Modulationofabnormalneuronalcircuitintemporallobeepilepsy
摘要: OBJECTIVETemporallobeepilepsy(TLE)isoneofthemostcommontypesofhumanepilepsy,andtheyareoftenresistanttocurrenttreatments.METHODSByusingoptogenetic,electrophysiological,imagingandpharmacologystrategies,weaimedtoinvestigatetheunderlyingcircuitmechanismofTLEandtriedtodevelopthenovelandefficientapproachtocontrolepilepsy.RESULTS(1)UsingmicroPETandmultichannelEEGrecording,wefoundanabnormalneuralnetwork,characterizedbyearlyhypometabolismandafterdischargespread,duringtheepileptogenensisofTLE.(2)Deepbrainstimulation,especiallylowfrequencystimulation,targetedtheepilepticfocusandtheareasoutsideofthefocus(criticalregionsforseizurespread),suchasthepiriformcortex,cerebellum,entorhinalcortexorsubiculum,reducedseizureseverityinTLE.Itsanti-epilepticeffectistime-windowdependentandpolaritydependent,whichshowsapromisingstrategyfortreatingepilepticseizures.(3)Usinganoptogeneticstrategy,wedemonstratedthatexcitatoryprojectionfromentorhinalcortextohippocampusinstructsthebrain-stimulationtreatmentsofepilepsy.(4)OurdatafromboththeclinicalandexperimentalstudiesfurtherdemonstratedthatadisinhibitoryGABAergicneuronmediatedmicrocircuitinthesubiculumcontributestosecondarygeneralizedseizuresinTLE.(5)Finally,basedonabnormalsynchronizationoftheelectricalactivityinepilepticcircuit,wedevelopedelectroresponsivehydrogelnanoparticlesmodifiedwithangiopep-2tofacilitatethedeliveryoftheantiepilepticdrugphenytoinsodium,whichgreatlyimprovesthetherapeuticindex.CONCLUSIONOurfindingsmayupdatethecurrentviewofepilepticneuronalnetworksandsuggestpossiblepromisingwaysforepilepsytreatment. ...
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