Department of Clinical & Experimental Epilepsy, UCL Queen Square Institute of Neurology, University College London, London WC1N 3BG, UK.
Janelia Research Campus, Howard Hughes Medical Institute, Ashburn, VA 20147, USA.
Brain. 2024 Mar 1;147(3):1011-1024. doi: 10.1093/brain/awad336.
Focal epilepsy is associated with intermittent brief population discharges (interictal spikes), which resemble sentinel spikes that often occur at the onset of seizures. Why interictal spikes self-terminate whilst seizures persist and propagate is incompletely understood. We used fluorescent glutamate and GABA sensors in an awake rodent model of neocortical seizures to resolve the spatiotemporal evolution of both neurotransmitters in the extracellular space. Interictal spikes were accompanied by brief glutamate transients which were maximal at the initiation site and rapidly propagated centrifugally. GABA transients lasted longer than glutamate transients and were maximal ∼1.5 mm from the focus where they propagated centripetally. Prior to seizure initiation GABA transients were attenuated, whilst glutamate transients increased, consistent with a progressive failure of local inhibitory restraint. As seizures increased in frequency, there was a gradual increase in the spatial extent of spike-associated glutamate transients associated with interictal spikes. Neurotransmitter imaging thus reveals a progressive collapse of an annulus of feed-forward GABA release, allowing seizures to escape from local inhibitory restraint.
局灶性癫痫与间歇性短暂的群体放电(发作间期棘波)有关,后者类似于发作开始时经常出现的“哨兵棘波”。为什么发作间期棘波会自行终止,而癫痫持续存在并传播的原因尚不完全清楚。我们在清醒的啮齿动物新皮层癫痫模型中使用荧光谷氨酸和 GABA 传感器,以解析细胞外空间中两种神经递质的时空演变。发作间期棘波伴随着短暂的谷氨酸瞬变,其在起始部位达到最大值,并迅速向离心方向传播。GABA 瞬变持续时间长于谷氨酸瞬变,在距焦点约 1.5 mm 处达到最大值,呈向心传播。在癫痫发作开始之前,GABA 瞬变减弱,而谷氨酸瞬变增加,这与局部抑制性约束的逐渐失效一致。随着癫痫发作频率的增加,与发作间期棘波相关的谷氨酸瞬变的空间范围逐渐增大。因此,神经递质成像揭示了一个渐进性的环形 GABA 释放的前馈崩溃,从而使癫痫发作能够逃脱局部抑制性约束。