Nichols Joshua, Perez Roxy, Wu Chen, Adelson P David, Anderson Trent
University of Arizona, College of Medicine - Phoenix, Phoenix, AZ, USA; School of Life Sciences, Arizona State University, Phoenix, AZ, USA.
CNS Neurosci Ther. 2015 Feb;21(2):193-203. doi: 10.1111/cns.12351. Epub 2014 Dec 5.
Following a traumatic brain injury (TBI), 5-50% of patients will develop posttraumatic epilepsy (PTE) with children being particularly susceptible. Currently, PTE cannot be prevented and there is limited understanding of the underlying epileptogenic mechanisms. We hypothesize that early after TBI the brain undergoes distinct cellular and synaptic reorganization that facilitates cortical excitability and promotes the development of epilepsy.
To examine the effect of pediatric TBI on cortical excitability, we performed controlled cortical impact (CCI) on juvenile rats (postnatal day 17). Following CCI, animals were monitored for the presence of epileptiform activity by continuous in vivo electroencephalography (EEG) and/or sacrificed for in vitro whole-cell patch-clamp recordings.
Following a short latent period, all animals subjected to CCI developed spontaneous recurrent epileptiform activity within 14 days. Whole-cell patch-clamp recordings of layer V pyramidal neurons showed no changes in intrinsic excitability or spontaneous excitatory postsynaptic currents (sEPSCs) properties. However, the decay of spontaneous inhibitory postsynaptic currents (sIPSCs) was significantly increased. In addition, CCI induced over a 300% increase in excitatory and inhibitory synaptic bursting. Synaptic bursting was prevented by blockade of Na(+)-dependent action potentials or select antagonism of glutamate or GABA-A receptors, respectively.
Our results demonstrate that CCI in juvenile rats rapidly induces epileptiform activity and enhanced cortical synaptic bursting. Detection of epileptiform activity early after injury suggests it may be an important pathophysiological component and potential indicator of developing PTE.
创伤性脑损伤(TBI)后,5% - 50%的患者会发生创伤后癫痫(PTE),儿童尤其易感。目前,PTE无法预防,且对其潜在的致痫机制了解有限。我们推测,TBI后早期大脑会经历独特的细胞和突触重组,这会促进皮层兴奋性并推动癫痫的发展。
为研究小儿TBI对皮层兴奋性的影响,我们对幼年大鼠(出生后第17天)进行了控制性皮层撞击(CCI)。CCI后,通过连续的体内脑电图(EEG)监测动物是否存在癫痫样活动,和/或处死后进行体外全细胞膜片钳记录。
经过短暂的潜伏期后,所有接受CCI的动物在14天内都出现了自发性反复癫痫样活动。对V层锥体神经元的全细胞膜片钳记录显示,内在兴奋性或自发性兴奋性突触后电流(sEPSCs)特性没有变化。然而,自发性抑制性突触后电流(sIPSCs)的衰减明显增加。此外,CCI导致兴奋性和抑制性突触爆发增加超过300%。分别通过阻断钠依赖性动作电位或选择性拮抗谷氨酸或GABA - A受体可防止突触爆发。
我们的结果表明,幼年大鼠的CCI可迅速诱导癫痫样活动并增强皮层突触爆发。损伤后早期检测到癫痫样活动表明它可能是PTE发展的重要病理生理成分和潜在指标。