Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; Department of Neurology, Xiangya Hospital, Central South University, Changsha 410008, China.
Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; Department of Anesthesia, Hangzhou First People's Hospital, Nanjing Medical University, Hangzhou 310006, China.
Epilepsy Behav. 2019 Jun;95:169-174. doi: 10.1016/j.yebeh.2019.04.010. Epub 2019 May 4.
Studies suggest that cardiorespiratory dysfunction likely contributes to sudden unexpected death in epilepsy (SUDEP). Seizures result in autonomic and respiratory dysfunction, leading to sympathetic hyperactivity and respiratory distress, including apnea. While the heart is vulnerable to catecholamine surges and hypoxia, it remains unknown if repetitive generalized seizures lead to cardiac damage. DBA/1 mice exhibit seizure-induced respiratory arrest (S-IRA) following generalized audiogenic seizures (AGS), which can be resuscitated using a rodent ventilator. In the current study, we induced different numbers of S-IRA episodes in DBA/1 mice and determined the association of repeated S-IRA induction with cardiac damage using histology. After repetitive induction of 18 S-IRA, calcified lesions, as revealed by calcium (Ca)-specific alizarin red staining, were observed in the ventricular myocardium in 61.5% of DBA/1 mice, which was higher compared to mice with 5 S-IRA and 1 S-IRA as well as age-matched untested control mice. The incidence of lesions in mice with 9 S-IRA was only higher than that of control mice. Only 1-2, small lesions were observed in mice with 5 S-IRA and 1 S-IRA and in control mice. Larger lesions (>2500 μm) were observed in mice with 9 and 18 S-IRA. The incidence of larger lesions was higher in mice with 18 S-IRA (53.8%) as compared to mice with 5 S-IRA and 1 S-IRA as well as with control mice, and the incidence of larger lesions in mice with 9 S-IRA was only higher than that of control mice. Repeated induction of S-IRA in DBA/1 mice can result in calcified necrotic lesions in the ventricles of the heart, and their incidence and size are dependent on the total number of S-IRA.
研究表明,心肺功能障碍可能导致癫痫猝死(SUDEP)。癫痫发作会导致自主和呼吸功能障碍,导致交感神经兴奋和呼吸窘迫,包括呼吸暂停。虽然心脏容易受到儿茶酚胺激增和缺氧的影响,但尚不清楚重复的全身性癫痫发作是否会导致心脏损伤。DBA/1 小鼠在全身性听觉性癫痫发作(AGS)后表现出癫痫诱导性呼吸暂停(S-IRA),可以使用啮齿动物呼吸机进行复苏。在本研究中,我们在 DBA/1 小鼠中诱导了不同数量的 S-IRA 发作,并通过组织学确定了重复 S-IRA 诱导与心脏损伤的关联。在重复诱导 18 次 S-IRA 后,在 61.5%的 DBA/1 小鼠的心室心肌中观察到钙(Ca)特异性茜素红染色显示的钙化病变,这一比例高于有 5 次 S-IRA 和 1 次 S-IRA 的小鼠以及年龄匹配的未测试对照小鼠。有 9 次 S-IRA 的小鼠的病变发生率仅高于对照小鼠。有 5 次 S-IRA 和 1 次 S-IRA 的小鼠以及对照小鼠仅观察到 1-2 个小病变。在有 9 和 18 次 S-IRA 的小鼠中观察到较大的病变(>2500μm)。有 18 次 S-IRA 的小鼠中较大病变的发生率(53.8%)高于有 5 次 S-IRA 和 1 次 S-IRA 的小鼠以及对照小鼠,有 9 次 S-IRA 的小鼠中较大病变的发生率仅高于对照小鼠。在 DBA/1 小鼠中重复诱导 S-IRA 可导致心脏心室中钙化坏死性病变,其发生率和大小取决于 S-IRA 的总次数。