Sandhu Mani Ratnesh S, Dhaher Roni, Gruenbaum Shaun E, Raaisa Raaisa, Spencer Dennis D, Pavlova Milena K, Zaveri Hitten P, Eid Tore
Department of Laboratory Medicine, Yale School of Medicine, New Haven, CT, United States.
Department of Neurosurgery, Yale School of Medicine, New Haven, CT, United States.
Front Neurol. 2020 May 15;11:398. doi: 10.3389/fneur.2020.00398. eCollection 2020.
Seizures often exhibit striking circadian-like (~24-h) rhythms. While chronotherapy has shown promise in treating epilepsy, it is not widely used, in part because the patterns of seizure rhythmicity vary considerably among patients and types of epilepsy. A better understanding of the mechanisms underlying rhythmicity in epilepsy could be expected to result in more effective approaches which can be tailored to each individual patient. The excitatory neurotransmitter glutamate is an essential modulator of circadian rhythms, and changes in the extracellular levels of glutamate likely affect the threshold to seizures. We used a reverse translational rodent model of mesial temporal lobe epilepsy (MTLE) combined with long-term intracerebral microdialysis to monitor the hourly concentrations of glutamate in the seizure onset area (epileptogenic hippocampus) over several days. We observed significant 24-h oscillations of extracellular glutamate in the epileptogenic hippocampus ( = 4, JTK_CYCLE test, < 0.05), but not in the hippocampus of control animals ( = 4). To our knowledge, circadian glutamate oscillations have not been observed in a seizure onset region, and we speculate that the oscillations contribute to the rhythmicity of seizures in MTLE.
癫痫发作常常呈现出显著的近似昼夜节律(约24小时)。尽管时间治疗法在治疗癫痫方面已显示出前景,但它并未得到广泛应用,部分原因是癫痫发作的节律模式在患者和癫痫类型之间差异很大。有望通过更好地理解癫痫节律性的潜在机制,从而产生更有效的方法,能够针对每个患者量身定制。兴奋性神经递质谷氨酸是昼夜节律的重要调节因子,细胞外谷氨酸水平的变化可能会影响癫痫发作阈值。我们使用了内侧颞叶癫痫(MTLE)的反向转化啮齿动物模型,并结合长期脑内微透析技术,在数天内每小时监测癫痫发作起始区域(致痫海马体)中谷氨酸的浓度。我们观察到致痫海马体中细胞外谷氨酸有显著的24小时振荡(n = 4,JTK_CYCLE检验,P < 0.05),但在对照动物的海马体中未观察到(n = 4)。据我们所知,尚未在癫痫发作起始区域观察到昼夜谷氨酸振荡,我们推测这些振荡促成了MTLE中癫痫发作的节律性。