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Cai Z, Jiang X, Bagić A, Worrell GA, Richardson M, He B. Spontaneous HFO Sequences Reveal Propagation Pathways for Precise Delineation of Epileptogenic Networks. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.05.02.592202. [PMID: 38746136 PMCID: PMC11092614 DOI: 10.1101/2024.05.02.592202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2024]
Abstract
Epilepsy, a neurological disorder affecting millions worldwide, poses great challenges in precisely delineating the epileptogenic zone - the brain region generating seizures - for effective treatment. High-frequency oscillations (HFOs) are emerging as promising biomarkers; however, the clinical utility is hindered by the difficulties in distinguishing pathological HFOs from non- epileptiform activities at single electrode and single patient resolution and understanding their dynamic role in epileptic networks. Here, we introduce an HFO-sequencing approach to analyze spontaneous HFOs traversing cortical regions in 40 drug-resistant epilepsy patients. This data- driven method automatically detected over 8.9 million HFOs, pinpointing pathological HFO- networks, and unveiled intricate millisecond-scale spatiotemporal dynamics, stability, and functional connectivity of HFOs in prolonged intracranial EEG recordings. These HFO sequences demonstrated a significant improvement in localization of epileptic tissue, with an 818.47% increase in concordance with seizure-onset zone (mean error: 2.92 mm), compared to conventional benchmarks. They also accurately predicted seizure outcomes for 90% AUC based on pre-surgical information using generalized linear models. Importantly, this mapping remained reliable even with short recordings (mean standard deviation: 3.23 mm for 30-minute segments). Furthermore, HFO sequences exhibited distinct yet highly repetitive spatiotemporal patterns, characterized by pronounced synchrony and predominant inward information flow from periphery towards areas involved in propagation, suggesting a crucial role for excitation-inhibition balance in HFO initiation and progression. Together, these findings shed light on the intricate organization of epileptic network and highlight the potential of HFO-sequencing as a translational tool for improved diagnosis, surgical targeting, and ultimately, better outcomes for vulnerable patients with drug-resistant epilepsy. One Sentence Summary Pathological fast brain oscillations travel like traffic along varied routes, outlining recurrently visited neural sites emerging as critical hotspots in epilepsy network.
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Bu J, Ren N, Wang Y, Wei R, Zhang R, Zhu H. Identification of abnormal closed-loop pathways in patients with MRI-negative pharmacoresistant epilepsy. Brain Imaging Behav 2024:10.1007/s11682-024-00880-z. [PMID: 38592332 DOI: 10.1007/s11682-024-00880-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/19/2024] [Indexed: 04/10/2024]
Abstract
Epilepsy is a disorder of brain networks, that is usually combined with cognitive and emotional impairment. However, most of the current research on closed-loop pathways in epilepsy is limited to the neuronal level or has focused only on known closed-loop pathways, and studies on abnormalities in closed-loop pathways in epilepsy at the whole-brain network level are lacking. A total of 26 patients with magnetic resonance imaging-negative pharmacoresistant epilepsy (MRIneg-PRE) and 26 healthy controls (HCs) were included in this study. Causal brain networks and temporal-lag brain networks were constructed from resting-state functional MRI data, and the Johnson algorithm was used to identify stable closed-loop pathways. Abnormal closed-loop pathways in the MRIneg-PRE cohort compared with the HC group were identified, and the associations of these pathways with indicators of cognitive and emotional impairments were examined via Pearson correlation analysis. The results revealed that the abnormal stable closed-loop pathways were distributed across the frontal, parietal, and occipital lobes and included altered functional connectivity values both within and between cerebral hemispheres. Four abnormal closed-loop pathways in the occipital lobe were associated with emotional and cognitive impairments. These abnormal pathways may serve as biomarkers for the diagnosis and guidance of individualized treatments for MRIneg-PRE patients.
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Affiliation(s)
- Jinxin Bu
- Department of Functional Neurosurgery, Affiliated Nanjing Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu, 210029, China
| | - Nanxiao Ren
- Department of Functional Neurosurgery, Affiliated Nanjing Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu, 210029, China
| | - Yonglu Wang
- Child Mental Health Research Center, Affiliated Nanjing Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu, 210029, China
| | - Ran Wei
- Division of Child Care, Suzhou Municipal Hospital, No. 26 Daoqian Road, Suzhou, Jiangsu, 215002, China
| | - Rui Zhang
- Department of Functional Neurosurgery, Affiliated Nanjing Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu, 210029, China.
| | - Haitao Zhu
- Department of Functional Neurosurgery, Affiliated Nanjing Brain Hospital of Nanjing Medical University, Nanjing, Jiangsu, 210029, China.
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Mousavi H, Dauly G, Dieuset G, El Merhie A, Ismailova E, Wendling F, Al Harrach M. Tuning Microelectrodes' Impedance to Improve Fast Ripples Recording. Bioengineering (Basel) 2024; 11:102. [PMID: 38275582 PMCID: PMC11154299 DOI: 10.3390/bioengineering11010102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 01/11/2024] [Accepted: 01/19/2024] [Indexed: 01/27/2024] Open
Abstract
Epilepsy is a chronic neurological disorder characterized by recurrent seizures resulting from abnormal neuronal hyperexcitability. In the case of pharmacoresistant epilepsy requiring resection surgery, the identification of the Epileptogenic Zone (EZ) is critical. Fast Ripples (FRs; 200-600 Hz) are one of the promising biomarkers that can aid in EZ delineation. However, recording FRs requires physically small electrodes. These microelectrodes suffer from high impedance, which significantly impacts FRs' observability and detection. In this study, we investigated the potential of a conductive polymer coating to enhance FR observability. We employed biophysical modeling to compare two types of microelectrodes: Gold (Au) and Au coated with the conductive polymer poly(3,4-ethylenedioxythiophene)-poly(styrene sulfonate) (Au/PEDOT:PSS). These electrodes were then implanted into the CA1 hippocampal neural network of epileptic mice to record FRs during epileptogenesis. The results showed that the polymer-coated electrodes had a two-order lower impedance as well as a higher transfer function amplitude and cut-off frequency. Consequently, FRs recorded with the PEDOT:PSS-coated microelectrode yielded significantly higher signal energy compared to the uncoated one. The PEDOT:PSS coating improved the observability of the recorded FRs and thus their detection. This work paves the way for the development of signal-specific microelectrode designs that allow for better targeting of pathological biomarkers.
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Affiliation(s)
- Hajar Mousavi
- Bioelectronics Department, Ecoles des Mines de Saint Etienne, CMP-EMSE, MOC, 13541 Gardanne, France; (H.M.); (A.E.M.); (E.I.)
| | - Gautier Dauly
- INSERM, LTSI-U1099, University of Rennes, 35000 Rennes, France; (G.D.); (G.D.); (F.W.)
| | - Gabriel Dieuset
- INSERM, LTSI-U1099, University of Rennes, 35000 Rennes, France; (G.D.); (G.D.); (F.W.)
| | - Amira El Merhie
- Bioelectronics Department, Ecoles des Mines de Saint Etienne, CMP-EMSE, MOC, 13541 Gardanne, France; (H.M.); (A.E.M.); (E.I.)
- Laboratoire Matière et Systèmes Complexes, Université Paris Cité, CNRS UMR 7057, 10 Rue Alice Domon et Léonie Duquet, 75013 Paris, France
| | - Esma Ismailova
- Bioelectronics Department, Ecoles des Mines de Saint Etienne, CMP-EMSE, MOC, 13541 Gardanne, France; (H.M.); (A.E.M.); (E.I.)
| | - Fabrice Wendling
- INSERM, LTSI-U1099, University of Rennes, 35000 Rennes, France; (G.D.); (G.D.); (F.W.)
| | - Mariam Al Harrach
- INSERM, LTSI-U1099, University of Rennes, 35000 Rennes, France; (G.D.); (G.D.); (F.W.)
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Santana‐Gomez CE, Engel J, Staba R. Drug-resistant epilepsy and the hypothesis of intrinsic severity: What about the high-frequency oscillations? Epilepsia Open 2021; 7 Suppl 1:S59-S67. [PMID: 34861102 PMCID: PMC9340307 DOI: 10.1002/epi4.12565] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 11/23/2021] [Accepted: 11/30/2021] [Indexed: 11/19/2022] Open
Abstract
Drug‐resistant epilepsy (DRE) affects approximately one‐third of the patients with epilepsy. Based on experimental findings from animal models and brain tissue from patients with DRE, different hypotheses have been proposed to explain the cause(s) of drug resistance. One is the intrinsic severity hypothesis that posits that drug resistance is an inherent property of epilepsy related to disease severity. Seizure frequency is one measure of epilepsy severity, but frequency alone is an incomplete measure of severity and does not fully explain basic research and clinical studies on drug resistance; thus, other measures of epilepsy severity are needed. One such measure could be pathological high‐frequency oscillations (HFOs), which are believed to reflect the neuronal disturbances responsible for the development of epilepsy and the generation of spontaneous seizures. In this manuscript, we will briefly review the intrinsic severity hypothesis, describe basic and clinical research on HFOs in the epileptic brain, and based on this evidence discuss whether HFOs could be a clinical measure of epilepsy severity. Understanding the mechanisms of DRE is critical for producing breakthroughs in the development and testing of novel strategies for treatment.
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Affiliation(s)
| | - Jerome Engel
- Department of NeurologyDavid Geffen School of Medicine at UCLALos AngelesCaliforniaUSA
- Brain Research InstituteDavid Geffen School of Medicine at UCLALos AngelesCaliforniaUSA
- Department of NeurobiologyDavid Geffen School of Medicine at UCLALos AngelesCaliforniaUSA
- Department of Psychiatry and Biobehavioral SciencesDavid Geffen School of Medicine at UCLALos AngelesCaliforniaUSA
| | - Richard Staba
- Department of NeurologyDavid Geffen School of Medicine at UCLALos AngelesCaliforniaUSA
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Lévesque M, Biagini G, de Curtis M, Gnatkovsky V, Pitsch J, Wang S, Avoli M. The pilocarpine model of mesial temporal lobe epilepsy: Over one decade later, with more rodent species and new investigative approaches. Neurosci Biobehav Rev 2021; 130:274-291. [PMID: 34437936 DOI: 10.1016/j.neubiorev.2021.08.020] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Revised: 08/17/2021] [Accepted: 08/21/2021] [Indexed: 01/19/2023]
Abstract
Fundamental work on the mechanisms leading to focal epileptic discharges in mesial temporal lobe epilepsy (MTLE) often rests on the use of rodent models in which an initial status epilepticus (SE) is induced by kainic acid or pilocarpine. In 2008 we reviewed how, following systemic injection of pilocarpine, the main subsequent events are the initial SE, the latent period, and the chronic epileptic state. Up to a decade ago, rats were most often employed and they were frequently analysed only behaviorally. However, the use of transgenic mice has revealed novel information regarding this animal model. Here, we review recent findings showing the existence of specific neuronal events during both latent and chronic states, and how optogenetic activation of specific cell populations modulate spontaneous seizures. We also address neuronal damage induced by pilocarpine treatment, the role of neuroinflammation, and the influence of circadian and estrous cycles. Updating these findings leads us to propose that the rodent pilocarpine model continues to represent a valuable tool for identifying the basic pathophysiology of MTLE.
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Affiliation(s)
- Maxime Lévesque
- Montreal Neurological Institute-Hospital and Departments of Neurology & Neurosurgery, McGill University, Montreal, QC, H3A 2B4, Canada
| | - Giuseppe Biagini
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena & Reggio Emilia, 41100 Modena, Italy
| | - Marco de Curtis
- Epilepsy Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milano, Italy
| | - Vadym Gnatkovsky
- Epilepsy Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, 20133 Milano, Italy; Department of Epileptology, University Hospital Bonn, 53127 Bonn, Germany
| | - Julika Pitsch
- Department of Epileptology, University Hospital Bonn, 53127 Bonn, Germany
| | - Siyan Wang
- Montreal Neurological Institute-Hospital and Departments of Neurology & Neurosurgery, McGill University, Montreal, QC, H3A 2B4, Canada
| | - Massimo Avoli
- Montreal Neurological Institute-Hospital and Departments of Neurology & Neurosurgery, McGill University, Montreal, QC, H3A 2B4, Canada; Departments of Physiology, McGill University, Montreal, QC, H3A 2B4, Canada; Department of Experimental Medicine, Sapienza University of Rome, 00185 Roma, Italy.
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Harrach MA, Benquet P, Wendling F. Long term evolution of fast ripples during epileptogenesis. J Neural Eng 2021; 18. [PMID: 33849005 DOI: 10.1088/1741-2552/abf774] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 04/13/2021] [Indexed: 11/12/2022]
Abstract
Objective.Fast ripples (FRs) have received considerable attention in the last decade since they represent an electrophysiological biomarker of the epileptogenic zone (EZ). However, the real dynamics underlying the occurrence, amplitude, and time-frequency content of FRs generation during epileptogenesis are still not well understood. This work aims at characterizing and explaining the evolution of these features.Approach.Intracortical electroencephalographic signals recorded in a kainate mouse model of temporal lobe epilepsy were processed in order to compute specific FR features. Then realistic physiologically based computational modeling was employed to explore the different elements that can explain the mechanisms of epileptogenesis and simulate the recorded FR in the early and late latent period.Main results.Results indicated that continuous changes of FR features are mainly portrayed by the epileptic (pathological) tissue size and synaptic properties. Furthermore, the microelectrodes characteristics were found to dramatically affect the observability and spectral/temporal content of FRs. Consequently, FRs evolution seems to mirror the continuous pathophysiological mechanism changes that occur during epileptogenesis as long as the microelectrode properties are taken into account.Significance.Our study suggests that FRs can account for the pathophysiological changes which might explain the EZ generation and evolution and can contribute in the treatment plan of pharmaco-resistant epilepsies.
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Affiliation(s)
- Mariam Al Harrach
- Laboratoire Traitement du Signal et de l'Image (LTSI-U1099), Université de Rennes 1, INSERM, 35000 Rennes, France
| | - Pascal Benquet
- Laboratoire Traitement du Signal et de l'Image (LTSI-U1099), Université de Rennes 1, INSERM, 35000 Rennes, France
| | - Fabrice Wendling
- Laboratoire Traitement du Signal et de l'Image (LTSI-U1099), Université de Rennes 1, INSERM, 35000 Rennes, France
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Dai Y, Song Y, Xie J, Xiao G, Li X, Li Z, Gao F, Zhang Y, He E, Xu S, Wang Y, Zheng W, Jiang X, Qi Z, Meng D, Fan Z, Cai X. CB1-Antibody Modified Liposomes for Targeted Modulation of Epileptiform Activities Synchronously Detected by Microelectrode Arrays. ACS APPLIED MATERIALS & INTERFACES 2020; 12:41148-41156. [PMID: 32809788 DOI: 10.1021/acsami.0c13372] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Temporal lobe epilepsy (TLE) is a focal, recurrent, and refractory neurological disorder. Therefore, precisely targeted treatments for TLE are greatly needed. We designed anti-CB1 liposomes that can bind to CB1 receptors in the hippocampus to deliver photocaged compounds (ruthenium bipyridine triphenylphosphine γ-aminobutyric acid, RuBi-GABA) in the TLE rats. A 16-channel silicon microelectrode array (MEA) was implanted for simultaneously monitoring electrophysiological signals of neurons. The results showed that anti-CB1 liposomes were larger in size and remained in the hippocampus longer than unmodified liposomes. Following the blue light stimulation, the neural firing rates and the local field potentials of hippocampal neurons were significantly reduced. It is indicated that RuBi-GABA was enriched near hippocampal neurons due to anti-CB1 liposome delivery and photolyzed by optical stimulation, resulting dissociation of GABA to exert inhibitory actions. Furthermore, K-means cluster analysis revealed that the firing rates of interneurons were decreased to a greater extent than those of pyramidal neurons, which may have been a result of the uneven diffusion of RuBi-GABA due to liposomes binding to CB1. In this study, we developed a novel, targeted method to regulate neural electrophysiology in the hippocampus of the TLE rat using antibody-modified nanoliposomes, implantable MEA, and photocaged compounds. This method effectively suppressed hippocampal activities during seizure ictus with high spatiotemporal resolution, which is a crucial exploration of targeted therapy for epilepsy.
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Affiliation(s)
- Yuchuan Dai
- State Key Laboratory of Transducer Technology, Aerospace Information Research Institute, Chinese Academy of Sciences, Beijing 100190, P. R. China
- University of Chinese Academy of Sciences, Beijing 100049, P. R. China
| | - Yilin Song
- State Key Laboratory of Transducer Technology, Aerospace Information Research Institute, Chinese Academy of Sciences, Beijing 100190, P. R. China
- University of Chinese Academy of Sciences, Beijing 100049, P. R. China
| | - Jingyu Xie
- State Key Laboratory of Transducer Technology, Aerospace Information Research Institute, Chinese Academy of Sciences, Beijing 100190, P. R. China
- University of Chinese Academy of Sciences, Beijing 100049, P. R. China
| | - Guihua Xiao
- State Key Laboratory of Transducer Technology, Aerospace Information Research Institute, Chinese Academy of Sciences, Beijing 100190, P. R. China
- University of Chinese Academy of Sciences, Beijing 100049, P. R. China
| | - Xuanyu Li
- Beijing Engineering Research Center for BioNanotechnology, CAS Key Laboratory for Biological Effects of Nanomaterials and Nanosafety, CAS Center for Excellence in Nanoscience, National Center for NanoScience and Technology, Beijing 100190, P. R. China
- University of Chinese Academy of Sciences, Beijing 100049, P. R. China
| | - Ziyue Li
- State Key Laboratory of Transducer Technology, Aerospace Information Research Institute, Chinese Academy of Sciences, Beijing 100190, P. R. China
- University of Chinese Academy of Sciences, Beijing 100049, P. R. China
| | - Fei Gao
- State Key Laboratory of Transducer Technology, Aerospace Information Research Institute, Chinese Academy of Sciences, Beijing 100190, P. R. China
- University of Chinese Academy of Sciences, Beijing 100049, P. R. China
| | - Yu Zhang
- State Key Laboratory of Transducer Technology, Aerospace Information Research Institute, Chinese Academy of Sciences, Beijing 100190, P. R. China
- University of Chinese Academy of Sciences, Beijing 100049, P. R. China
| | - Enhui He
- State Key Laboratory of Transducer Technology, Aerospace Information Research Institute, Chinese Academy of Sciences, Beijing 100190, P. R. China
- University of Chinese Academy of Sciences, Beijing 100049, P. R. China
| | - Shengwei Xu
- State Key Laboratory of Transducer Technology, Aerospace Information Research Institute, Chinese Academy of Sciences, Beijing 100190, P. R. China
- University of Chinese Academy of Sciences, Beijing 100049, P. R. China
| | - Yun Wang
- State Key Laboratory of Transducer Technology, Aerospace Information Research Institute, Chinese Academy of Sciences, Beijing 100190, P. R. China
- University of Chinese Academy of Sciences, Beijing 100049, P. R. China
| | - Wenfu Zheng
- Beijing Engineering Research Center for BioNanotechnology, CAS Key Laboratory for Biological Effects of Nanomaterials and Nanosafety, CAS Center for Excellence in Nanoscience, National Center for NanoScience and Technology, Beijing 100190, P. R. China
- University of Chinese Academy of Sciences, Beijing 100049, P. R. China
| | - Xingyu Jiang
- Beijing Engineering Research Center for BioNanotechnology, CAS Key Laboratory for Biological Effects of Nanomaterials and Nanosafety, CAS Center for Excellence in Nanoscience, National Center for NanoScience and Technology, Beijing 100190, P. R. China
- University of Chinese Academy of Sciences, Beijing 100049, P. R. China
| | - Zhimei Qi
- State Key Laboratory of Transducer Technology, Aerospace Information Research Institute, Chinese Academy of Sciences, Beijing 100190, P. R. China
- University of Chinese Academy of Sciences, Beijing 100049, P. R. China
| | - Dongdong Meng
- National Engineering Research Center for DPSSL, Aerospace Information Research Institute, Chinese Academy of Sciences, Beijing 100094, P. R. China
- University of Chinese Academy of Sciences, Beijing 100049, P. R. China
| | - Zhongwei Fan
- National Engineering Research Center for DPSSL, Aerospace Information Research Institute, Chinese Academy of Sciences, Beijing 100094, P. R. China
- University of Chinese Academy of Sciences, Beijing 100049, P. R. China
| | - Xinxia Cai
- State Key Laboratory of Transducer Technology, Aerospace Information Research Institute, Chinese Academy of Sciences, Beijing 100190, P. R. China
- University of Chinese Academy of Sciences, Beijing 100049, P. R. China
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Köhling R. Translational perspectives: Interneurones start seizures. J Physiol 2019; 597:5525-5526. [PMID: 31603536 DOI: 10.1113/jp278966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Accepted: 10/09/2019] [Indexed: 11/08/2022] Open
Affiliation(s)
- Rüdiger Köhling
- Oscar-Langendorff-Institute of Physiology, Rostock University Medical Center, Rostock, Germany
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Avoli M. Inhibition, oscillations and focal seizures: An overview inspired by some historical notes. Neurobiol Dis 2019; 130:104478. [PMID: 31125597 DOI: 10.1016/j.nbd.2019.104478] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
GABA (i.e., γ-amino-butyric acid) is the main inhibitory neurotransmitter in the adult mammalian brain. Once released from inhibitory cells, it activates pre- and post-synaptic GABA receptors that have been categorized into type A and type B. GABAA receptors open ionotropic anionic channels while GABAB receptors are metabotropic, acting through second messengers. In the 1980s, decreased GABA receptor signaling was considered an appealing factor in making cortical neurons generate synchronous epileptiform oscillations and thus a good, perhaps obvious, candidate for causing focal epileptic disorders. However, studies published during the last four decades have demonstrated that interneuron firing - which causes GABA release and thus GABAA receptor activation - can lead to the generation of both physiological (e.g., theta and gamma oscillations or sharp wave-ripples) and pathological oscillations including focal interictal spikes, high frequency oscillations and seizures. Taken together, the reviews published in this special issue of Neurobiology of Disease highlight the key role of inhibition, and in particular of GABAA receptor signaling, in neuronal network functions under physiological and pathological conditions that include epilepsy and Alzheimer's disease.
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Affiliation(s)
- Massimo Avoli
- Montreal Neurological Institute, McGill University, Montreal, H3A 2B4, QC, Canada; Department of Neurology & Neurosurgery, McGill University, Montreal, H3A 2B4, QC, Canada; Department of Experimental Medicine, Facoltà di Medicina e Odontoiatria, Sapienza University of Rome, 00185 Roma, Italy; Department of Physiology, McGill University, Montreal, H3A 2B4, QC, Canada.
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