Department of Neurosurgery, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan.
Epilepsy Center, Yamaguchi University Hospital, Yamaguchi, Japan.
J Cereb Blood Flow Metab. 2019 Nov;39(11):2286-2294. doi: 10.1177/0271678X18795365. Epub 2018 Aug 17.
This study aimed to understand the mechanism by which brain cooling terminates epileptic discharge. Cortical slices were prepared from rat brains (n = 19) and samples from patients with intractable epilepsy that had undergone temporal lobectomy (n = 7). We performed whole cell current clamp recordings at approximately physiological brain temperature (35℃) and at cooler temperatures (25℃ and 15℃). The firing threshold in human neurons was lower at 25℃ (-32.6 mV) than at 35℃ (-27.0 mV). The resting potential and spike frequency were similar at 25℃ and 35℃. Cooling from 25℃ to 15℃ did not change the firing threshold, but the resting potential increased from -65.5 to -54.0 mV and the waveform broadened from 1.85 to 6.55 ms, due to delayed repolarization. These changes enhanced the initial spike appearance and reduced spike frequency; moreover, spike frequency was insensitive to increased levels of current injections. Similar results were obtained in rat brain studies. We concluded that the reduction in spike frequency at 15℃, due to delayed repolarization, might be a key mechanism by which brain cooling terminates epileptic discharge. On the other hand, spike frequency was not influenced by the reduced firing threshold or the elevated resting potential caused by cooling.
本研究旨在了解脑冷却终止癫痫发作的机制。我们从大鼠脑(n=19)和接受颞叶切除术的难治性癫痫患者(n=7)的样本中制备了皮质切片。我们在接近生理脑温度(35℃)和较低温度(25℃和 15℃)下进行全细胞膜片钳记录。在 25℃下,人类神经元的放电阈值(-32.6 mV)低于 35℃(-27.0 mV)。在 25℃和 35℃时,静息电位和尖峰频率相似。从 25℃冷却至 15℃不会改变放电阈值,但由于复极化延迟,静息电位从-65.5 mV 增加至-54.0 mV,波形从 1.85 ms 变宽至 6.55 ms,这增强了初始尖峰的出现并降低了尖峰频率;此外,尖峰频率对增加的电流注入不敏感。在大鼠脑研究中也得到了类似的结果。我们得出结论,由于复极化延迟导致 15℃时尖峰频率降低,可能是脑冷却终止癫痫发作的关键机制。另一方面,由于冷却引起的放电阈值降低或静息电位升高,尖峰频率不受影响。