Buckmaster Paul S, Reyes Bianca, Kahn Tahsin, Wyeth Megan
Departments of Comparative Medicine
Neurology & Neurological Sciences, Stanford University, Stanford, California 94305.
J Neurosci. 2022 Sep 28;42(39):7482-7495. doi: 10.1523/JNEUROSCI.0429-22.2022.
Temporal lobe epilepsy is common, but mechanisms of seizure initiation are unclear. We evaluated seizure initiation in female and male rats that had been systemically treated with pilocarpine, a widely used model of temporal lobe epilepsy. Local field potential (LFP) recordings from many brain regions revealed variable sites of earliest recorded seizure activity, but mostly the ventral hippocampal formation. To test whether inactivation of the ventral hippocampal formation would reduce seizures, mini-osmotic pumps were used to continually and focally deliver TTX. High doses of TTX infused unilaterally into the ventral hippocampal formation blocked seizures reversibly but also reduced LFP amplitudes in remote brain regions, indicating distant effects. A lower dose did not reduce LFP amplitudes in remote brain regions but did not reduce seizures when infused unilaterally. Instead, seizures tended to initiate in the contralateral ventral hippocampal formation. Bilateral infusion of the lower dose into the ventral hippocampal formation reduced seizure frequency 85%. Similar bilateral treatment in the amygdala was not effective. Bilateral infusion of the dorsal hippocampus reduced seizure frequency, but only 17%. Together, these findings reveal that the ventral hippocampal formation is a primary bilaterally independent epileptogenic zone, and the dorsal hippocampus is a secondary epileptogenic zone in pilocarpine-treated rats. This is consistent with many human patients, and the results further validate the LFP method for identifying seizure onset zones. Finally, the findings are more consistent with a focal mechanism of ictogenesis rather than one involving a network of interdependent nodes. To better understand how seizures start, investigators need to know where seizures start in the animal models they study. In the widely used pilocarpine-treated rat model of temporal lobe epilepsy, earliest seizure activity was most frequently recorded in the ventral hippocampal formation. Confirming the primary role of the ventral hippocampal formation, seizure frequency was reduced most effectively when it was inactivated focally, bilaterally, and continually with infused TTX. These findings suggest that the ventral hippocampal formation is the primary site of seizure initiation in this animal model of temporal lobe epilepsy, consistent with findings in many human patients.
颞叶癫痫很常见,但癫痫发作起始机制尚不清楚。我们评估了用毛果芸香碱进行全身治疗的雌性和雄性大鼠的癫痫发作起始情况,毛果芸香碱是一种广泛使用的颞叶癫痫模型。来自多个脑区的局部场电位(LFP)记录显示,最早记录到癫痫活动的部位各不相同,但大多位于腹侧海马结构。为了测试腹侧海马结构失活是否会减少癫痫发作,使用微型渗透泵持续并局部递送河豚毒素(TTX)。单侧向腹侧海马结构注入高剂量TTX可可逆地阻断癫痫发作,但也会降低远处脑区的LFP振幅,表明存在远距离效应。较低剂量在单侧注入时不会降低远处脑区的LFP振幅,但也不会减少癫痫发作。相反,癫痫发作倾向于在对侧腹侧海马结构起始。双侧向腹侧海马结构注入较低剂量可使癫痫发作频率降低85%。在杏仁核进行类似的双侧治疗无效。双侧注入背侧海马可降低癫痫发作频率,但仅为17%。总之,这些发现表明,腹侧海马结构是一个主要的双侧独立致痫区,而背侧海马是毛果芸香碱治疗大鼠中的次要致痫区。这与许多人类患者的情况一致,结果进一步验证了LFP方法用于识别癫痫发作起始区的有效性。最后,这些发现更符合癫痫发生的局灶性机制,而不是涉及相互依赖节点网络的机制。为了更好地理解癫痫发作是如何开始的,研究人员需要知道在他们研究的动物模型中癫痫发作从何处开始。在广泛使用的毛果芸香碱治疗的颞叶癫痫大鼠模型中,最早的癫痫活动最常记录在腹侧海马结构中。通过用注入的TTX进行双侧、局部和持续失活,癫痫发作频率最有效地降低,这证实了腹侧海马结构的主要作用。这些发现表明,在这个颞叶癫痫动物模型中,腹侧海马结构是癫痫发作起始的主要部位,与许多人类患者的发现一致。