Scheffel Thamiris Becker, Diz Fernando Mendonça, Wieck Andréa, Begnini Karine Rech, da Costa Jaderson Costa
Brain Institute (BraIns), Pontifical Catholic University of Rio Grande Do Sul, Avenida Ipiranga, 6690, Partenon, Porto Alegre, 90610-000, Brazil.
Department of Biophysics, Institute of Biosciences, Federal University of Rio Grande do Sul, Avenida Bento Gonçalves 9500, Porto Alegre, 91501-970, Brazil.
J Mol Med (Berl). 2025 Jun 27. doi: 10.1007/s00109-025-02567-4.
Glioblastoma (GBM) is the most prevalent and aggressive primary brain tumor. Tumor-associated epilepsy is a clinical challenge in GBM patients, with seizures being a common symptom and reflecting complex interactions within the tumor microenvironment. This review highlights key molecular mechanisms behind GBM-associated epilepsy, including genetic alterations, increased glutamate release, ion channel dysfunction, and inflammation. These factors disrupt the surrounding neurons, promoting seizures. Shared pathways between epilepsy and GBM, such as those involved in synaptic signaling and immune responses, present potential therapeutic targets. Antiseizure drugs remain the primary treatment, with newer options like perampanel showing promise in reducing seizures and possibly influencing tumor growth. Understanding the interplay between epilepsy and GBM at the molecular level is crucial for advancing personalized treatment strategies and improving outcomes for patients.
胶质母细胞瘤(GBM)是最常见且侵袭性最强的原发性脑肿瘤。肿瘤相关性癫痫是GBM患者面临的一项临床挑战,癫痫发作是常见症状,反映了肿瘤微环境内的复杂相互作用。本综述重点介绍了GBM相关性癫痫背后的关键分子机制,包括基因改变、谷氨酸释放增加、离子通道功能障碍和炎症。这些因素会扰乱周围神经元,引发癫痫发作。癫痫和GBM之间的共同通路,如参与突触信号传导和免疫反应的通路,是潜在的治疗靶点。抗癫痫药物仍然是主要治疗方法,像吡仑帕奈这样的新选择在减少癫痫发作以及可能影响肿瘤生长方面显示出前景。在分子水平上理解癫痫和GBM之间的相互作用对于推进个性化治疗策略和改善患者预后至关重要。