Laboratorio de Neurofisiología del Control y la Regulación, Dirección de Investigaciones en Neurociencias, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Mexico; Carrera de Psicología, Facultad de Estudios Superiores Zaragoza-UNAM, Ciudad de México, Mexico.
Laboratorio de Neurofisiología del Control y la Regulación, Dirección de Investigaciones en Neurociencias, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Mexico; Carrera de Psicología, Facultad de Estudios Superiores Zaragoza-UNAM, Ciudad de México, Mexico.
Brain Stimul. 2014 Jul-Aug;7(4):587-94. doi: 10.1016/j.brs.2014.03.012. Epub 2014 Apr 4.
Deep brain stimulation, specifically high-frequency stimulation (HFS), is an alternative and promising treatment for intractable epilepsies; however, the optimal targets are still unknown. The thalamic reticular nucleus (TRN) occupies a key position in the modulation of the cortico-thalamic and thalamo-cortical pathways.
We determined the efficacy of HFS in the TRN against tonic-clonic generalized seizures (TCGS) and status epilepticus (SE), which were induced by scheduled pentylenetetrazole (PTZ) injections.
Male Wistar rats were stereotactically implanted and assigned to three experimental groups: Control group, which received only PTZ injections; HFS-TRN group, which received HFS in the left TRN prior to PTZ injections; and HFS-Adj group, which received HFS in the left adjacent nuclei prior to PTZ injections.
The HFS-TRN group reported a significant increase in the latency for development of TCGS and SE compared with the HFS-Adj and Control groups (P < 0.009). The number of PTZ-doses required for SE was also significantly increased (P < 0.001). Spectral analysis revealed a significant decrease in the frequency band from 0.5 Hz to 4.5 Hz of the left motor cortex in the HFS-TRN and HFS-Adj groups, compared to the Control group. Conversely, HFS-TRN provoked a significant increase in all frequency bands in the TRN. EEG asynchrony was observed during spike-wave discharges by HFS-TRN.
These data indicate that HFS-TRN has an anti-epileptogenic effect and is able to modify seizure synchrony and interrupt abnormal EEG recruitment of thalamo-cortical and, indirectly, cortico-thalamic pathways.
深部脑刺激,特别是高频刺激(HFS),是治疗难治性癫痫的一种替代和有前途的方法;然而,最佳靶点仍不清楚。丘脑网状核(TRN)在皮质丘脑和丘脑皮质通路的调制中占据关键位置。
我们确定 HFS 在 TRN 中对强直阵挛性全面性发作(TCGS)和戊四氮(PTZ)诱导的癫痫持续状态(SE)的疗效。
雄性 Wistar 大鼠被立体定向植入,并分为三组实验:对照组,仅接受 PTZ 注射;HFS-TRN 组,在接受 PTZ 注射前,在左侧 TRN 中接受 HFS;HFS-毗邻核组,在接受 PTZ 注射前,在左侧毗邻核中接受 HFS。
与 HFS-毗邻核组和对照组相比,HFS-TRN 组 TCGS 和 SE 的发作潜伏期明显延长(P<0.009)。SE 所需的 PTZ 剂量也显著增加(P<0.001)。频谱分析显示,与对照组相比,HFS-TRN 和 HFS-毗邻核组左侧运动皮层的 0.5 Hz 至 4.5 Hz 频段的频率明显降低。相反,HFS-TRN 引起 TRN 中所有频段的显著增加。HFS-TRN 引起棘波放电时 EEG 失同步。
这些数据表明,HFS-TRN 具有抗癫痫作用,能够改变癫痫发作的同步性,并中断丘脑皮质和间接皮质丘脑通路的异常 EEG 募集。