Doisy Emily T, Wenzel H Jürgen, Mu Yi, Nguyen Danh V, Schwartzkroin Philip A
Department of Neurological Surgery, University of California, Davis, Davis, California, U.S.A.
Epilepsia. 2015 Apr;56(4):626-35. doi: 10.1111/epi.12945. Epub 2015 Mar 6.
Aberrations in brain development may lead to dysplastic structures such as periventricular nodules. Although these abnormal collections of neurons are often associated with difficult-to-control seizure activity, there is little consensus regarding the epileptogenicity of the nodules themselves. Because one common treatment option is surgical resection of suspected epileptic nodules, it is important to determine whether these structures in fact give rise, or essentially contribute, to epileptic activities.
To study the excitability of aberrant nodules, we have examined c-fos activation in organotypic hippocampal slice cultures generated from an animal model of periventricular nodular heterotopia created by treating pregnant rats with methylazoxymethanol acetate. Using this preparation, we have also attempted to assess tissue excitability when the nodule is surgically removed from the culture. We then compared c-fos activation in this in vitro preparation to c-fos activation generated in an intact rat treated with kainic acid.
Quantitative analysis of c-fos activation failed to show enhanced nodule excitability compared to neocortex or CA1 hippocampus. However, when we compared cultures with and without a nodule, presence of a nodule did affect the excitability of CA1 and cortex, at least as reflected in c-fos labeling. Surgical removal of the nodule did not result in a consistent decrease in excitability as reflected in the c-fos biomarker.
Our results from the organotypic culture were generally consistent with our observations on excitability in the intact rat-as seen not only with c-fos but also in previous electrophysiologic studies. At least in this model, the nodule does not appear to be responsible for enhanced excitability (or, presumably, seizure initiation). Excitability is different in tissue that contains a nodule, suggesting altered network function, perhaps reflecting the abnormal developmental pattern that gave rise to the nodule.
大脑发育异常可能导致发育异常结构,如脑室周围结节。尽管这些异常的神经元聚集通常与难以控制的癫痫活动相关,但关于结节本身的致痫性几乎没有共识。由于一种常见的治疗选择是手术切除疑似癫痫结节,因此确定这些结构是否实际上引发或基本上促成癫痫活动非常重要。
为了研究异常结节的兴奋性,我们检查了从用乙酸甲基偶氮甲醇处理怀孕大鼠创建的脑室周围结节性异位动物模型生成的海马器官型脑片培养物中的c-fos激活。使用这种制备方法,我们还试图评估从培养物中手术切除结节时的组织兴奋性。然后,我们将这种体外制备中的c-fos激活与用海藻酸处理的完整大鼠中产生的c-fos激活进行了比较。
与新皮层或海马CA1相比,c-fos激活的定量分析未能显示结节兴奋性增强。然而,当我们比较有结节和无结节的培养物时,结节的存在确实影响了CA1和皮层的兴奋性,至少在c-fos标记中有所体现。如c-fos生物标志物所示,手术切除结节并没有导致兴奋性持续下降。
我们从器官型培养物中得到的结果与我们在完整大鼠中关于兴奋性的观察结果总体一致——不仅在c-fos方面,而且在以前进行的电生理研究中也是如此。至少在这个模型中,结节似乎不是兴奋性增强(或者推测是癫痫发作起始)的原因。含有结节的组织中的兴奋性不同,这表明网络功能发生了改变,这可能反映了导致结节的异常发育模式。