Differential effects of naloxone on postictal depression

Adenosine A1 Receptors Participate in Excitability Changes after Cortical Epileptic Afterdischarges in Immature Rats

Background: Postictal refractoriness, i.e., the inability to elicit a new epileptic seizure immediately after the first one, is present in mature animals. Immature rats did not exhibit this refractoriness, and it is replaced by postictal potentiation. In addition to the immediate postictal potentiation, there is a delayed potentiation present at both ages. These phenomena were studied using cortical epileptic afterdischarges as a model. Objective: We aimed to analyze participation of adenosine A1 receptors in postictal potentiation and depression. Methods: Adenosine A1 receptors were studied by means of Western blotting in the cerebral cortex with a focus on the age groups studied electrophysiologically. Stimulation and recording electrodes were implanted epidurally in 12- and 25-day-old rats. The first stimulation always induced conditioning epileptic afterdischarge (AD), and 1 min after its end, the stimulation was repeated to elicit the second, testing AD. Then, the drugs were administered and paired stimulations were repeated 10 min later. A selective agonist CCPA (0.5 and 1 mg/kg i.p.) and a selective antagonist DPCPX (0.1, 0.5 and 1 mg/kg i.p.) were used to examine the possible participation of adenosine A1 receptors. Results: Control younger animals exhibited potentiation of the testing AD and a moderate increase in both conditioning and testing ADs after an injection of saline. The A1 receptor agonist CCPA shortened both post-drug ADs, and neither potentiation was present. The administration of an antagonist DPCPX resulted in marked prolongation of the conditioning AD (delayed potentiation), and the second testing AD was shorter than the post-drug conditioning AD, i.e., there was no longer immediate potentiation of ADs. To eliminate effects of the solvent dimethylsulfoxide, we added experiments with DPCPX suspended with the help of Tween 80. The results were similar, only the prolongation of ADs was not as large, and the testing ADs were significantly depressed. The older control group exhibited a nearly complete suppression of the first testing AD. There was no significant change in the conditioning and testing ADs after CCPA (delayed potentiation was blocked). Both groups of DPCPX-treated rats (with DMSO or Tween) exhibited significant augmentation of delayed potentiation but no significant difference in the immediate depression. Adenosine A1 receptors were present in the cerebral cortex of both age groups, and their quantity was higher in 12- than in 25-day-old animals. Conclusions: An agonist of the A1 receptor CCPA suppressed both types of postictal potentiation in 12-day-old rats, whereas the A1 antagonist DPCPX suppressed immediate potentiation but markedly augmented the delayed one. Immediate postictal refractoriness in 25-day-old rats was only moderately (non-significantly) affected; meanwhile, the delayed potentiation was strongly augmented.

Participation of GABAB receptors in cortical postictal excitability in immature rats

Arrest of seizures is due to an active inhibition and is followed in mature brain by period of refractoriness markedly present one min after the end of seizures. To study changes in cortical excitability after epileptic seizures we used electrical stimulation of sensorimotor cortical area in immature rats - 25-day-old ones with mature postictal refractoriness and 12-day-old where postictal potentiation of afterdischarges (ADs) is present instead of refractoriness at one minute after the end of the conditioning AD. GABA_B receptor antagonist CGP35348 was found to partly suppress postictal refractoriness. In present study not only an antagonist CGP46381 (3 and 10mg/kg i.p.) but also positive allosteric modulator of GABA_B receptors CGP7930 (20 and 40mg/kg i.p.) were used to study the role of GABA_B receptors in both age groups. They were injected immediately after testing AD and 10min later the two stimulations were repeated. CGP46381 partly antagonized postictal refractoriness in 25-day-old rats but did not significantly affect ADs in 12-day-old animals. CGP7930 did not significantly change ADs duration in either age group. GABAB receptors participate in mechanism of postictal refractoriness but did not play an important role in 12-day-old rats where potentiation instead of refractoriness is present.

Repeated 6-Hz Corneal Stimulation Progressively Increases FosB/ΔFosB Levels in the Lateral Amygdala and Induces Seizure Generalization to the Hippocampus

Exposure to repetitive seizures is known to promote convulsions which depend on specific patterns of network activity. We aimed at evaluating the changes in seizure phenotype and neuronal network activation caused by a modified 6-Hz corneal stimulation model of psychomotor seizures. Mice received up to 4 sessions of 6-Hz corneal stimulation with fixed current amplitude of 32 mA and inter-stimulation interval of 72 h. Video-electroencephalography showed that evoked seizures were characterized by a motor component and a non-motor component. Seizures always appeared in frontal cortex, but only at the fourth stimulation they involved the hippocampus, suggesting the establishment of an epileptogenic process. Duration of seizure non-motor component progressively decreased after the second session, whereas convulsive seizures remained unchanged. In addition, a more severe seizure phenotype, consisting of tonic-clonic generalized convulsions, was predominant after the second session. Immunohistochemistry and double immunofluorescence experiments revealed a significant increase in neuronal activity occurring in the lateral amygdala after the fourth session, most likely due to activity of principal cells. These findings indicate a predominant role of amygdala in promoting progressively more severe convulsions as well as the late recruitment of the hippocampus in the seizure spread. We propose that the repeated 6-Hz corneal stimulation model may be used to investigate some mechanisms of epileptogenesis and to test putative antiepileptogenic drugs.

Developmental patterns of postictal refractoriness and potentiation akin to cortical stimulation

Postictal refractoriness checked by paired stimulations of the limbic structures was demonstrated to fail in rats<2 weeks old. Cortical epileptic afterdischarges were used in our study to examine if this phenomenon is restricted to old cortical structures or if it is a general one. Rats 12, 15, 18, 25, and 90 days old with implanted electrodes formed the experimental groups. Stimulation was performed by 15-s series of 1-msec pulses with suprathreshold intensity and frequency of 8 Hz. Paired stimulation of the cerebral cortex in 12-day-old rats elicited the second afterdischarge, even if the 30-s interval was used. Refractoriness started to appear in the third postnatal week and developed progressively so that 25-day-old rats did not differ from adult animals, that is, an interval longer than 1 min was necessary for elicitation of the second seizure.

GABAB, not GABAA receptors play a role in cortical postictal refractoriness

Postictal refractoriness may be taken as an expression of lasting activity of inhibitory systems arresting seizures. We tested drugs interfering with GABAergic inhibitory system in pairs of cortical epileptic afterdischarges induced with 1-min interval in rats. Under control conditions the second stimulation failed to elicit an afterdischarge. This postictal refractoriness was not affected by antagonists of GABAA receptors acting at three binding sites (bicuculline, picrotoxin, benzodiazepine inverse agonist Ro 19-4603) as well as by a less specific antagonist pentetrazol. In contrast, antagonist of GABAB receptors CGP35348 partially blocked the refractoriness. Cooperation of different inhibitory systems is probably necessary to abolish postictal refractoriness in neocortex. This article is part of the Special Issue entitled 'GABAergic Signaling in Health and Disease'.

A1 not A2A adenosine receptors play a role in cortical epileptic afterdischarges in immature rats

Endo- as well as exogenous adenosine exhibits anticonvulsant action. Participation of individual types of adenosine receptors was studied in present experiments in immature rats. Cortical epileptic afterdischarges were used as a model in rat pups 12, 18 and 25 days old. CCPA, an agonist of A1 adenosine receptors, decreased markedly duration of afterdischarges whereas DPCPX, an antagonist of A1 receptors, exhibited strong proconvulsant action. Action of either drug was best expressed in 12-day-old rats and it decreased with age. Drugs influencing A2A adenosine receptors (agonist CGS21680 and antagonist ZM241385) did not exhibit systematic effects in our model. Motor phenomena accompanying cortical stimulation or epileptic afterdischarge were never influenced by any of the four drugs studied. A1 adenosine receptors are important in the model of cortical seizures, especially in the youngest group studied.

Effects of LiCl/pilocarpine-induced status epilepticus on rat brain mu and benzodiazepine receptor binding: regional and ontogenetic studies

Neurochemical studies document involvement of benzodiazepine (BDZ) and mu opioid receptors in seizure development and their possible age-related role during epileptogenesis. To study developmental changes of this role LiCl/pilocarpine status epilepticus (SE) was induced in P12, P25 and/or adult rats. This SE leads to epilepsy in all adult and subpopulation of immature rats. Using in vitro autoradiography, benzodiazepine (BDZ) and mu opioid receptor binding was evaluated 1 week (early phase of epileptogenesis) and 3 months (chronic phase) after SE in 27 brain structures involved in seizure generation and spread (amygdala, hippocampus, basal ganglia and thalamic nuclei). The pattern of receptor binding changes was related to the age at SE, interval after SE and to brain structures. Enhanced BDZ binding was found 1 week after SE in many cortical areas in P12 and also in the amygdala complex and dentate gyrus in both P12 and P25. No changes of BDZ binding occurred in adults at that time, but 3 months after SE a decrease of binding appeared in all evaluated areas in both adult and P25 but not P12 rats. This decrease did not reflect neuronal loss. mu opioid receptors were less significantly affected but clear tendency to decrease binding occurred in adult rats in various cortical, amygdala and thalamic regions early after SE. Changes were less expressed in immature rats. Our data support the hypothesis that age-related changes of receptor properties may participate in different functional consequences of SE including epileptogenesis (more common in older age groups) and behavioral changes.

Alternating and postictal psychoses: review and a unifying hypothesis

A comparison of the clinical and pathophysiological features of postictal psychosis and brief interictal or alternating psychosis was undertaken to examine if the underlying mechanisms are distinct in these 2 conditions. A selective review of the published literature in English on epilepsy and brief psychosis was carried out. The literature indicates that even though brief postictal and alternating psychoses are considered to be separate syndromes, they have a number of similarities. It can be argued that the underlying pathomechanisms are common, with the brain's inhibitory processes in response to seizures playing a key role in the development of the psychosis. These homeostatic mechanisms manifest as electrophysiological, cerebral blood flow, and neurotransmitter and receptor changes. Both syndromes are likely to be associated with prolonged inhibition in limbic circuits, with further seizures modifying the psychosis depending upon whether it is associated with disinhibition or hypersynchrony involving enhanced inhibition. The neurotransmitter with a key role is GABA, although ionic currents, catecholamines, opiates, adenosine, glutamate, and nitric oxide play a role. Brief postictal and alternating psychoses provide an opportunity to understand the complex relationships between epilepsy and schizophrenia-like brief psychotic episodes, and this understanding can assist in their management.

α2-Adrenergic inhibition prevents the accompanied anticonvulsant effect of swim stress on behavioral convulsions induced by lithium and pilocarpine

There has been much debate regarding the potential influence of stress on epilepsy. Many studies have reported that stress can affect seizure susceptibility through eliciting either proconvulsant or anticonvulsant effects within the nervous system. In this study, we investigated the potential anticonvulsant effect of a 10-min swim stress on convulsions induced by a single systemic injection of lithium chloride followed 4 h later with pilocarpine. Rats pretreated with lithium chloride and exposed to a 10-min swim stressor prior to pilocarpine injection displayed a significant delay to seizure onset compared to unstressed rats or rats exposed to swim stress 10 min after lithium chloride, 2 h after lithium chloride, or immediately after pilocarpine injection. We then determined whether administration of a glucocorticoid antagonist (mifepristone; 10 or 50 mg/kg), an alpha(2)-adrenergic antagonist (yohimbine; 2 or 5 mg/kg), or a nonspecific opioid blocker (naloxone; 0.2 or 1 mg/kg) could prevent the anticonvulsant effect of swim stress. Only the high dose of yohimbine was capable of inhibiting the anticonvulsant effect of swim stress on lithium-pilocarpine seizures. Our findings highlight the importance of an endogenous noradrenergic-dependent anticonvulsant system in mediating the effects of swim stress on seizures. Further studies exploring the benefits of treatments with noradrenergic acting drugs in epilepsy is well warranted.

Short bursts of weak pulses break postictal inhibition in the neocortex of Wistar rats

PURPOSE

Postictal inhibition (PI) is a decrease in excitability that follows an epileptic seizure and decreases probability of new seizure occurrence. PI may involve both increased inhibition and persisting elevated excitation. Our experiments tested whether shorter trains of weak stimuli are able to unmask this residual increase of excitability during the PI.

METHODS

Four epileptic afterdischarges (ADs) were evoked by intense electrical stimulation (20 s, 8 Hz, current intensity at 5x threshold) of the neocortex in two groups (A, B) of Wistar rats. Before the first AD and during the 10-min interictal period, 8-Hz trains of four weak pulses (half of the intensity used for the AD triggering; 4P) were applied every 20 s in group B and a single pulse with similar parameters in group A.

RESULTS

The number of interictal epileptiform events evoked by 4P in the group B was significantly higher than that in the group A (evoked by single pulses) except after the second AD. Epileptic events were triggered by 4P also immediately after the AD termination.

CONCLUSIONS

It is apparent that weak stimulation can trigger epileptic phenomena during PI. Our results indicate that it is no longer possible to perceive PI only as persisting extreme and active inhibition. An appropriate stimulation can reveal more subtle (but important) excitatory events contributing to the functional status during the postictal period.

Prenatal morphine exposure induces age- and sex-dependent changes in seizure susceptibility

1. Prenatal exposure to morphine induces long-term alterations in seizure susceptibility, which are age-, sex-, and seizure model-specific. 2. Adult male and female rats exposed prenatally to morphine show decreased susceptibility to GABA-regulated seizures. 3. Prenatally morphine-exposed, adult male rats are more sensitive to excitatory amino acid receptor-mediated seizures than control males, control females, or morphine-exposed females.

The postictal state: a neglected entity in the management of epilepsy

Some of the disability deriving from epilepsy derives from the postictal state (PS). The PS may be complicated by impaired cognition, headache, injuries, or secondary medical conditions. Postictal depression is common, postictal psychosis relatively rare, but both add to the morbidity of seizures. The mechanisms of the PS are poorly understood. Alteration of cerebral blood flow both results from and contributes to the PS. Many neurotransmitters or neuromodulators are involved in the physiology of the PS. Response to glutamate may partially desensitize after a seizure. Endogenous opiates and adenosine serve as natural antiepileptic medications in some circumstances. Nitric oxide has numerous effects on brain excitability, and may be particularly important in regulating postictal cerebral blood flow. Just as the pathophysiology of seizures is complicated, so is that of the PS multifactorial. As a practical issue, it would be very useful to have medications that reduce the morbidity of the PS.

Prenatal morphine exposure alters ovarian steroid hormonal regulation of seizure susceptibility

The present study examined the ovarian hormonal regulation of seizure susceptibility in prenatally morphine- and saline-exposed adult female rats in the flurothyl seizure model in vivo, and in low-magnesium-induced epileptiform activity in brain slices, in vitro. All females were ovariohysterectomized (OVX); some received either estrogen (E) or progesterone (P) replacement, while others were injected with E + P sequentially. In prenatally saline-treated control females, there was an increase in the flurothyl-induced clonic seizure threshold (anticonvulsant effect) in the presence of both hormones (E + P) compared to OVX controls. In morphine-exposed females, there was an increase in the flurothyl-induced clonic seizure threshold after an E injection alone while there was a reduced tonic--clonic seizure threshold in the presence of both hormones (E + P) compared to the hormone treatment-matched group of saline-exposed females. In control females, in low magnesium medium in vitro, the development of two types of epileptiform activity (seizure-like events and status of short discharges) was not affected by the different hormonal conditions. However, prenatal morphine exposure suppressed the development of both types of epileptiform activity in the E-injected females compared to the E-injected, control females. The present data demonstrate that the anticonvulsant effects of P on seizure susceptibility requires the presence of E. Furthermore, prenatal morphine exposure alters ovarian steroid hormone-regulated seizure susceptibility.

Effects of a subconvulsant dose of kainic acid on afterdischarges elicited by cortical stimulation in rats

The aim of this study was to test the hypothesis that nonconvulsive seizures elicited by a low dose of kainic acid may induce acute as well as chronic changes in brain function. Cortical epileptic afterdischarges (ADs) characterized by spike-and-wave rhythm and clonic seizures of facial and forelimb muscles were elicited in adult male rats with chronically implanted electrodes. Four stimulations were given in each of four weekly sessions. In the second session, 26 animals were injected with kainic acid (6 mg/kg i.p.) and 19 rats received no injection. The acute effects of kainic acid were to increase the intensity of movements accompanying stimulation and abruptly prolong ADs. Epileptic ADs were followed by a depression of electrocorticographic activity in both noninjected and kainic acid groups. In addition, when kainate was administered, interictal spike activity was registered mostly in the occipital region. One and two weeks after kainate administration, i.e. in the third and fourth stimulation sessions, there was an increased incidence of transitions from spike-and-wave ADs to another, limbic type of afterdischarge. This functional change persisted although no obvious neuronal death was found in the hippocampi of 12 other rats that received the same dose of kainic acid.

Endogenous opiates: 1992

This paper is the fifteenth installment of our annual review of research concerning the opiate system. It includes papers published during 1992 involving the behavioral, non-analgesic, effects of the endogenous opiate peptides. The specific topics this year include stress; tolerance and dependence; eating; drinking; gastrointestinal and renal function; mental illness and mood; learning, memory, and reward; cardiovascular responses; respiration and thermoregulation; seizures and other neurological disorders; electrical-related activity; general activity and locomotion; sex, pregnancy, and development; immunological responses; and other behaviors.

The effect of naloxone on cerebral blood flow and glucose metabolism in patients with complex partial seizures

We used positron emission tomography with [15O]water and [18F]fluoro-2-deoxyglucose (FDG) to study the effect of naloxone on cerebral blood flow (CBF) and glucose metabolism (LCMRglc) in patients with complex partial seizures. There was no effect on glucose metabolism, but blood flow was reduced 7-12% 45-60 min after infusion of 1 mg/kg naloxone, as was the degree of lateral temporal CBF asymmetry in patients with > 10% baseline hypoperfusion. Endogenous opiates are involved in regulation of human CBF, and possibly in hypoperfusion in epileptic foci. Since [18F]FDG PET measures mean LCMRglc over the tracer uptake and scanning periods, it is inferior to [15O]H2O PET for detecting drug effects which may be time dependent.

Characterization of mu opioid receptor binding during amygdala kindling in rats and effects of chronic naloxone pretreatment: an autoradiographic study

Using in vitro autoradiography, mu receptor binding in rat brain was characterized at different amygdala kindling stages and in amygdaloid kindled animals pretreated chronically with naloxone. Male Sprague-Dawley rats implanted with bipolar electrodes in the right amygdala received one of the following pretreatments s.c. for 14 days via osmotic minipumps: normal saline solution, 0.5 microliters/h, or naloxone HCl, 75 micrograms/h. Two days after treatments were accomplished animals were stimulated daily. Our data showed different patterns of mu receptor binding during the normal kindling process: during stage II-III, pronounced binding increase was detected in cingulate, temporal and entorhinal cortices, anterior amygdala, caudate putamen, thalamic nuclei, ventrolateral and dorsolateral portions of central gray, substantia nigra pars compacta and pars reticulata. Twenty-four hours after the last stage V kindled seizure, enhanced binding was observed in cingulate and frontoparietal cortices, anterior amygdala, caudate putamen and ventromedial thalamic nucleus. Twenty-eight days after the last stage V kindled seizure, binding augmentation was noticed in cingulate and frontoparietal cortices, whereas decreased binding was detected in amygdala complex, substantia nigra pars reticulata, piriform, perirhinal, parietal, temporal and entorhinal cortices. Mu receptor binding in kindled rats chronically pretreated with naloxone was significantly higher in several structures when compared with control and normal kindled groups. Our data indicate different regional selective patterns of mu receptor binding during amygdala kindling which may depend on epileptogenesis and long-term changes induced by this process. In addition, even higher mu receptor binding results from chronic naloxone administration prior to kindling.