Penicillin as epileptogenic agent: its effect on an isolated neuron

The effect of vortioxetine on penicillin-induced epileptiform activity in rats

Vortioxetine is a multimodal antidepressant agent that modulates 5-HT receptors and inhibits the serotonin transporter. It is indicated especially in cases of major depressive disorder related to cognitive dysfunction. There are many studies investigating the effects of antidepressants on the seizure threshold and short-term epileptic activity. However, the effect of vortioxetine on epileptic seizures is not exactly known. Our aim was to investigate the effects of vortioxetine on penicillin-induced epileptiform activity. Twenty-seven Wistar rats were divided into three groups: sham-control group, positive control group (diazepam), and vortioxetine group. After a penicillin-induced epilepsy model was formed in each of the three groups of animals, 0.1 ml of saline was administered to the control group, 0.1 ml (10 mg/kg) vortioxetine was administered in the vortioxetine group, and 0.1 mL (5 mg/kg) of diazepam was administered in the positive control group, intraperitoneally. The epileptic activity records were obtained for 120 minutes after the onset of seizure. There was no significant difference in spike wave activity between the vortioxetine and diazepam groups, whereas this was significantly reduced in the vortioxetine group compared with the controls. The administration of vortioxetine at a dose of 10 mg/kg immediately after the seizure induction significantly decreased the spike frequencies of epileptiform activity compared with the control group. No significant difference was found between the vortioxetine and positive controls. This study showed that vortioxetine reduces the number of acutely-induced epileptic discharges. Vortioxetine may be an important alternative for epileptic patients with major depressive disorder-related cognitive dysfunction.

Seizures induced by penicillin microinjections in the mesencephalic tegmentum

The location and extension of a convulsive area in the brain stem in cats was determined through penicillin microinjections (0.5-1.0 microl) of a concentrated sodium penicillin solution (500 IU/microl), stereotactically oriented to multiple structures, in fully awake animals, partially restrained through a rod fixation system that avoided pain, allowed the observation of clinical seizures and simultaneous recording of EEG, EMG and multiple unit activity (MUA) from the injected site and the motor cortex (Cx). Clinical and EEG seizure patterns in relation to the injected sites and penicillin doses were studied in another group of animals using doses from 12.5 IU/0.1 microl to 125 IU/1.0 microl. The time relationship between muscular clonus, EEG spikes and MUA at the injected site and Cx were analyzed. The only area in which penicillin induced seizures was the mesencephalic tegmentum (MT). The amount of penicillin but not the stereotactic coordinates determined the seizure type. MT EEG and MUA paroxysms anticipated clinical seizure and Cx EEG spikes. When Cx EEG appeared, they were accompanied by an increase in MUA beginning in the Cx and EMG, followed by significant increase in MT MUA. The sequence of events suggest that MT seizure activity propagates via alternative pathways not involving direct reticulospinal or pyramidal tract pathways.

The role of excitatory amino acids in the generation of spontaneous hippocampal oscillations

We examined the role of N-methyl-D-aspartate (NMDA) and non-NMDA glutamate receptors in generating spontaneous CA3 field potential oscillations in the hippocampal slice. Non-NMDA EPSPs are responsible for a portion of the spontaneous activity recorded in standard perfusion medium. NMDA receptors are not activated when inhibition is intact, however, recurrent excitation via NMDA receptors accounts for an increasing proportion of the low frequency (2-4 Hz) rhythms produced as inhibition is progressively blocked by low concentrations of the GABAA antagonist, penicillin. Production of these rhythms involves complex interactions among NMDA, non-NMDA and GABAA receptors. NMDA EPSPs can drive the rhythm in the absence of non-NMDA receptors only when inhibition is suppressed by more than 50%. Otherwise non-NMDA EPSPs appear to be necessary to depolarize neurons before NMDA EPSPs can be activated.

Animal models of the epilepsies

The study of mechanisms of the epilepsies requires employment of animal models. Choice of a model system depends upon several factors, including the question to be studied, the type of epilepsy to be modelled, familiarity and convenience. Over 50 models are reviewed. Major categories of models are those for simple partial seizures: topical convulsants, acute electrical stimulation, cortically implanted metals, cryogenic injury; for complex partial seizures: kainic acid, tetanus toxin, injections into area tempesta, kindling, rodent hippocampal slice, isolated cell preparations, human neurosurgical tissue; for generalized tonic-clonic seizures: genetically seizure-prone strains of mouse, rat, gerbil, fruitfly and baboon, maximal electroshock seizures, systemic chemical convulsants, metabolic derangements; and for generalized absence seizures: thalamic stimulation, bilateral cortical foci, systemic penicillin, gamma-hydroxy-butyrate, intraventricular opiates, genetic rat models. The lithium-pilocarpine, homocysteine and rapid repetitive stimulation models are most useful in studies of status epilepticus. Key findings learned from each of the models, the model's strengths and weaknesses are detailed. Interpretation of findings from each of these models can be difficult. Do results pertain to the epilepsies or to the particular model under study? How important are species differences? Which clinical seizure type is really being modelled? In a model are behavior or EEG findings only similar superficially to epilepsy, or are the mechanisms comparable? The wealth of preparations available to model the epilepsies underscores the need for unifying themes, and for better understanding of basic mechanisms of the epilepsies.

Bicuculline epileptogenesis in the rat

Bicuculline has been applied electrophoretically from a fluid filled microelectrode at different depths within the primary somatosensory area of the cerebral cortex of rats anaesthetized with urethane. The delay between onset of drug application at a constant rate and onset of spontaneous focal interictal epileptiform discharges (FIEDs), detected by a nearby recording microelectrode, was least when bicuculline was applied at a depth of 0.65 mm below the pial surface. The subsequent frequency of FIEDs and their voltage excursion were also greatest at this depth. The relationship between the delay of onset of epileptiform spiking and the depth of drug application was very similar to that previously determined for penicillin. This similarity of the sensitivity profiles suggests that the epileptogenic actions of the two agents may be attributable to a common mechanism. At low concentrations, both agents specifically block GABAergic inhibitory synaptic transmission in brain tissue. This is likely to be the mechanism of their epileptogenic effects. Other synaptic and non-synaptic mechanisms cannot, however, be ruled out because of the high concentrations which are achieved locally when a chemical is applied from a point source.

Penicillin epileptogenesis in the rat: diffusion and the differential laminar sensitivity of the cortex cerebri

When penicillin is applied electrophoretically from a fluid-filled microelectrode into the substance of the somatosensory cortex of the rat under urethane anaesthesia, the latent period for production of interictal epileptic spikes is least when the electrode lies 0.7 mm below the cortical surface. With low electrophoretic currents of --50 to 100 nA the increase in latent period as the tip of the electrode is placed further and further away from this level can be quantitatively accounted for by the time taken for penicillin to diffuse and to reach a threshold concentration throughout a critical mass of tissue at the 0.7 mm level. With these low currents, the generators of the interictal spikes are confined to a band of cortex centred at the 0.7 mm level. This is true even when the penicillin is applied away from the sensitive layer; in this circumstance the duration of electrophoresis needed to evoke interictal spikes is greater but when they do eventually appear the spikes are generated at the 0.7 mm layer. Histologically, the sensitive layer has been identified as the deep part of layer III. So far as the generation of interictal spikes is concerned, there is no evidence that, with low electrophoretic currents, penicillin has effects other than at the deep part of layer III; all the available evidence indicates that the penicillin has to diffuse to this layer and produces its effects there.

Monosynaptic transmission during epileptiform activity induced by penicillin in hippocampal slices in vitro

Synaptic transmission was studied in the CA1 region of transverse hippocampal slices in vitro before and after the addition of the epileptogenic agent sodium benzyl penicillin. The presynaptic fibre volley and the field potential associated with the intracellular EPSP, 'field EPSP', were recorded from the layer of the activated synapses. Addition of penicillin did not change either response. The rising phase of the intracellularly recorded EPSP did not change. However, the peak amplitude and, particularly, the duration of the EPSP both increased. The prolongation of the EPSP may be of importance for the triggering of epileptiform bursts.

Changes in excitatory and inhibitory synaptic potentials leading to epileptogenic activity

The effects of the epileptogenic agent, penicillin, on excitatory and inhibitory postsynaptic potentials (EPSPs and IPSPs) were studied in the hippocampal in vitro slice preparation. The actions of penicillin were compared to those of bicuculline, an antagonist of gamma-aminobutyric acid. Neither substance enhanced monosynaptic EPSP amplitude in CA1 pyramidal cells, but both penicillin and bicuculline depressed IPSPs. Large depolarizations that gave rise to cellular bursting activity did develop after addition of penicillin or bicuculline to the bathing medium. There was also an increase in the incidence of fast prepotentials of 'd-spikes.' These observations are interpreted according to the hypothesis that penicillin and bicuculline block cellular IPSPs, and consequently allow remote intrinsic excitatory events to invade the cell soma and trigger action potentials.

Decrease of inhibitory driving force in crayfish stretch reception: a mechanism of the convulsant action of penicillin

The effect of penicillin on the evoked IPSP was investigated in the isolated crayfish stretch receptor. The IPSP driving force (IPSP reversal potential minus membrane potential) was reduced in a dose-dependent fashion but, when necessary correction was made for the decrease in resting membrane conductance, the synaptic conductance was only slightly reduced. The possibility that a penicillin-induced intracellular acidification was responsible for the decrease in IPSP driving force is considered.

Excitability increase of neurons in olfactory cortex slices of the guinea pig after penicillin administration

The mechanism underlying the effects of penicillin on slices of the olfactory cortex of the guinea pig was examined. In a previous report it was shown that penicillin increases the amplitude of the presynaptic action potential, the population EPSP and, more strongly, the population responses of the postsynaptic cells. Moreover, the postsynaptic population responses increased in number and suggested strong repetitive firing. These results were confirmed in the present study. Analysis of stimulus-response relationships suggested that the enhancement of the postsynaptic response was due to an increase in excitability of the postsynaptic neurons by penicillin. The amplitude changes of the presynaptic action potential and the EPSP were probably largely, if not completely, due to an increase in resistance of the bathing fluid. It was found that the changes in population responses paralleled to a large extent changes in cell discharge. In addition, penicillin was found to induce spontaneous firing of the postsynaptic cells. The changes in cell discharge were consistent with an increase in excitability of the postsynaptic cells.

The effect of progesterone on the spontaneous interictal spike evoked by the application of penicillin to the cat's cerebral cortex

The effect of intravenous infusion of progesterone and Mebumal (ACO, Sweden; penotobarbital, INN) on the frequency and amplitude of the spontaneous interictal spikes from a penicillin focus in the cerebral cortex was investigated in ovariectomized cats anaesthetized with chloralose. The plasma concentration of progesterone was determined. It was found that the generation of penicillin spikes was depressed by progesterone in plasma concentrations as low as 40 ng/ml. Equimolar doses of Mebumal were less effective.

Presynaptic origin of penicillin after discharges at mammalian nerve terminals

The site of origin and mechanism underlying the generation of repetitive after-discharges produced by penicillin was studied in the isolated rat phrenic nerve-hemidiaphragm preparation. Application of low concentrations of sodium penicillin to the bathing solution initiated bursts of antidromic action potentials originating at or near the motor nerve terminals following single orthodromic stimuli to the nerve. Afterdischarges could not be elicited by direct stimulation of the muscle fibers alone, or when the nerve trunk was isolated from the neuromuscular junction and exposed to penicillin. D-Tubocurarine applied in doses sufficient to abolish postsynaptic responses did not diminish penicillin-induced after discharges. At concentrations which most reliably produced repetitive firing (5000 IU/ml; 8.5 mM), penicillin did not accelerate the frequency of spontaneous transmitter release (MEPPs), yet significantly increased the relative excitability of nerve endings to extracellular stimulation. It is concluded that penicillin acts directly and preferentially on presynaptic nerve terminals to induce repetitive afterdischarges which arise independently of postsynaptic depolarization, transmitter-mediated potassium efflux, or muscle fiber contraction. The results suggest that the convulsant effects of penicillin at a mammalian neuromuscular junction are due to non-depolarizing alterations in the intrinsic excitability of the terminal membrane which increase the probability of suprathreshold depolarizations during the recovery period of spike electrogenesis. Several models of the mechanisms which might produce hyperexcitability at presynaptic nerve terminals are discussed.

Penicillin effects on iontophoretic responses in Aplysia californica

The effect of penicillin on neurons of Aplysia californica was studied using drug concentrations which would be convulsant in mammalian nervous systems. Iontophoretic responses were elicited by the application of acetylcholine, dopamine, gamma-aminobutyric acid and serotonin. Low concentrations of penicillin (2 mM) consistently and reversibly reduced the chloride-dependent hyperpolarizing responses by approximately 70%, regardless of the transmitter required to evoke them. The short depolarizing responses which are sodium sensitive are slightly reduced by a much higher (10 mM) concentration. The extent of the reduction of the excitatory response varied with the transmitter. The slow sodium-dependent depolarizations and the slow potassium-dependent hyperpolarizations were unaffected by the concentrations of penicillin used. The possibility that the convulsant effect of penicillin is due to interference with membrane conductance to chloride is discussed.

Ultrastructural and biochemical studies on ouabain-induced oedematous brain

Ouabain, a specific inhibitor of active cation transport across cell membrane, was applied topically to brain surface of cats. The cerebral cortex to which 10(3) M ouabain was applied showed a spongy state, which was ultrastructurally revealed to be swelling of the neuronal cell processes, especially of dendrites. Astrocytes did not show swelling even in the most severely affected lesions. There was a marked increase in sodium with a slight increase of water in the cortex treated with 10(3) M ouabain. No evidence of increased vascular permeability was noted in the cortex, morphologically or biochemically. Electron microscopic cytochemistry to detect the sodium ion revealed that the increased sodium in the cortex accumulated in the swollen neuronal cell processes. It is speculated that neuronal rather than astocytic elements might be highly dependent upon active cation transport, and that intracellular oedema in the brain tissue responsible for impairment of active cation transport might be related primarily to neuronal elements.

Penicillin decreases chloride conductance in crustacean muscle: a model for the epileptic neuron

The effects of penicillin were studied on the neuromuscular preparation of the ghost crab, Ocypoda cursor. Penicillin in doses lower than 2 mM reduced both the amplitude of inhibitory junction potentials and conductance increases induced by external application of GABA. The nature of the latter effect appears to be 2-fold, a weaker competitive inhibition and a more powerful non-competitive effech which may be ionophore blockade. Penicillin in concentrations above 2 mM diminished resting conductance, especially that of chloride. The action of penicillin is, in general, to decrease chloride conductance in this preparation. The crustacean neuromuscular preparation may provide a useful analogue for understanding penicillin evoked epilepsy. The reduced chloride conductance could explain decreased inhibition, increased excitation and depolarization shifts in cortical neurons.

Effect of penicillin on an excitatory synapse

When penicillin, an epileptogenic agent, was applied to the neuromuscular junctions of the superficial flexor muscles of crayfish, the excitatory junctional potential (EJP) amplitudes were increased by 50-200%. This effect of the drug was not due to changes in the passive electrical properties of the muscle cell membrane or to an increase in its chemical sensitivity to acetylcholine (ACh), the presumed transmitter at the junction studied. Inactivating the penicillin with the enzyme penicillinase, or substituting acetate for penicillin in the test solutions eliminated the effect on EJPs, showing that the penicillin ion was the active agent. Penicillin ions did decrease the frequency of spontaneous miniature EJPs and increase the amplitude or presynaptic spikes recorded extracellularly, suggesting that augmentation of EJPs may have been due to alterations at the presynaptic nerve terminals.

Neuroexcitatory and depressant effects of penicillin at the cat soleus neuromuscular junction

Penicillin administered intraarterially in a dose of 200 units per kg produced high frequency (ca 300 Hz) repetitive discharges originating in motor nerve endings in response to single stimuli applies to the cat soleus nerve. The high frequency repetitive discharges were antidromically conducted and recorded on ventral root filaments. Simultaneously each repetitive burst was transmitted to the muscle, producing an increase in contractile strength by converting a twitch into a brief tetanic contraction. Posttetanic potentiation in this system, which is mediated by repetitive discharges originating in nerve terminals after high frequency stimulation, is augmented by penicillin; larger doses depressed posttetanic potentiation, and still larger doses produced varying degrees of neuromuscular block. Events similar to those observed after intraarterial injections were recorded when penicillin was administered intravenously in larger doses. These data suggest that in the presence of penicillin the motor nerve terminals remain depolarized for a prolonged period after excitation by the stimulus, thus providing a current sink for the parent axon. Under the influence of this constant cathodal focus the axon fires repetitively at the high frequency.

Blockage of cortical spreading depression by picrotoxin foci of paroxysmal activity

1 per cent Picrotoxin placed on cortex of rat caused paroxysmal ECoG discharges with concomitant increase in [Ke"] from 3 to 6.7 mM with oscillations corresponding to ictal (maximum) and interictal (minimum) spiking. Invasion of the epileptogenic focus by spreading depression was blocked when the amplitude of oscillations of [Ke+] reached 2.6 mM. Epileptogenic activity induced by topical 10 per cent pentazol caused a less marked increase in [Ke+] (4.6 mM) and did not prevent depression from invading the focal area, but did diminish [Ke+] from the normal of 60 to 70 mM to 39 mM. It is concluded that seizure-induced depolarization of neural elements in deep cortical layers, though inadequate to trigger spreading depression, does prevent it from spreading, in part by activating the sodium pump.

A comparative study of some convulsant substances as gamma-aminobutyric acid antagonists in the feline cerebral cortex

1. By the use of microiontophoretic techniques, quantitative estimates were obtained of the depressant effects of gamma-aminobutyric acid (GABA) on single feline cortical neurones.2. Picrotoxin, bicuculline, strychnine, (+)-tubocurarine, penicillin and leptazol were also applied microiontophoretically to single neurones. Sequential GABA applications were made before, during and after the microiontophoresis of these substances and any effects on the time course of the GABA depression were measured as an estimate of antagonism or potentiation of GABA.3. (+)-Tubocurarine was found to be a potent GABA antagonist. Picrotoxin and bicuculline were rather less potent and strychnine and penicillin only weakly active as GABA antagonists. Leptazol appeared to be inactive against GABA depressions.4. In addition, bicuculline and strychnine were found to be capable of potentiating the depressant action of GABA. This property was not shared by the other substances studied.5. All the substances studied produced changes in neuronal firing rate that did not correlate with GABA antagonism.6. In conclusion, several potent convulsants have been shown to be capable of GABA antagonism. It is not yet clear that this effect, rather than a direct effect on neuronal excitability, is the prime mechanism behind their convulsant properties.

Effects of a focal penicillin lesion on responses of rabbit cortical neurones to putative neurotransmitters

1. Epileptogenic foci were generated in rabbit cerebral cortex by the topical application of penicillin.2. Responses to iontophoretically applied putative neurotransmitters were compared in cortical neurones firing spontaneously with those driven by applied excitant substances, both before and after establishing the penicillin focus.3. In the presence of the spiking focus, currents of gamma-aminobutyric acid, which normally produced 100% depression of neuronal firing, were ineffective.4. In the same situation, currents of (+/-)-homocysteic acid, glutamate and acetylcholine produced predominantly depolarization block responses, and hence depression of firing.5. It is concluded that an epileptogenic focus can alter the responses of rabbit cortical neurones to microiontophoretically applied neurotransmitter substances. Possible mechanisms for the spread of seizure activity are discussed.

Penicillin as an epileptogenic agent: effect on an isolated synapse

Penicillin enhances the excitatory postsynaptic potential of the squid stellate ganglion. This effect suggests the hypothesis that the epileptic focus created by the topical application of penicillin to the mammalian cerebral cortex is produced by the facilitation of excitatory synaptic coupling within the preexisting positive recurrent feedback system.