Neural transplantation of GABA-producing cells into key structures within seizure-suppressing circuits holds promise for medication-resistant epilepsy patients not eligible for resection of the epileptic focus. The substantia nigra pars reticulata (SNr), a basal ganglia output structure, is well known to modulate different seizure types. A recent microinjection study by our group indicated that the subthalamic nucleus (STN), which critically regulates nigral activity, might be a more promising target for focal therapy in epilepsies than the SNr. As a proof of principle, we therefore assessed the anticonvulsant efficacy of bilateral and unilateral allografting of GABA-producing cell lines into the STN using the timed intravenous pentylenetetrazole seizure threshold test, which allows repeated seizure threshold determinations in individual rats. We observed (a) that grafted cells survived up to the end of the experiments, (b) that anticonvulsant effects can be induced by bilateral transplantation into the STN using immortalized GABAergic cells derived from the rat embryonic striatum and cells additionally transfected to obtain higher GABA synthesis than the parent cell line, and (c) that anticonvulsant effects were observed even after unilateral transplantation into the STN. Neither grafting of control cells nor transplantation outside the STN induced anticonvulsant effects, emphasizing the site and cell specificity of the observed anticonvulsant effects. To our knowledge, the present study is the first showing anticonvulsant effects by grafting of GABA-producing cells into the STN. The STN can be considered a highly promising target region for modulation of seizure circuits and, moreover, has the advantage of being clinically established for functional neurosurgery.

译文

将产生GABA的细胞神经移植到癫痫发作抑制回路中的关键结构中,对于不符合切除癫痫灶的药物耐药性癫痫患者有望实现。众所周知,黑质网状组织 (SNr) 是基底神经节的输出结构,可以调节不同的癫痫发作类型。我们小组最近的一次显微注射研究表明,严格调节黑质活性的丘脑底核 (STN) 可能比SNr更有希望成为癫痫局灶性治疗的靶标。作为原理证明,因此,我们使用定时静脉内戊四唑癫痫发作阈值测试评估了将产生GABA的细胞系双侧和单侧同种异体移植到STN中的抗惊厥功效,该测试可在单个大鼠中反复确定癫痫发作阈值。我们观察到 (a) 移植的细胞存活到实验结束,(b) 使用源自大鼠胚胎纹状体的永生化GABA能细胞和另外转染的细胞通过双侧移植到STN中可以诱导抗惊厥作用,从而获得比亲本细胞系更高的GABA合成,(c) 即使单侧移植到STN中,也观察到抗惊厥作用。对照细胞的移植或STN外的移植均未引起抗惊厥作用,强调了观察到的抗惊厥作用的部位和细胞特异性。据我们所知,本研究是第一个通过将产生GABA的细胞移植到STN中而显示出抗惊厥作用的研究。STN可以被认为是调节癫痫发作回路的非常有前途的靶区,而且具有在临床上为功能性神经外科手术建立的优势。

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