Participation of interneurons in penicillin-induced epileptic discharges

Electrical cortical stimulations modulate spike and post-spike slow-related high-frequency activities in human epileptic foci

OBJECTIVE

Using interictal epileptiform discharges (IEDs), consisting of spikes and post-spike slow waves (PSSs), and IED-related high-frequency activities (HFAs), we elucidated inhibitory effects of electrical cortical stimulation (ECS) on human epileptic foci.

METHODS

We recruited 8 patients with intractable focal epilepsy, and 50-Hz ECS was applied to the seizure-onset zone (SOZ) and non-SOZ. Before (5-min) and after (20-min) ECS, we evaluated the number of IED, the amplitudes of spikes and PSSs, spike-related HFA power, and PSS-related low gamma (30-50 Hz) activities.

RESULTS

SOZ stimulation significantly decreased the number of IEDs and amplitude of spikes. Spike-related HFA power values in fast ripple (200-300 Hz) and ripple (80-150 Hz) bands were significantly suppressed only by SOZ stimulation in 4 and 3 patients, respectively. Among 4 patients with discrete PSSs, the amplitude ratio of spike/PSS decreased and the PSS-related low gamma activity power increased significantly in 2 patients and marginally in 1 patient.

CONCLUSIONS

ECS potentially modulates cortical excitability by reducing excitation and increasing inhibition, and monitoring IED-related HFAs may help achieve the optimal effects of ECS.

SIGNIFICANCE

IED and IED-related HFAs are dynamic, potential surrogate markers for epileptic excitability during the interictal period.

Functional, metabolic, and synaptic changes after seizures as potential targets for antiepileptic therapy

Little is known about how the brain limits seizure duration and terminates seizures. Depending on severity and duration, a single seizure is followed by various functional, metabolic, and synaptic changes that may form targets for novel therapeutic strategies. It is long known that most seizures are followed by a period of postictal refractoriness during which the threshold for induction of additional seizures is increased. The endogenous anticonvulsant mechanisms involved in this phenomenon may be relevant for both spontaneous seizure arrest and increase of seizure threshold after seizure arrest. Postictal refractoriness has been extensively studied in various seizure and epilepsy models, including electrically and chemically induced seizures, kindling, and genetic animal models of epilepsy. During kindling development, two antagonistic processes occur simultaneously, one responsible for kindling-like events and the other for terminating ictus and postictal refractoriness. Frequently occurring seizures may lead to an accumulation of postictal refractoriness that may last weeks. The mechanisms involved in seizure termination and postictal refractoriness include changes in ionic microenvironment, in pH, and in various endogenous neuromodulators such as adenosine and neuropeptides. In animal models, the anticonvulsant efficacy of several antiepileptic drugs (AEDs) is increased during postictal refractoriness, which is a logical consequence of the interaction between endogenous anticonvulsant processes and the mechanism of AEDs. As discussed in this review, enhanced understanding of these endogenous processes may lead to novel targets for AED development.

Seizure-like activity in the disinhibited CA1 minislice of adult guinea-pigs

Spontaneous activity was monitored during pharmacological blockade of GABA(A) receptor function in the CA1 minislice (CA3 was cut off). Synaptic inhibition was blocked by competitive GABA(A) antagonists bicuculline-methiodide (Bic) or GABAZINE (GBZ) and the chloride channel blocker picrotoxin (PTX). Extra- and intracellular recordings using sharp electrodes were carried out in stratum radiatum and pyramidale. At low antagonist concentrations (Bic, GBZ: 1-10 microM; PTX: < 100 microM), synchronized bursts (< 500 ms in duration, interictal activity) were seen as described previously. However, in the presence of high concentrations (Bic, GBZ: 50-100 microM; PTX: 100-200 microM), seizure-like, ictal events (duration 4-17 s) were observed in 67 of 88 slices. No other experimental measures to increase excitability were applied: cation concentrations ([Ca2+]o = 2 mM, [Mg2+]o = 1.7 mM, [K+]o = 3 mM) and recording temperature (30-32 degrees C) were standard and GABA(B)-mediated inhibition was intact. In whole-slice recordings prominent interictal activity, but fewer ictal events were observed. A reduced ictal activity was also observed when interictal-like responses were evoked by afferent stimulation. Ictal activity was reversibly blocked by antagonists of excitatory transmission, CNQX (40 microM) or D-AP5 (50 microM). Disinhibition-induced ictal development did not rely on group I mGluR activation as it was not prevented in the presence of group I mGluR antagonists (AIDA or 4CPG). (RS)-3,5-DHPG prevented the induction and reversed the tertiary component of the ictal event through a group I mGluR-independent mechanism.

Ictal epileptiform activity is facilitated by hippocampal GABAA receptor-mediated oscillations

The cellular and network mechanisms of the transition of brief interictal discharges to prolonged seizures are a crucial issue in epilepsy. Here we used hippocampal slices exposed to ACSF containing 0 Mg(2+) to explore mechanisms for the transition to prolonged (3-42 sec) seizure-like ("ictal") discharges. Epileptiform activity, evoked by Shaffer collateral stimulation, triggered prolonged bursts in CA1, in 50-60% of slices, from both adult and young (postnatal day 13-21) rats. In these cases the first component of the CA1 epileptiform burst was followed by a train of population spikes at frequencies in the gamma band and above (30-120 Hz, reminiscent of tetanically evoked gamma oscillations). The gamma burst in turn could be followed by slower repetitive "tertiary" bursts. Intracellular recordings from CA1 during the gamma phase revealed long depolarizations, action potentials rising from brief apparent hyperpolarizations, and a drop of input resistance. The CA1 gamma rhythm was completely blocked by bicuculline (10-50 microm), by ethoxyzolamide (100 microm), and strongly attenuated in hyperosmolar perfusate (50 mm sucrose). Subsequent tertiary bursts were also blocked by bicuculline, ethoxyzolamide, and in hyperosmolar perfusate. In all these cases intracellular recordings from CA3 revealed only short depolarizations. We conclude that under epileptogenic conditions, gamma band oscillations arise from GABA(A)ergic depolarizations and that this activity may lead to the generation of ictal discharges.

Synchronization of GABAergic interneuronal networks during seizure-like activity in the rat horizontal hippocampal slice

We studied the contribution of GABAergic (gamma-aminobutyric acid) neurotransmission to epileptiform activity using the horizontal hippocampal rat brain slice. Seizure-like (ictal) activity was evoked in the CA1 area by applying high-frequency trains (80 Hz for 2 s) to the Schaffer collaterals. Whole-cell recordings from stratum oriens-alveus interneurons revealed burst firing with superimposed high-frequency spiking which was synchronous with field events and pyramidal cell firing during ictal activity. On the other hand, interictal interneuronal bursts were synchronous with large-amplitude inhibitory postsynaptic potentials (IPSPs) in pyramidal cells. Excitatory and inhibitory postsynaptic potentials were simultaneously received by pyramidal neurons during the ictal afterdischarge, and were synchronous with interneuronal bursting and field potential ictal events. The GABAA receptor antagonist bicuculline greatly reduced the duration of the ictal activity in the CA1 layer, and evoked rhythmic interictal synchronous bursting of interneurons and pyramidal cells. With intact GABAergic transmission, interictal field potential events were synchronous with large amplitude IPSPs (9.8 +/- 2.4 mV) in CA1 pyramidal cells, and with interneuronal bursting. Simultaneous dual recordings revealed synchronous IPSPs received by widely separated pyramidal neurons during ictal and interictal periods, indicative of widespread interneuronal firing synchrony throughout the hippocampus. CA3 pyramidal neurons fired in synchrony with interictal field potential events recorded in the CA1 layer, and glutamate receptor antagonists abolished interictal interneuronal firing and synchronous large amplitude IPSPs received by CA1 pyramidal cells. These observations provide evidence that the interneuronal network may be entrained in hyperexcitable states by GABAergic and glutamatergic mechanisms.

Inhibitory function in two models of chronic epileptogenesis

Although drug-induced disinhibition is a potent method for producing acute epileptogenesis, data with respect to possible disorders of GABAergic inhibitory function in models of chronic epilepsy are incomplete and inconsistent. We examined rat models of cortical post-traumatic epilepsy, and epileptogenic cortical microgyri. Results suggest enhanced rather than decreased inhibitory function in cortical networks in these preparations. In brain slices from epileptogenic chronically isolated cortex, the frequency of spontaneous inhibitory postsynaptic currents (sIPSCs) and miniature (m)IPSCs in layer V pyramidal neurons is increased compared to control. In the epileptogenic zone adjacent to the microgyrus, both spontaneous and stimulus-induced IPSCs are larger in amplitude than control, and the frequency of sIPSCs is more dependent upon glutamatergic excitation of interneurons than in control layer V neurons of homotopic cortex. Immunocytochemical studies show that there is enhanced immunoreactivity for several proteins in GABAergic interneurons of chronic cortical isolations, and suggest that there may be sprouting of GABAergic axons in the area of injury. This conclusion is supported by anatomic data showing an approximate doubling of the number of presumed inhibitory synapses on somata of layer V pyramidal neurons. These anatomic findings are consistent with the increased frequency of mIPSCs on these neurons. Inhibition is robust in both of these chronic models of epileptogenesis. Increased inhibitory electrogenesis might be pictured as part of the epileptogenic process, e.g. a mechanism for synchronizing the discharge of pyramidal neurons, or as a compensatory mechanism that might prevent the development of abnormal activities in some cases, or limit the intensity of epileptogenesis in others.

Simulation of gamma rhythms in networks of interneurons and pyramidal cells

Networks of hippocampal interneurons, with pyramidal neurons pharmacologically disconnected, can generate gamma-frequency (20 Hz and above) oscillations. Experiments and models have shown how the network frequency depends on excitation of the interneurons, and on the parameters of GABAA-mediated IPSCs between the interneurons (conductance and time course). Here we use network simulations to investigate how pyramidal cells, connected to the interneurons and to each other through AMPA-type and/or NMDA-type glutamate receptors, might modify the interneuron network oscillation. With or without AMPA-receptor mediated excitation of the interneurons, the pyramidal cells and interneurons fired in phase during the gamma oscillation. Synaptic excitation of the interneurons by pyramidal cells caused them to fire spike doublets or short bursts at gamma frequencies, thereby slowing the population rhythm. Rhythmic synchronized IPSPs allowed the pyramidal cells to encode their mean excitation by their phase of firing relative to the population waves. Recurrent excitation between the pyramidal cells could modify the phase of firing relative to the population waves. Our model suggests that pools of synaptically interconnected inhibitory cells are sufficient to produce gamma frequency rhythms, but the network behavior can be modified by participation of pyramidal cells.

Cellular activity underlying altered brain metabolism during focal epileptic activity

Demonstration of focal alterations of brain metabolism with positron emission tomography has become a widely used method for identifying epileptic foci. Here we investigated how neuronal and glial cell activity relates to alterations of brain metabolism. Acutely induced epileptic activity in the motor cortex of rat brain increased metabolism in the focus and homotopic contralateral areas, and decreased metabolism in the ipsilateral somatosensory area. Increases and decreases of deoxyglucose uptake did not directly correlate with excitations and inhibitions; instead, deoxyglucose uptake was related to the overall strength of synaptic activity, and both strong excitations and strong inhibitions increased brain metabolism. Reduction of metabolism below normal values was associated with reduced synaptic activity and with tonic hyperpolarization of the cells. Our results show that in the absence of structural abnormalities, hypometabolism indicates functional disturbances which may be both reversible and remote from the epileptogenic focus.

Inhibitory mechanisms in epileptiform activity induced by low magnesium

In rat hippocampal slices epileptiform activity was induced by superfusion with Mg(2+)-free artificial cerebrospinal fluid (ACSF). Paroxysmal depolarization shifts (PDS) were evoked by electrical stimulation of Schaffer collaterals. To investigate the afterpotentials that follow PDS, intracellular recordings were made from CA1 pyramidal cells. The experiments revealed that several components are engaged in the generation of PDS afterpotentials in Mg(2+)-free ACSF. A long lasting component which determined the overall duration of the PDS afterhyperpolarization was blocked by intracellular application of ethylenebis(oxonitrilo)-tetraacetate (EGTA); concomitantly, the afterhyperpolarizations following depolarizing current injections were blocked. This indicated that the long lasting component was due to a slow Ca(2+)-activated K+ current. The block of Ca(2+)-activated K+ current uncovered a depolarizing PDS afterpotential with an N-shaped voltage dependence, suggesting that this depolarizing afterpotential component may be due to an N-methyl D-aspartate (NMDA) conductance. Intracellular injection of Cl- revealed that the PDS were followed by Cl- currents lasting about 500 ms. This component could be blocked by application of bicuculline suggesting that it is due to a synaptically GABA-mediated (i.e. gamma-aminobutyric acid) Cl- current. A comparison of PDS afterpotentials in Mg(2+)-free ACSF and those in other models of epileptiform activity suggests that similar sequences of inhibitory components are activated in spite of different pharmacological alterations of membrane conductances which induce the epileptiform discharges.

Enhanced NMDA conductance can account for epileptiform activity induced by low Mg2+ in the rat hippocampal slice

1. Why does lowering extracellular Mg2+ cause synchronous neuronal bursts and after-discharges? To address this question, a computer model of the CA3 region was constructed with 1000 pyramidal neurones and 100 inhibitory neurones. Pyramidal neurones were multicompartmental and contained five ionic conductances, distributed non-uniformly on the membrane. In parallel, experiments were performed on rat hippocampal slices perfused in solutions without added Mg2+. 2. Model neurones were interconnected randomly as follows. Recurrent excitatory connections between pyramidal neurones, and from pyramidal neurones to inhibitory cells, stimulated both alpha-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid (AMPA) receptors (rapid, voltage and Mg2+ independent) and NMDA receptors (slow conductance decay, voltage and Mg2+ dependent). A time-dependent 'desensitization' process was included whereby the NMDA-mediated conductance declined after the onset of synchronized firing. Half of the inhibitory neurones activated GABAA receptors on pyramidal cells (perisomatic, rapid), and half activated GABAB receptors (dendritic, slow onset and decay). 3. We examined patterns of synchronous firing in the pyramidal cells as parameters defining model features were manipulated. These parameters included the maximum conductance of individual synapses, [Mg2+]o, excitatory connectivity, and parameters that defined the NMDA 'desensitization' process. Comparisons were made with experiment where possible. 4. GABAA blockade in 1 mM [Mg2+]o induces single bursts and bursts with after-discharges. Synchronized bursts and after-discharges also occurred in the model when NMDA conductances were sufficiently enhanced, even with GABAA inhibition present. Both in simulated and experimental after-discharges in low-Mg2+ solutions, the level of GABAA inhibition was important in determining the number of secondary bursts and the number of somatic spikes per wave. 5. The model of low-Mg(2+)-induced synchrony predicts that each somatic wave is induced by a dendritic Ca2+ spike and that the dendritic spikes are superimposed on a tonic dendritic depolarization generated by the enhanced NMDA conductance. We further predict the recurrent activation of interneurones by NMDA receptors, based both on experiments and simulations in which AMPA receptors are blocked. 6. Many of the mechanisms underlying low-Mg(2+)-induced after-discharges appear to resemble those underlying picrotoxin-induced after-discharges. These mechanisms can operate in low-Mg2+ solutions because of the increase in NMDA conductance in the recurrent excitatory connections.

Cellular mechanisms of neocortical secondary epileptogenesis

Firing activity, membrane parameters and postsynaptic responses were studied by recording intracellularly from different types of neurons during the development of a secondary neocortical epileptiform focus (mirror focus, Mf) contralateral to the site of an aminopyridine-induced focus (primary focus, Pf) in anesthetized rats. Three different stages in the development of secondary epileptogenesis were observed. (i) in the Pf stage epileptiform discharges appeared only in the ECoG recorded from the Pf, but neurons in the Mf showed reduced firing activity; (ii) in the Pf + Mf stage, synchronous ictal epileptiform activity occurred in the Pf and Mf. Changes in the balance between inhibition and excitation, appearance of novel electrophysiological phenomena (e.g. antidromic like action potentials, PDS (paroxysmal depolarization shift) potentials, rebound bursts), enhanced intrinsic bursting, and a transition from regular spiking to bursting were observed at the cellular level; (iii) in the Pf/Mf stage in 10% of the animals, the surface epileptic discharges were in synchrony with cellular activity in the Mf but were temporally independent of Pf activity, suggesting that during secondary epileptogenesis the Pf and the Mf can have underlying epileptogenic mechanisms which are different in origin.

Afterpotentials of penicillin-induced epileptiform neuronal discharges in the motor cortex of the rat in vivo

Interictal spikes and sharp waves in the EEG are followed by intervals in which the excitability of the brain seems to be normal or decreased. Often interictal spikes even appear in rhythmical patterns with intervals in the order of 0.5-2 s. These observations suggest that intrinsic and synaptic inhibitory and excitatory processes are activated which outlast the duration of the interictal discharge. In the present study such afterpotentials were analyzed in penicillin foci of the rat motor cortex in vivo using intracellular recording techniques. Paroxysmal depolarizations (PDS) of neurons within the focus were followed by afterpotentials comprising several components. Fast afterpotentials with a duration of 640 ms were associated with a sevenfold increase in membrane conductance. The fast afterpotentials were depolarizing in the majority of recordings and had an average equilibrium potential of -62 mV. This equilibrium potential was Cl(-)-dependent and was not affected by intracellular EGTA or Cs+. It is suggested that these afterpotentials represent GABAA responses. In 38% of the neurons slow afterhyperpolarizations with a twofold increase in membrane conductance and a duration of 2 s were observed. These afterhyperpolarizations had a reversal potential of -79 mV, were blocked by intracellular Cs+, were reduced in duration and amplitude by intracellular EGTA, and are suggested to present a combination of a GABAB response and a calcium-dependent potassium current. In addition, slow afterdepolarizations with a duration of about 1900 ms were registered in 16% of the recordings. It is concluded that afterpotentials with several intrinsic and synaptic components follow penicillin-induced PDS. Among these are giant Cl(-)-dependent potentials which probably represent GABAA responses, GABAB responses and a slow calcium-dependent potassium current. It is suggested that the depolarizing equilibrium potential of the Cl(-)-dependent component is due to intracellular Cl- accumulation which might favor transition to ictal discharges.

Analysis of the propagation of disinhibition-induced after-discharges along the guinea-pig hippocampal slice in vitro

1. A model has been proposed of picrotoxin-induced hippocampal in vitro after-discharges; it depends critically upon alpha-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid (AMPA) and N-methyl-D-aspartate (NMDA) receptors in the recurrent excitatory connections between pyramidal neurones, and upon the ability of pyramidal neurones to generate bursts at about 10 Hz when their dendrites are sufficiently depolarized. 2. We study here the question of whether this model can account for spatial--as well as temporal--aspects of after-discharges in guinea-pig hippocampal slices. For example, can the model explain the propagation along a transverse slice of the initial burst and the secondary bursts at about the same velocity, approximately 0.10-0.20 m s-1? Under what conditions might the secondary bursts exhibit a different spatial pattern to the initial burst, as we now show can occur in longitudinal slices? To examine these questions, we increased the number of cells in our model from 100 to 8000 (in a 20 x 400 array), arranging the excitatory synaptic connections in a spatially restricted fashion, with an average extent of 1.0 mm (as suggested experimentally). 3. Our model suggests that both AMPA and NMDA receptors contribute to the propagation pattern and velocity of the initial and the secondary bursts in an after-discharge. 4. When unitary AMPA and NMDA conductances are in the range where the primary burst lasts for 100-200 ms, and there are three or four secondary bursts, then both primary and secondary bursts propagate near to the experimentally observed velocity for transverse slices. In the model, however, secondary bursts propagate at somewhat slower velocities than the initial burst. 5. The mechanisms of propagation are different for the initial and for the secondary bursts: propagation of the primary burst depends upon the initiation of electrogenesis in 'resting' dendrites by AMPA and NMDA inputs that are rapidly increasing in time. Propagation of secondary bursts depends upon the timing of calcium spikes in depolarized dendrites with slowly varying NMDA inputs; the timing of calcium spikes can be influenced by a 'wave' of AMPA input, but calcium spikes--we predict--should occur even without the AMPA input, once the after-discharge has been initiated. The blockade of firing in an intermediate region of the disinhibited slice is predicted to have different effects on the primary burst and on secondary bursts distal to the region of blockade.(ABSTRACT TRUNCATED AT 400 WORDS)

Separation of different interictal discharge patterns in acute experimentally induced epileptic foci of the rat in vivo

Epileptic discharge patterns in an acute experimental model of epilepsy were analyzed. Epileptic foci were induced by epicortical application of penicillin on the rat motor cortex in vivo. Patterns with regular 1/s discharges, patterns with irregular discharges of about 0.5/s as well as compound patterns comprising discharges with intervals of about 300 ms could be differentiated by means of interval histograms and autocorrelation functions. These patterns occurred in an ordered sequence indicating that the different rhythms are activated by a progressive enlargement of the focus and duration of focal activity. The experiments suggest that different interictal discharge patterns can occur within the same brain regions and are not specific for a certain etiology; instead they seem to represent 'resonance' frequencies characteristic for the brain tissue which are disclosed under pathophysiological conditions.