Gale K
Adv Neurol. 1986;44:343-64.
The relationship between cerebral GABA content and susceptibility to seizures is addressed from the point of view of specific brain loci at which GABA synapses may control convulsive activity. The substantia nigra (SN) has been identified as a critical site at which GABA-agonist drugs act to reduce susceptibility to a number of types of experimentally induced generalized seizures. Moreover, the ability of GABA-elevating agents to protect against seizures in the maximal electroshock model is directly correlated with increases in GABA specifically in the nerve-terminal compartment of SN. Studies with 2-deoxyglucose indicate that a marked increase in metabolic activity in SN is a common feature of several types of generalized seizures; it is possible that some of this increased activity is associated with GABAergic nerve terminals that become activated in an attempt to suppress seizure spread. Because GABA has been shown to inhibit nigral efferents, it is likely that GABA terminals inhibit nigral projections that are permissive or facilitative to seizure propagation. In support of this, bilateral destruction of SN attenuated clonic and tonic chemoconvulsant and electroshock seizures. Other treatments capable of reducing nigral output, namely opiate agonists (morphine and D-Ala-Met-enkephalin), and substance P antagonist analogs, were also found to have anticonvulsant effects when applied bilaterally into SN. Thus, the seizure-facilitating nigral efferents may be subject to inhibition by both GABA and opiates and may normally be driven by substance P. Of the various outputs from SN, the GABAergic projections to thalamus, reticular formation and/or superior colliculus are most likely responsible for influencing seizure propagation. Experimental evidence does not indicate a significant role of pars compacta nigrostriatal dopamine neurons for controlling the various types of seizures subject to nigral influence. We propose that the inhibition of the GABAergic outputs from SN pars reticulata can suppress the progression of seizure discharge through circuits involving the target areas of these outputs. Because chemical or electrical stimulation of SN does not initiate convulsions, it appears that seizure activity generated elsewhere in the brain may be amplified or sustained by activity in these nigral outputs.
从GABA突触可能控制惊厥活动的特定脑区角度探讨了脑内GABA含量与癫痫易感性之间的关系。黑质(SN)已被确定为一个关键部位,GABA激动剂药物在此发挥作用以降低对多种实验性诱导的全身性癫痫发作的易感性。此外,在最大电休克模型中,提高GABA水平的药物预防癫痫发作的能力与SN神经末梢区GABA的增加直接相关。用2-脱氧葡萄糖进行的研究表明,SN代谢活动的显著增加是几种全身性癫痫发作的共同特征;这种增加的活动可能部分与GABA能神经末梢有关,这些神经末梢被激活以试图抑制癫痫扩散。由于已证明GABA可抑制黑质传出纤维,因此GABA末梢可能抑制对癫痫传播具有允许或促进作用的黑质投射。支持这一观点的是,双侧损毁SN可减轻阵挛性和强直性化学惊厥和电休克性癫痫发作。还发现,其他能够减少黑质输出的治疗方法,即阿片类激动剂(吗啡和D-丙氨酸-甲硫氨酸-脑啡肽)和P物质拮抗剂类似物,双侧注入SN时也具有抗惊厥作用。因此,促进癫痫发作的黑质传出纤维可能受到GABA和阿片类药物的抑制,并且通常可能由P物质驱动。在SN的各种输出中,向丘脑、网状结构和/或上丘的GABA能投射最有可能影响癫痫传播。实验证据并未表明黑质致密部-纹状体多巴胺神经元在控制受黑质影响的各种类型癫痫发作中起重要作用。我们提出,抑制SN网状部的GABA能输出可通过涉及这些输出靶区的回路抑制癫痫放电的进展。由于对SN的化学或电刺激不会引发惊厥,因此似乎大脑其他部位产生的癫痫活动可能会被这些黑质输出的活动放大或维持。