Pathophysiogenesis of mesial temporal lobe epilepsy: is prevention of damage antiepileptogenic?
Pathophysiogenesis of mesial temporal lobe epilepsy: is prevention of damage antiepileptogenic?
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DOI：
10.2174/0929867320666131119152201
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发表时间：
2014
影响因子：
4.1
通讯作者：
Biagini G
中科院分区：
文献类型：
--
作者：
Curia G;Lucchi C;Vinet J;Gualtieri F;Marinelli C;Torsello A;Costantino L;Biagini G
颞叶癫痫（TLE）经常与海马硬化有关，可能是由神经系统症状出现前很长一段时间发生的原发性脑损伤引起的。这种类型的癫痫的特点是对药物治疗无效，因此需要手术切除癫痫发作涉及的内侧颞区。即使这种最后的治疗方法也可能无法缓解患者的痛苦。虽然在原发事件后预防海马损伤和癫痫发生可能是TLE的关键创新方法，但缺乏导致TLE的病理生理学机制的明确数据不允许任何合理的治疗。在这里，我们解决目前的知识机制应该参与癫痫，以及可能的创新治疗，可能导致一种预防性的方法。除了主要神经元和特定中间神经元的损失之外，由轴突发芽和神经发生引起的网络重排是众所周知的现象，其通过受体和通道功能的变化以及其他细胞组分的修饰而整合。特别是，越来越多的动物模型研究证据表明，血脑屏障的血管和星形胶质细胞成分的破坏发生在海马和梨状皮质等受损的大脑区域。这些事件可以通过能够防止血管成分损伤的药物来抵消，如生长激素促分泌素ghrelin及其类似物的情况。对这些新的药理学工具的深入研究可能会导致设计有效的预防治疗。
Temporal lobe epilepsy (TLE) is frequently associated with hippocampal sclerosis, possibly caused by a primary brain injury that occurred a long time before the appearance of neurological symptoms. This type of epilepsy is characterized by refractoriness to drug treatment, so to require surgical resection of mesial temporal regions involved in seizure onset. Even this last therapeutic approach may fail in giving relief to patients. Although prevention of hippocampal damage and epileptogenesis after a primary event could be a key innovative approach to TLE, the lack of clear data on the pathophysiological mechanisms leading to TLE does not allow any rational therapy. Here we address the current knowledge on mechanisms supposed to be involved in epileptogenesis, as well as on the possible innovative treatments that may lead to a preventive approach. Besides loss of principal neurons and of specific interneurons, network rearrangement caused by axonal sprouting and neurogenesis are well known phenomena that are integrated by changes in receptor and channel functioning and modifications in other cellular components. In particular, a growing body of evidence from the study of animal models suggests that disruption of vascular and astrocytic components of the blood-brain barrier takes place in injured brain regions such as the hippocampus and piriform cortex. These events may be counteracted by drugs able to prevent damage to the vascular component, as in the case of the growth hormone secretagogue ghrelin and its analogues. A thoroughly investigation on these new pharmacological tools may lead to design effective preventive therapies.
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影响因子：
3.5
作者：
Benini, Ruba;Longo, Daniela;Avoli, Massimo
通讯作者：
Avoli, Massimo
影响因子：
3.3
作者：
Andrioli, A.;Alonso-Nanclares, L.;Defelipe, J.
通讯作者：
Defelipe, J.
影响因子：
6.1
作者：
Abraham, Jayne;Fox, Patrick D.;Condello, Carlo;Bartolini, Alyssa;Koh, Sookyong
通讯作者：
Koh, Sookyong
影响因子：
--
作者：
Aberg ND;Brywe KG;Isgaard J
通讯作者：
Isgaard J
影响因子：
9.9
作者：
Bernasconi, N;Bernasconi, A;Reutens, DC
通讯作者：
Reutens, DC