Aix-Marseille Université, INSERM, INMED, Marseille, France.
Department of Neurological sciences, University of Vermont, Burlington, VT, USA.
Curr Top Behav Neurosci. 2022;55:65-106. doi: 10.1007/7854_2020_193.
Epilepsy is commonly associated with cognitive and behavioral deficits that dramatically affect the quality of life of patients. In order to identify novel therapeutic strategies aimed at reducing these deficits, it is critical first to understand the mechanisms leading to cognitive impairments in epilepsy. Traditionally, seizures and epileptiform activity in addition to neuronal injury have been considered to be the most significant contributors to cognitive dysfunction. In this review we however highlight the role of a new mechanism: alterations of neuronal dynamics, i.e. the timing at which neurons and networks receive and process neural information. These alterations, caused by the underlying etiologies of epilepsy syndromes, are observed in both animal models and patients in the form of abnormal oscillation patterns in unit firing, local field potentials, and electroencephalogram (EEG). Evidence suggests that such mechanisms significantly contribute to cognitive impairment in epilepsy, independently of seizures and interictal epileptiform activity. Therefore, therapeutic strategies directly targeting neuronal dynamics rather than seizure reduction may significantly benefit the quality of life of patients.
癫痫通常与认知和行为缺陷相关，这些缺陷极大地影响了患者的生活质量。为了确定旨在减少这些缺陷的新的治疗策略，首先了解导致癫痫认知障碍的机制至关重要。传统上，癫痫发作和癫痫样活动以及神经元损伤被认为是导致认知功能障碍的最重要因素。然而，在这篇综述中，我们强调了一个新机制的作用：神经元动力学的改变，即神经元和网络接收和处理神经信息的时间。这些由癫痫综合征的潜在病因引起的改变，在动物模型和患者中都表现为单位放电、局部场电位和脑电图 (EEG) 中的异常振荡模式。有证据表明，这些机制独立于癫痫发作和发作间期癫痫样活动，对癫痫导致的认知障碍有重要影响。因此，直接针对神经元动力学而不是减少癫痫发作的治疗策略可能会显著改善患者的生活质量。
