Department of Pharmacy, School of Pharmacy, University of Washington, United States of America.
Department of Neurology, School of Medicine, University of Washington, United States of America.
Neurobiol Dis. 2020 Mar;136:104719. doi: 10.1016/j.nbd.2019.104719. Epub 2019 Dec 17.
Patients with Alzheimer's disease (AD) experience seizures at higher rates than the general population of that age, suggesting an underexplored role of hyperexcitability in AD. Genetic variants in presenilin (PSEN) 1 and 2 genes lead to autosomal dominant early-onset AD (ADAD); patients with PSEN gene variants also report seizures. Pharmacological control of seizures in AD may be disease-modifying. Preclinical efficacy of FDA-approved antiseizure drugs (ASDs) is well defined in young adult rodents; however, the efficacy of ASDs in aged rodents with chronic seizures is less clear. The mechanism by which ADAD genes lead to AD remains unclear, and even less studied is the pathogenesis of epilepsy in AD. PSEN variants generally all result in a biochemical loss of function (De Strooper, 2007). We herein determined whether well-established models of acute and chronic seizure could be used to explore the relationship between AD genes and seizures through investigating whether loss of normal PSEN2 function age-dependently influenced susceptibility to seizures and/or corneal kindling acquisition. PSEN2 knockout (KO) and age-matched wild-type (WT) mice were screened from 2- to 10-months-old to establish age-dependent focal seizure threshold. Additionally, PSEN2 KO and WT mice aged 2- and 8-months-old underwent corneal kindling such that mice were aged 3- and 9-months old at the beginning of ASD efficacy testing. We then defined the dose-dependent efficacy of mechanistically distinct ASDs on kindled seizures of young versus aged mice to better understand the applicability of corneal kindling to real-world use for geriatric patients. PSEN2 KO mice demonstrated early-life reductions in seizure threshold. However, kindling acquisition was delayed in 2-month-old PSEN2 KO versus WT mice. Young male WT mice took 24.3 ± 1.3 (S.E.M.) stimulations to achieve kindling criterion, whereas age-matched PSEN2 KO male mice took 41.2 ± 1.1 stimulations (p < .0001). The rate of kindling acquisition of 8-month-old mice was no longer different from WT. This study demonstrates that loss of normal PSEN2 function is associated with age-dependent changes in the in vivo susceptibility to acute seizures and kindling. Loss of normal PSEN2 function may be an underexplored molecular contributor to seizures. The use of validated models of chronic seizures in aged rodents may uncover age-related changes in susceptibility to epileptogenesis and/or ASD efficacy in mice with AD-associated genotypes, which may benefit the management of seizures in AD.
患有阿尔茨海默病(AD)的患者比同龄人群更容易发生癫痫发作,这表明过度兴奋在 AD 中具有未被充分探索的作用。早发性 AD(ADAD)的常染色体显性遗传与早老素(PSEN)1 和 2 基因的遗传变异有关;携带 PSEN 基因突变的患者也会报告癫痫发作。AD 中癫痫发作的药物控制可能具有疾病修饰作用。FDA 批准的抗癫痫药物(ASD)在年轻成年啮齿动物中的临床前疗效已得到很好的定义;然而,在患有慢性癫痫发作的老年啮齿动物中,ASD 的疗效不太清楚。ADAD 基因导致 AD 的机制仍不清楚,AD 中癫痫的发病机制研究得更少。PSEN 变体通常都会导致生化功能丧失(De Strooper,2007)。我们在此通过研究正常 PSEN2 功能的丧失是否会随年龄的增长而影响对癫痫发作的易感性和/或角膜点燃的获得,来确定是否可以使用已建立的急性和慢性癫痫发作模型来探索 AD 基因与癫痫发作之间的关系。从 2 至 10 个月大的 PSEN2 敲除(KO)和年龄匹配的野生型(WT)小鼠中筛选出建立年龄依赖性局灶性癫痫发作阈值的小鼠。此外,2 个月大和 8 个月大的 PSEN2 KO 和 WT 小鼠进行角膜点燃,以便在 ASD 疗效测试开始时,小鼠分别为 3 个月大和 9 个月大。然后,我们确定了机制不同的 ASD 对年轻和老年小鼠点燃发作的剂量依赖性疗效,以便更好地理解角膜点燃在老年患者中的实际应用。PSEN2 KO 小鼠在生命早期表现出癫痫发作阈值降低。然而,2 个月大的 PSEN2 KO 与 WT 小鼠相比,点燃获得被延迟。年轻雄性 WT 小鼠需要 24.3 ± 1.3(S.E.M.)刺激才能达到点燃标准,而年龄匹配的 PSEN2 KO 雄性小鼠则需要 41.2 ± 1.1 次刺激(p<.0001)。8 个月大的老鼠的点燃获得速度不再与 WT 不同。这项研究表明,正常 PSEN2 功能的丧失与体内对急性癫痫发作和点燃的易感性的年龄依赖性变化有关。正常 PSEN2 功能的丧失可能是癫痫发作的一个未被充分探索的分子贡献者。在老年啮齿动物中使用已验证的慢性癫痫发作模型可能会揭示与 AD 相关基因型的小鼠对癫痫发生和/或 ASD 疗效的易感性的年龄相关变化,这可能有助于 AD 中癫痫发作的管理。