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癫痫和神经炎症的行为共病:来自实验和临床研究的证据。

Behavioral comorbidities of epilepsy and neuroinflammation: Evidence from experimental and clinical studies.

机构信息

Institute of Higher Nervous Activity and Neurophysiology of RAS, 117485 Butlerova 5A, Moscow, Russia.

出版信息

Epilepsy Behav. 2021 Apr;117:107869. doi: 10.1016/j.yebeh.2021.107869. Epub 2021 Mar 5.

Abstract

Currently, a significant amount of data is accumulated showing that neuroinflammation is one of the key processes in the development of brain pathology in trauma, neurodegenerative diseases, and epilepsy. Various brain insults, such as prolonged seizure activity, trigger the activation of microglia and astrocytes in the brain. These cells, in turn, begin to synthesize pro-inflammatory cytokines. The inflammatory response to the insult causes a cascade of processes leading to a wide range of pathological effects, including changes in neuronal excitability, long-term plastic changes, astrocyte dysfunction, impaired blood-brain barrier (BBB) permeability, and neurodegeneration. These effects may ultimately contribute to the development of chronic spontaneous seizures. On the other hand, neuroinflammation contributes to the pathogenesis of a number of neuropsychiatric disorders. Therefore, neuroinflammation can be a link between epilepsy and its comorbidities, such as mood and anxiety disorders and memory impairment. The mechanisms behind these behavioral and cognitive impairments remain not fully understood. In this paper, clinical evidence of an important role of neuroinflammation in epilepsy and potentially comorbid neurological disorders is reviewed, as well as possible mechanisms of its involvement in the pathogenesis of these conditions obtained from experimental data.

摘要

目前,大量数据表明,神经炎症是创伤、神经退行性疾病和癫痫中脑病理学发展的关键过程之一。各种脑损伤,如长时间的癫痫发作,会触发大脑中小胶质细胞和星形胶质细胞的激活。这些细胞反过来开始合成促炎细胞因子。对损伤的炎症反应会引发一连串的过程,导致广泛的病理效应,包括神经元兴奋性的改变、长期的可塑性变化、星形胶质细胞功能障碍、血脑屏障(BBB)通透性受损和神经退行性变。这些效应最终可能导致慢性自发性癫痫发作的发展。另一方面,神经炎症有助于多种神经精神疾病的发病机制。因此,神经炎症可能是癫痫与其共病(如情绪和焦虑障碍以及记忆障碍)之间的联系。这些行为和认知障碍的机制仍不完全清楚。本文综述了神经炎症在癫痫和潜在共患神经疾病中的重要作用的临床证据,以及从实验数据中获得的其参与这些疾病发病机制的可能机制。

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