Acetylcholine and the epileptiform activity of chronically isolated cortex. I. Macroelectrode studies

A critical period for prevention of posttraumatic neocortical hyperexcitability in rats

Penetrating cortical trauma frequently results in delayed development of epilepsy. In the rat undercut model of neocortical posttraumatic hyperexcitability, suppression of neuronal activity by exposing the injured cortex to tetrodotoxin (TTX) in vivo for approximately 2 weeks prevents the expression of abnormal hypersynchronous discharges in neocortical slices. We examined the relationship between neuronal activity during the latent period after trauma and subsequent expression of hyperexcitability by varying the timing of TTX treatment. Partially isolated islands of rat sensorimotor cortex were treated with Elvax polymer containing TTX to suppress cortical activity and slices obtained for in vitro experiments 10 to 15 days later. TTX treatment was either started immediately after injury and discontinued after a variable number of days or delayed for a variable time after the lesion was placed. Immediate treatment lasting only 2 to 3 days and treatment delayed up to 3 days prevented hyperexcitability. Thus, there is a critical period for development of hyperexcitability in this model that depends on cortical activity. We propose that the hyperexcitability caused by partial cortical isolation may represent an early stage of posttraumatic epileptogenesis. A hypothetical cascade of events leading to subsequent pathophysiological activity is likely initiated at the time of injury but remains plastic during this critical period.

Status epilepticus induced by pilocarpine and picrotoxin

Since its original description over 10 years ago, the pilocarpine model of status epilepticus (SE) has gained considerable attention. Much work has been done with the model in order to characterize the involvement of different brain structures in seizure genesis and spread. Electrophysiological studies of temporal lobe epileptic slices of both human and animal models, have failed to reveal hyperexcitability, unless blockade of GABAergic inhibition is performed. Thus, we have decided to evaluate potential contributions of picrotoxin, a GABAA channel blocker, on pilocarpine-induced SE. Animals injected with three-specific dose combinations (pilocarpine dose/picrotoxin dose), 150/0.5, 75/1.5 and 50/2.0 mg/kg, evoked status epilepticus (SE) within 23, 31 and 27 min, respectively. Ictal events and EEG spikes were initially observed either in the amygdala or in the hippocampus, with a later spread to cerebral cortex. Neuropathological analysis, performed 5-7 days after SE, has shown a high degree of cell loss predominantly in the piriform cortex, amygdala, hippocampus, thalamus and substantia nigra. Mortality rates for 150/0.5, 75/1.5 and 50/2.0 mg/kg (pilocarpine dose/picrotoxin dose) were 53, 42 and 51%, respectively. Single injections of 150 mg/kg of pilocarpine or 3 mg/kg of picrotoxin did not evoke any form of sustained epileptic activity. Previous studies in which simultaneous injections of other GABAA antagonists (i.e. bicuculline) and pilocarpine were performed, did not show clear evidences of a synergistic action between these two systems. The present study reveals a proconvulsant role for picrotoxin when co-administered with subconvulsant doses of pilocarpine. Possible mechanisms that might account for the interactions between the cholinergic and GABAergic systems in regard to epileptogenesis are discussed.

Epileptiform and non-epileptiform paroxysmal activity from isolated cortex after functional hemispherectomy

The relationship of acute complete cortical isolation to paroxysmal cerebral activity was examined in 16 patients with electrocorticography (ECOG) before and after functional hemispherectomy (FH). Burst-suppression activity appeared over isolated cortex in all cases, the severity of which could be increased by systemic administration of propofol or methohexital. Interictal epileptiform activity (EA) recorded from frontal or parietal-occipital cortex before FH invariably persisted after FH (11 cases). No EA was recorded before or after FH in 3 cases while in 2 cases EA appeared following FH which had not been present before FH. The intensity of burst-suppression activity was not related to the presence or absence of post-excision EA. In total, 30 disconnected cortices were recorded from; relative abundance of EA was increased in 10, unchanged in 17, and decreased in 3 cases. Unrelated to the induction of burst-suppression activity, cortical isolation may decrease the threshold for expression of interictal EA.

Induction of burst-suppression and activation of epileptiform activity after methohexital and selective amygdalo-hippocampectomy

Electrocorticography (ECOG) compared the effects of methohexital (MTH) and selective amygdalo-hippocampectomy (selAH) upon lateral temporal neocortical epileptiform activity (EA) in 31 patients with mesial temporal epilepsy. Pre-excision ECOG showed independent neocortical EA before MTH in 12/31 and after MTH in 18/31. MTH (20-50 mg) activated neocortical EA in 12 cases and induced burst-suppression (BS) over temporal neocortex in 14/31. Post-excision ECOG showed neocortical EA in 21/31 and BS in 27/31: compared with pre-excision ECOG before MTH, selAH activated neocortical EA in 15 cases. Significant correlations were found between presence of pre-excisional neocortical EA and presence of post-excisional neocortical EA (P < 0.001) and between activation of pre-excisional neocortical EA by MTH and activation of (post-excisional) neocortical EA by selAH (P < 0.006). Presence or severity of BS in the post-excision ECOG was not correlated with presence, absence or activation of post-excisional EA. Presence of neocortical EA was significantly correlated with a higher pre-operative seizure frequency (P < 0.001) but not with duration of epilepsy nor surgical outcome. Both MTH and selAH can induce neocortical BS, likely through chemical and surgical disconnection of cortex, respectively. Unrelated to induction of BS, MTH and selAH appear to decrease threshold for expression of neocortical EA in a similar fashion.

Cholinergic mechanisms in generalized seizures: importance of the zona incerta

OBJECTIVE

Stimulation of the central cholinergic system results in generalized epileptic seizures. The goal of this study was to map the epileptogenic effects of the cholinergic agonist, carbachol injected into different sites of the basal forebrain and diencephalon of the rat brain.

METHODS

Carbachol was injected directly into the brain in a dose of 1 or 3 micrograms. Seizures were assessed behaviourally on a five-stage scale with electroencephalographic controls. Seizures at stage 1 were the least severe and those at stage 5 the most severe.

RESULTS

Injections of high dose carbachol (3 micrograms) induced seizures from 40% of all injected brain sites. Injections of low dose carbachol (1 microgram) or isotonic saline into the same brain sites did not cause any behavioural or electrographic seizures. The majority of sites (84%) producing generalized seizures (stage 5) were concentrated in or around the zona incerta.

CONCLUSIONS

Within the anatomical limits of the study, the zona incerta is the area most sensitive to carbachol-induced generalized seizures.

Involvement of M1 muscarinic receptors in the initiation of cholinergically induced epileptic seizures in the rat brain

The present study was designed to determine the types of acetylcholine receptors involved in the initiation of epileptic seizures from the zona incerta and surrounding structures by cholinergic stimulation in rats. Unilateral intracerebral microinjection of the mixed muscarinic and nicotinic agonist carbachol (3 micrograms) produced generalized seizures in 12 of 20 rats studied. Local pretreatment with equimolar doses of acetylcholine receptor antagonists was used as a method of determining the receptor type involved in the initiation of cholinergically induced seizures in the rat diencephalon. Pretreatment with the M1 muscarinic receptor antagonist, pirenzepine (7 micrograms), abolished carbachol-induced seizures in 91% of the animals tested. The M2 muscarinic receptor antagonist, methoctramine (12 micrograms) and the nicotinic receptor antagonist, mecamylamine (3 micrograms), were relatively ineffective in antagonizing seizures in 9% and 27%, respectively. The results suggest that M1 muscarinic receptors are preferentially involved in the initiation of generalized epileptic seizures in the basal diencephalon of the rat.

The effects of sleep on neurons in isolated cerebral cortex

Slabs of cat parietal cortex with some 2 mm of underlying white matter were surgically isolated from the rest of the nervous system, without interference with the superficial blood supply. Wire micro-recording electrodes were inserted into the isolated cortex; bone, muscle and skin wounds were repaired and the animal allowed to recover from anaesthesia. The adequacy of surgical isolation was examined histologically 8--12 weeks after operation. Only one of the six preparations reported here showed surviving neural connections with the rest of the brain. Soon after operation, spontaneous bursts of neural activity appeared within the isolated area. These became more frequent until neural discharge was continuous but irregular. Our records were made from this time onwards. The interval distributions obtained from neurons within the isolated area did not differ significantly from log-normal curves. When the unrestrained animal fell asleep, there was no significant alteration in the model interval or geometric standard deviation of interval distributions recorded from cells in isolated cortex. The interval distributions of neurons in isolated cerebral cortex resembled those of neurons in the intact cortex of an alarmed animal. It is concluded that the reduction of modal interval that is shown by neurons in intact cortex when an animal falls asleep is probably due to the neural influence of infracortical structures.

Cortical modification of an epileptogenic focus

The influence of cerebral cortex on penicillin-induced spikes in striate cortex was studied with the technique of hypothermic block. Direct cooling of the involved or contralateral striate cortex markedly reduced seizure activity. Significant reduction in seizure activity was also seen with cooling of ipsilateral and contralateral visual association cortex. None of the other cortical areas tested had a reproducible effect on the frequency of seizures. These findings are discussed in term of local and remote factors influencing the epileptogenic focus.

Does the brain actively maintain itself?

All living systems have special mechanisms for combatting entropy; however, the brain has dimensions of organized complexity beyong those manifest in the anatomical structure and physiology of the rest of the body. Reasons are given in support of the notion that the brain therefore must have a special, intrinsic "homeostatic" system for its information bearing structures, and, further, that slow electroencephalographic activity has properties which might make it useful for such an order-maintaining function. Recovery from brain damage is hypothesized to be a byproduct of this process, which may involve a cruder sort of information processing than occurs with such functions as perception and learning. Synchronized EEG activity may be adequate to handle this sort of information processing. Speculations are offered about possible mechanics, on the neuronal level, of slow wave participation in plasticity; for example, one such suggestion is based on findings that electrical fields can influence cellular orientation. The methodology of discovering the distribution within the brain of the hypothetical maintenance system is discussed briefly.

Influence of association cortex on penicillin discharges in the primary visual cortex

The influence of visual association cortex on the pattern of neuronal activity in the lateral geniculate body, during penicillin-induced discharges in visula cortex, was studied. In a majority of those geniculate cells which exhibited a pre-penicillin discharge increment in activity, that increment was abolished or significantly reduced during focal hypothermia of the visual association cortex. The frequency of penicillin discharges in visual cortex was, in most cases, reduced during cooling of association cortex. These findings are briefly discussed in terms of corticothalamic interactions.

Time course of development of supersensitivity to topical acetylcholine in partially isolated cortex

In alert monkeys the time course for development of supersensitivity to topical acetylcholine in partially isolated frontal cerebral cortex was determined. Thresholds for paroxysmal discharge fell progressively and markedly during 3 weeks, further in 5 and somewhat more after 6 months. ACh supersensitivity was demonstrated in chronic "isolated" occipital cortex. Epileptiform discharges were recorded selectively from chronic partially isolated frontal cortex on peripheral nerve stimulation and these spread, causing a clinical convulsive siezure when the open end of the isolation extended into the precentral gyrus. The basic mechanisms responsible for the supersensitivity are unknown but evidence presented and much in the pertinent literature is in keeping with the hypothesis that partial isolation of cortical cells, i.e., denervation, deafferentation, or disuse may be important. It is suggrested that peripheral nerve stimulation, like arousal, may cause an outflow of ACh on the normal brain surface and over the open end of a partially isolated area, which, especially, in the presence of a diminished cholinesterase activity (in partially isolated cortex), could act like topical ACh, cause a DC shift and an epileptiform discharge.