Mukherjee Sanjib, Arisi Gabriel M, Mims Kaley, Hollingsworth Gabriela, O'Neil Katherine, Shapiro Lee A
Department of Neuroscience and Experimental Therapeutics, College of Medicine, Texas A&M University Health Science Center, Bryan, TX, USA.
Department of Physiology, Federal University of Sao Paulo - Escola Paulista de Medicina, Sao Paulo, Brazil.
J Neuroinflammation. 2020 Jun 17;17(1):193. doi: 10.1186/s12974-020-01854-w.
Traumatic brain injury (TBI) occurs in as many as 64-74 million people worldwide each year and often results in one or more post-traumatic syndromes, including depression, cognitive, emotional, and behavioral deficits. TBI can also increase seizure susceptibility, as well as increase the incidence of epilepsy, a phenomenon known as post-traumatic epilepsy (PTE). Injury type and severity appear to partially predict PTE susceptibility. However, a complete mechanistic understanding of risk factors for PTE is incomplete.
From the earliest days of modern neuroscience, to the present day, accumulating evidence supports a significant role for neuroinflammation in the post-traumatic epileptogenic progression. Notably, substantial evidence indicates a role for astrocytes, microglia, chemokines, and cytokines in PTE progression. Although each of these mechanistic components is discussed in separate sections, it is highly likely that it is the totality of cellular and neuroinflammatory interactions that ultimately contribute to the epileptogenic progression following TBI.
This comprehensive review focuses on the neuroinflammatory milieu and explores putative mechanisms involved in the epileptogenic progression from TBI to increased seizure-susceptibility and the development of PTE.
创伤性脑损伤(TBI)每年在全球多达6400万至7400万人中发生,并且常常导致一种或多种创伤后综合征,包括抑郁、认知、情感和行为缺陷。TBI还会增加癫痫易感性,以及增加癫痫的发病率,这一现象被称为创伤后癫痫(PTE)。损伤类型和严重程度似乎部分预测了PTE易感性。然而,对PTE危险因素的完整机制理解并不完整。
从现代神经科学的早期到现在,越来越多的证据支持神经炎症在创伤后致痫进展中起重要作用。值得注意的是,大量证据表明星形胶质细胞、小胶质细胞、趋化因子和细胞因子在PTE进展中起作用。尽管这些机制成分中的每一个都在单独的章节中讨论,但极有可能是细胞和神经炎症相互作用的整体最终导致了TBI后的致痫进展。
这篇综述聚焦于神经炎症环境,并探讨了从TBI到癫痫易感性增加以及PTE发生的致痫进展中涉及的假定机制。