Handforth A, Ackermann R F
Department of Neurology, UCLA School of Medicine, Reed Neurological Research Center 90024, USA.
Brain Res Brain Res Rev. 1995 Jan;20(1):1-23. doi: 10.1016/0165-0173(94)00003-8.
We have previously described a model of limbic status epilepticus in which chronic prolonged seizure states of immobile, exploratory, minor convulsive or clonic convulsive behavior are induced by intracerebral electrical stimulation; these states appear to belong to the same behavioral progression as kindled seizures. We postulated that the underlying seizure substrates, as mapped by the 14C-2-deoxyglucose method, should reflect a corresponding anatomic progression of discharge spread. Status epilepticus was induced in rat by pulsed-train current delivered for up to 90 min to one of several subcortical areas. Autoradiographs revealed that most of the observed patterns of seizure-induced metabolic activation comprised a hierarchical sequence, such that progressively more extensive patterns subsumed anatomic territories activated in less extensive patterns, thus allowing inferences as to the progression of discharge spread. In this sequence, the basolateral amygdala ipsilateral to the induction electrode was among the first structures to be activated. In successively larger activation patterns a small unilateral network related to basolateral amygdala was involved; this evolved through a transitional state to a unilateral extensive limbic pattern; which in turn was succeeded by bilateral extensive limbic activation. This hierarchical sequence culminated in a neocortical activation pattern, in which most of the forebrain was involved in intense seizure-induced activation. Seizure behaviors increased in severity in correspondence with the underlying seizure-activated anatomic substrate. In contrast, patterns of seizure activation were observed which did not fit within the early stages of the above sequence, although analysis indicates that the later stages of spread may be shared. The study of these patterns and those reported in the literature indicates that although limbic seizure networks may be anatomically distinct at their origination, further expansion is characterized by overlap; upon assumption of extensive patterns of activation the number of nuclei participating is so vast that the identity of the limbic originator is lost and common convulsive manifestations occur.
我们之前描述过一种边缘性癫痫持续状态模型,通过脑内电刺激可诱发慢性长期的癫痫发作状态,表现为不动、探索、轻微惊厥或阵挛性惊厥行为;这些状态似乎与点燃性癫痫发作属于相同的行为进展过程。我们推测,通过¹⁴C-2-脱氧葡萄糖法绘制的潜在癫痫发作基质应反映放电扩散的相应解剖学进展。通过向几个皮质下区域之一施加长达90分钟的脉冲串电流在大鼠中诱发癫痫持续状态。放射自显影片显示,大多数观察到的癫痫发作诱导的代谢激活模式构成一个层次序列,即逐渐更广泛的模式包含了在较不广泛模式中激活的解剖区域,从而能够推断放电扩散的进展。在这个序列中,与诱导电极同侧的基底外侧杏仁核是最早被激活的结构之一。在相继更大的激活模式中,涉及一个与基底外侧杏仁核相关的小的单侧网络;这个网络通过一个过渡状态演变为单侧广泛的边缘模式;接着又被双侧广泛的边缘激活所取代。这个层次序列以新皮质激活模式达到顶峰,其中大部分前脑参与了强烈的癫痫发作诱导激活。癫痫发作行为的严重程度与潜在的癫痫发作激活的解剖基质相对应。相比之下,观察到一些癫痫发作激活模式不符合上述序列的早期阶段,尽管分析表明扩散的后期阶段可能是相同的。对这些模式以及文献中报道的模式的研究表明,尽管边缘性癫痫发作网络在起源时可能在解剖学上是不同的,但进一步扩展的特征是重叠;在呈现广泛的激活模式时,参与的核数量如此之多,以至于边缘起源者的身份丧失,出现常见的惊厥表现。