Brotchi J
Acta Neurol Belg. 1979 May-Jun;79(3):137-304.
The author reports the discovery of an original entity, the activated astrocyte, which is an essential component and the first anatomical sign of the epileptogenic focus. The importance of the activated astrocyte is demonstrated by the fact that it is observed before the clinical signs appear and as soon as the first spikes are recorded on the electrocortigram. Cautious conclusions are drawn. The authors recognizes the essential role of the neurons and does not suggest that astrocytes are the cause of epilepsy. However, since astrocyte activation is observed before the first electrical signs announce the beginning of an epileptogenic focus, he suggests that activated astrocytes probably offer morphological evidence of certain mechanisms closely concerned in the formation of the epileptogenic focus. The metabolic activation of the astrocyte is not surprising, and is probably related to the increase in loco-regional metabolism due to neuronal hyperactivity, the starting point of epilepsy. It confirms current opinion, especially in biochemistry, on the importance of the glial cells in the neuronastrocyte association. This work opens up certain prospects. First, the significance of the activated astrocyte in the context of current biochemical, neuro-physiological and morphological studies of the glial compartment is a promising research field. Second, from the clinical angle, it is very important to be able to identify an epileptogenic gliosis on the basis of activated astrocytes. Used in conjunction with modern neuro-physiological techniques to locate the epileptogenic focus, the search for activated astrocytes in biopsy material obtained stereotactically should permit better detection of the affected area and thus ensure more successful surgery in cases of focal epilepsy resistant to medication.
作者报告发现了一种原始实体——活化星形胶质细胞,它是致痫灶的重要组成部分和首个解剖学标志。活化星形胶质细胞的重要性体现在其在临床症状出现之前以及脑电图上首次记录到棘波时就已被观察到这一事实。作者得出了谨慎的结论。作者认识到神经元的重要作用,并未表明星形胶质细胞是癫痫的病因。然而,由于在首个电信号宣告致痫灶开始之前就观察到了星形胶质细胞的活化,作者认为活化的星形胶质细胞可能为某些与致痫灶形成密切相关的机制提供了形态学证据。星形胶质细胞的代谢活化并不令人惊讶,可能与癫痫起始点——神经元过度活跃导致的局部代谢增加有关。这证实了当前尤其是在生物化学领域关于神经胶质细胞在神经元 - 星形胶质细胞关联中重要性的观点。这项工作开辟了某些前景。首先,在当前对神经胶质区室的生物化学、神经生理学和形态学研究背景下,活化星形胶质细胞的意义是一个有前景的研究领域。其次,从临床角度来看,能够基于活化星形胶质细胞识别致痫性胶质增生非常重要。将其与现代神经生理学技术结合用于定位致痫灶,在立体定向获取的活检材料中寻找活化星形胶质细胞应能更好地检测出受累区域,从而确保在药物难治性局灶性癫痫病例中手术更成功。