感性发生显著改变，并且表明这种损伤不应被认为是神经学上惰性的。
