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Zhao T, Zhang X, Cui X, Su S, Li L, Chen Y, Wang N, Sun L, Zhao J, Zhang J, Han X, Cao J. Inhibiting the IRAK4/NF-κB/NLRP3 signaling pathway can reduce pyroptosis in hippocampal neurons and seizure episodes in epilepsy. Exp Neurol 2024; 377:114794. [PMID: 38685307 DOI: 10.1016/j.expneurol.2024.114794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Revised: 04/15/2024] [Accepted: 04/20/2024] [Indexed: 05/02/2024]
Abstract
BACKGROUND Interleukin-1 receptor-associated kinase 4 (IRAK4) plays an important role in immune modulation in various central nervous system disorders. However, IRAK4 has not been reported in epilepsy models in animal and clinical studies, nor has its involvement in regulating pyroptosis in epilepsy. METHOD First, we performed transcriptome sequencing, quantitative real-time polymerase chain reaction, and western blot analysis on the hippocampal tissues of refractory epilepsy patients to measure the mRNA and protein levels of IRAK4 and pyroptosis-related proteins. Second, we successfully established a pentylenetetrazol (PTZ)-induced seizure mouse model. We conducted behavioral tests, electroencephalography, virus injection, and molecular biology experiments to investigate the role of IRAK4 in seizure activity regulation. RESULTS IRAK4 is upregulated in the hippocampus of epilepsy patients and PTZ-induced seizure model mice. IRAK4 expression is observed in the hilar neurons of PTZ-induced mice. Knocking down IRAK4 in PTZ-induced mice downregulated pyroptosis-related protein expression and alleviated seizure activity. Overexpressing IRAK4 in naive mice upregulated pyroptosis-related protein expression and increased PTZ-induced abnormal neuronal discharges. IRAK4 and NF-κB were found to bind to each other in patient hippocampal tissue samples. Pyrrolidine dithiocarbamate reversed the pyroptosis-related protein expression increase caused by PTZ. PF-06650833 alleviated seizure activity and inhibited pyroptosis in PTZ-induced seizure mice. CONCLUSION IRAK4 plays a key role in the pathological process of epilepsy, and its potential mechanism may be related to pyroptosis mediated by the NF-κB/NLRP3 signaling pathway. PF-06650833 has potential as a therapeutic agent for alleviating epilepsy.
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Affiliation(s)
- Ting Zhao
- Department of Neurology and Basic Medicine, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, Henan 450000, China
| | - Xuefei Zhang
- Department of Neurology and Basic Medicine, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, Henan 450000, China
| | - Xiaoxiao Cui
- Department of Neurology and Basic Medicine, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, Henan 450000, China
| | - Songxue Su
- Department of Neurology and Basic Medicine, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, Henan 450000, China
| | - Lei Li
- Department of Neurology and Basic Medicine, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, Henan 450000, China
| | - Yanan Chen
- Department of Neurology and Basic Medicine, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, Henan 450000, China
| | - Na Wang
- Department of Neurology and Basic Medicine, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, Henan 450000, China
| | - Lei Sun
- Department of Neurology and Basic Medicine, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, Henan 450000, China
| | - Jianyuan Zhao
- Institute for Developmental and Regenerative Cardiovascular Medicine, MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China.
| | - Jiewen Zhang
- Department of Neurology and Basic Medicine, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, Henan 450000, China.
| | - Xiong Han
- Department of Neurology and Basic Medicine, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, Henan 450000, China.
| | - Jing Cao
- Department of Neurology and Basic Medicine, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, Henan 450000, China.
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Ikegaya N, Aung T, Mallela A, Hect JL, Damiani A, Gonzalez-Martinez JA. Thalamic stereoelectroencephalography for neuromodulation target selection: Proof of concept and review of literature of pulvinar direct electrical stimulation. Epilepsia 2024. [PMID: 38625609 DOI: 10.1111/epi.17986] [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: 11/08/2023] [Revised: 04/01/2024] [Accepted: 04/02/2024] [Indexed: 04/17/2024]
Abstract
In patients with drug-resistant epilepsy (DRE) who are not candidates for resective surgery, various thalamic nuclei, including the anterior, centromedian, and pulvinar nuclei, have been extensively investigated as targets for neuromodulation. However, the therapeutic effects of different targets for thalamic neuromodulation on various types of epilepsy are not well understood. Here, we present a 32-year-old patient with multifocal bilateral temporoparieto-occipital epilepsy and bilateral malformations of cortical development (MCDs) who underwent bilateral stereoelectroencephalographic (SEEG) recordings of the aforementioned three thalamic nuclei bilaterally. The change in the rate of interictal epileptiform discharges (IEDs) from baseline were compared in temporal, central, parietal, and occipital regions after direct electrical stimulation (DES) of each thalamic nucleus. A significant decrease in the rate of IEDs (33% from baseline) in the posterior quadrant regions was noted in the ipsilateral as well as contralateral hemisphere following DES of the pulvinar. A scoping review was also performed to better understand the current standpoint of pulvinar thalamic stimulation in the treatment of DRE. The therapeutic effect of neuromodulation can differ among thalamic nuclei targets and epileptogenic zones (EZs). In patients with multifocal EZs with extensive MCDs, personalized thalamic targeting could be achieved through DES with thalamic SEEG electrodes.
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Affiliation(s)
- Naoki Ikegaya
- Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- Department of Neurosurgery, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Thandar Aung
- Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- Department of Neurology, Epilepsy Center, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Arka Mallela
- Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Jasmine L Hect
- Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Arianna Damiani
- Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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Mastrangelo M, Manti F, Ricciardi G, Bove R, Greco C, Tolve M, Pisani F. The burden of epilepsy on long-term outcome of genetic developmental and epileptic encephalopathies: A single tertiary center longitudinal retrospective cohort study. Epilepsy Behav 2024; 152:109670. [PMID: 38335860 DOI: 10.1016/j.yebeh.2024.109670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 01/11/2024] [Accepted: 01/25/2024] [Indexed: 02/12/2024]
Abstract
BACKGROUND This retrospective cohort analysis highlighted neurodevelopmental outcome predictors of genetic developmental and epileptic encephalopathies (DEE). PATIENTS AND METHODS Patients' demographic, clinical and molecular genetics data were collected. All patients underwent clinical, developmental, and neuropsychological assessments. RESULTS We recruited 100 participants (53 males, 47 females) with a mean follow-up lasting 10.46 ± 8.37 years. Age at epilepsy-onset was predictive of poor adaptive and cognitive functions (VABS-II score, r = 0.350, p = 0.001; BRIEF control subscale, r = -0.253; p = 0.031). Duration of epilepsy correlated negatively with IQ (r = -0.234, p = 0.019) and VABS-II score (r = -0.367, p = 0.001). Correlations were found between delayed/lacking EEG maturation/organization and IQ (r = 0.587, p = 0.001), VABS-II score (r = 0.658, p = 0.001), BRIEF-MI and BRIEF-GEC scores (r = -0.375, p = 0.001; r = -0.236, p = 0.033), ASEBA anxiety (r = -0.220, p = 0.047) and ADHD (r = -0.233, p = 0.035) scores. The number of antiseizure medications (ASMs) correlated with IQ (r = -0.414, p = 0.001), VABS-II (r = -0.496, p = 0.001), and BRIEF-MI (r = 0.294, p = 0.012) scores; while age at the beginning of therapy with ASEBA anxiety score (r = 0.272, p = 0.013). The occurrence of status epilepticus was associated with worse adaptive performances. The linear regression analysis model showed that delayed/lacking EEG maturation/organization had a significant influence on the IQ (R2 = 0.252, p < 0.001) and the BRIEF-GEC variability (R2 = 0.042, p = 0.036). The delayed/lacking EEG maturation/organization and the duration of epilepsy also had a significant influence on the VABS-II score (R2 = 0.455, p = 0.005). CONCLUSIONS Age at seizure-onset, EEG maturation/organization, duration of epilepsy, occurrence of status epilepticus, age at the introduction and number of ASMs used are reliable predictors of long-term outcomes in patients with genetic DEE.
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Affiliation(s)
- Mario Mastrangelo
- Department of Women/Child Health and Urological Science, Sapienza University of Rome, Rome, Italy; Unit of Child Neurology and Psychiatry, Azienda Ospedaliero Universitaria Policlinico Umberto, Rome, Italy.
| | - Filippo Manti
- Unit of Child Neurology and Psychiatry, Azienda Ospedaliero Universitaria Policlinico Umberto, Rome, Italy; Unit of Child Neurology and Psychiatry, Department of Human Neuroscience, Sapienza University of Rome, Rome, Italy
| | - Giacomina Ricciardi
- Unit of Child Neurology and Psychiatry, Department of Human Neuroscience, Sapienza University of Rome, Rome, Italy
| | - Rossella Bove
- Unit of Child Neurology and Psychiatry, Department of Human Neuroscience, Sapienza University of Rome, Rome, Italy
| | - Carlo Greco
- Unit of Child Neurology and Psychiatry, Department of Human Neuroscience, Sapienza University of Rome, Rome, Italy
| | - Manuela Tolve
- Unit of Child Neurology and Psychiatry, Department of Human Neuroscience, Sapienza University of Rome, Rome, Italy; Department of Experimental Medicine, Sapienza University of Rome, Italy
| | - Francesco Pisani
- Unit of Child Neurology and Psychiatry, Azienda Ospedaliero Universitaria Policlinico Umberto, Rome, Italy; Unit of Child Neurology and Psychiatry, Department of Human Neuroscience, Sapienza University of Rome, Rome, Italy
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Dorokhov VB, Runnova A, Tkachenko ON, Taranov AO, Arseniev GN, Kiselev A, Selskii A, Orlova A, Zhuravlev M. Analysis two types of K complexes on the human EEG based on classical continuous wavelet transform. CHAOS (WOODBURY, N.Y.) 2023; 33:031102. [PMID: 37003802 DOI: 10.1063/5.0143284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Accepted: 02/20/2023] [Indexed: 06/19/2023]
Abstract
In our work, we compare EEG time-frequency features for two types of K-complexes detected in volunteers performing the monotonous psychomotor test with their eyes closed. Type I K-complexes preceded spontaneous awakenings, while after type II K-complexes, subjects continued to sleep at least for 10 s after. The total number of K-complexes in the group of 18 volunteers was 646, of which of which type I K-complexes was 150 and type II K-complexes was 496. Time-frequency analysis was performed using continuous wavelet transform. EEG wavelet spectral power was averaged upon several brain zones for each of the classical frequency ranges (slow wave, δ, θ, α, β1, β2, γ bands). The low-frequency oscillatory activity ( δ-band) preceding type I K-complexes was asymmetrical and most prominent in the left hemisphere. Statistically significant differences were obtained by averaging over the left and right hemispheres, as well as projections of the motor area of the brain, p<0.05. The maximal differences between the types I and II of K-complexes were demonstrated in δ-, θ-bands in the occipital and posterior temporal regions. The high amplitude of the motor cortex projection response in β2-band, [20;30] Hz, related to the sensory-motor modality of task in monotonous psychomotor test. The δ-oscillatory activity preceding type I K-complexes was asymmetrical and most prominent in the left hemisphere may be due to the important role of the left hemisphere in spontaneous awakening from sleep during monotonous work, which is an interesting issue for future research.
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Affiliation(s)
- V B Dorokhov
- Laboratory of Sleep/Wake Neurobiology, Institute of Higher Nervous Activity and Neurophysiology of the Russian Academy of Sciences, 117865 Moscow, Russia
| | - A Runnova
- Center for Coordination of Fundamental Scientific Activities, National Medical Research Center for Therapy and Preventive Medicine, 101990 Moscow, Russia
| | - O N Tkachenko
- Laboratory of Sleep/Wake Neurobiology, Institute of Higher Nervous Activity and Neurophysiology of the Russian Academy of Sciences, 117865 Moscow, Russia
| | - A O Taranov
- Laboratory of Sleep/Wake Neurobiology, Institute of Higher Nervous Activity and Neurophysiology of the Russian Academy of Sciences, 117865 Moscow, Russia
| | - G N Arseniev
- Laboratory of Sleep/Wake Neurobiology, Institute of Higher Nervous Activity and Neurophysiology of the Russian Academy of Sciences, 117865 Moscow, Russia
| | - A Kiselev
- Center for Coordination of Fundamental Scientific Activities, National Medical Research Center for Therapy and Preventive Medicine, 101990 Moscow, Russia
| | - A Selskii
- Institute of Physics, Saratov State University, 410012 Saratov, Russia
| | - A Orlova
- Center for Coordination of Fundamental Scientific Activities, National Medical Research Center for Therapy and Preventive Medicine, 101990 Moscow, Russia
| | - M Zhuravlev
- Center for Coordination of Fundamental Scientific Activities, National Medical Research Center for Therapy and Preventive Medicine, 101990 Moscow, Russia
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Brain Connectivity: When too much of a good thing is not so good. Clin Neurophysiol 2022; 144:117-118. [PMID: 36244914 DOI: 10.1016/j.clinph.2022.09.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 09/28/2022] [Indexed: 11/20/2022]
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Zhang D, Chen S, Xu S, Wu J, Zhuang Y, Cao W, Chen X, Li X. The clinical correlation between Alzheimer's disease and epilepsy. Front Neurol 2022; 13:922535. [PMID: 35937069 PMCID: PMC9352925 DOI: 10.3389/fneur.2022.922535] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 06/30/2022] [Indexed: 11/17/2022] Open
Abstract
Alzheimer's disease and epilepsy are common nervous system diseases in older adults, and their incidence rates tend to increase with age. Patients with mild cognitive impairment and Alzheimer's disease are more prone to have seizures. In patients older than 65 years, neurodegenerative conditions accounted for ~10% of all late-onset epilepsy cases, most of which are Alzheimer's disease. Epilepsy and seizure can occur in the early and late stages of Alzheimer's disease, leading to functional deterioration and behavioral alterations. Seizures promote amyloid-β and tau deposits, leading to neurodegenerative processes. Thus, there is a bi-directional association between Alzheimer's disease and epilepsy. Epilepsy is a risk factor for Alzheimer's disease and, in turn, Alzheimer's disease is an independent risk factor for developing epilepsy in old age. Many studies have evaluated the shared pathogenesis and clinical relevance of Alzheimer's disease and epilepsy. In this review, we discuss the clinical associations between Alzheimer's disease and epilepsy, including their incidence, clinical features, and electroencephalogram abnormalities. Clinical studies of the two disorders in recent years are summarized, and new antiepileptic drugs used for treating Alzheimer's disease are reviewed.
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