Time course of the reduction of GABA terminals in a model of focal epilepsy: a glutamic acid decarboxylase immunocytochemical study.

Immunocytochemical localization of glutamic acid decarboxylase (GAD), the synthesizing enzyme for the neurotransmitter gamma-aminobutyric acid (GABA), has been used to study the time course of the decrease in putative GABAergic synaptic terminals that occurs in an alumina gel-induced model of focal epilepsy. Monkeys were studied at progressive intervals following unilateral application of alumina gel to sensorimotor cerebral cortex, and were categorized into 3 different experimental groups depending upon their clinical status. These groups respectively exhibited: (1) no abnormal bioelectrical (EEG and ECoG) activity; (2) abnormal bioelectrical activity, but no clinical seizures; and (3) both abnormal bioelectrical activity and clinical seizures. Normal and sham-operated monkeys were also studied. The amounts of GAD-positive terminal-like structures were determined on control and experimental sides of motor cortex (layer V) of all specimens with an image analysis system. This quantitative study revealed that monkeys from the 3 experimental groups showed reductions of GAD-positive terminals on the experimental cortical side, with greater losses occurring at progressively longer times following alumina gel implants. Statistical tests showed that there were no significant cortical side differences for the normal and sham groups, but that cortical side variations were significantly different for each of the 3 experimental groups. Conventional electron microscopy of an early experimental stage revealed degenerating axon terminals in layer V of motor cortex, as well as phagocytosis of degenerating material and astrogliosis. Similar findings were obtained from a chronically epileptic specimen, except that degenerating terminals were observed less often and fibrous astrocytic scarring was more prevalent, especially surrounding the somata of pyramidal neurons. The main conclusion drawn from the results of this investigation is that significant decreases of GAD-positive terminals occur prior to the onset of clinical seizures, and this is consistent with a causal role for a loss of GABAergic innervation in the development of seizure activity in this primate model of focal epilepsy.