Cooling of the epileptic focus suppresses seizures with minimal influence on neurologic functions
Cooling of the epileptic focus suppresses seizures with minimal influence on neurologic functions
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DOI：
10.1111/j.1528-1167.2011.03388.x
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发表时间：
2012-03-01
期刊：
影响因子：
5.6
通讯作者：
Suzuki, Michiyasu
中科院分区：
文献类型：
--
作者：
Fujii, Masami;Inoue, Takao;Suzuki, Michiyasu
目的：局灶性脑冷却对于抑制癫痫发作是有效的，但尚不清楚是否可以在不对正常神经功能产生实质性影响的情况下抑制癫痫发作。为了解决这个问题，热电驱动的冷却系统的开发和应用在自由移动的大鼠模型的局灶性癫痫发作和epilepsy.Methods：局灶性癫痫发作局限于单侧前肢诱导局部应用青霉素G溶液或钴粉的单侧感觉运动皮层。一种比例积分和微分（PID）控制的热电驱动冷却装置，（重11 g）和双极电极长期植入功能区（关于癫痫灶）和冷却的影响（20、15和10 ℃）对皮质电图、癫痫发作频率和神经系统变化的影响进行了研究。冷却与癫痫放电的明显减少有关。在两种模型中，从20 ℃降至15 ℃，癫痫灶的冷却显著改善了癫痫发作频率和神经功能。冷却到10摄氏度也抑制了癫痫发作，但神经功能没有进一步改善。随后的调查发现，感觉运动功能显着恶化的脚故障测试和感受野的大小在15摄氏度的意义：尽管在发作大鼠的有益效果，感觉运动功能恶化在15摄氏度，从而表明治疗温度的下限。这些结果提供了使用可植入的低温装置在20至15摄氏度的温度下治疗局灶性癫痫的重要证据。
Purpose: Focal brain cooling is effective for suppression of epileptic seizures, but it is unclear if seizures can be suppressed without a substantial influence on normal neurologic function. To address the issue, a thermoelectrically driven cooling system was developed and applied in free-moving rat models of focal seizure and epilepsy.Methods: Focal seizures limited to the unilateral forelimb were induced by local application of a penicillin G solution or cobalt powder to the unilateral sensorimotor cortex. A proportional integration and differentiation (PID)-controlled, thermoelectrically driven cooling device (weight of 11 g) and bipolar electrodes were chronically implanted on the eloquent area (on the epileptic focus) and the effects of cooling (20, 15, and 10 degrees C) on electrocorticography, seizure frequency, and neurologic changes were investigated.Key Findings: Cooling was associated with a distinct reduction of the epileptic discharges. In both models, cooling of epileptic foci significantly improved both seizure frequency and neurologic functions from 20 degrees C down to 15 degrees C. Cooling to 10 degrees C also suppressed seizures, but with no further improvement in neurologic function. Subsequent investigation of sensorimotor function revealed significant deterioration in foot-fault tests and the receptive field size at 15 degrees C.Significance: Despite the beneficial effects in ictal rats, sensorimotor functions deteriorated at 15 degrees C, thereby suggesting a lower limit for the therapeutic temperature. These results provide important evidence of a therapeutic effect of temperatures from 20 to 15 degrees C using an implantable, hypothermal device for focal epilepsy.