Nehlig A, Vergnes M, Waydelich R, Hirsch E, Charbonne R, Marescaux C, Seylaz J
INSERM U 398, Faculté de Médecine, Strasbourg, France.
J Cereb Blood Flow Metab. 1996 Jan;16(1):147-55. doi: 10.1097/00004647-199601000-00017.
Our previous studies on cerebral metabolic activity in genetic absence epilepsy rats from Strasbourg (GAERS) were in favor of decreased functional activity during absences and normal or increased interictal activity. To ascertain that hypothesis, in the present study we performed continuous measurements of CBF in both children with typical absence epilepsy and GAERS, using Doppler ultrasonography and laser-Doppler flowmetry, respectively. CBF fluctuations during absences were recorded in four children between 5 and 6 years of age and 16 adult GAERS. In both children and animals, CBF measured in the middle cerebral artery and cortical capillaries, respectively, significantly decreased by a median value of 20-24% under basal levels during spontaneous absences. In GAERS, CBF levels were continuously decreased during haloperidol-induced absence status epilepticus, while they were not affected by ethosuximide. Conversely, convulsive seizures induced in rats either by kainate or picrotoxin led to a 175-664% increase in CBF levels. In conclusion, the present data show that during spontaneous absences, CBF decreases under basal levels in both cortical capillaries (GAERS) and the middle cerebral artery (children). Moreover, these fluctuations occur in vessels with normal vascular reactivity, are not mediated by changes in PO2, PCO2, or arterial blood pressure, and represent rather a response to reduced metabolic demand.
我们之前对来自斯特拉斯堡的遗传性失神癫痫大鼠（GAERS）脑代谢活动的研究表明，失神发作期间功能活动降低，发作间期活动正常或增加。为了验证这一假设，在本研究中，我们分别使用多普勒超声和激光多普勒血流仪，对典型失神癫痫患儿和GAERS的脑血流量（CBF）进行了连续测量。记录了4名5至6岁儿童和16只成年GAERS在失神发作期间的CBF波动情况。在儿童和动物中，分别在大脑中动脉和皮质毛细血管中测量的CBF，在自发失神发作期间，基础水平下均显著降低，中位数降低了20 - 24%。在GAERS中，氟哌啶醇诱导的失神癫痫持续状态期间CBF水平持续降低，而乙琥胺对其无影响。相反，海藻酸或印防己毒素诱导的大鼠惊厥性发作导致CBF水平升高175 - 664%。总之，目前的数据表明，在自发失神发作期间，皮质毛细血管（GAERS）和大脑中动脉（儿童）中的CBF均降至基础水平以下。此外，这些波动发生在血管反应性正常的血管中，不受PO2、PCO2或动脉血压变化的介导，而是对代谢需求降低的一种反应。
