Secondarily generalized tonic clonic seizure; a functional anatomy

我们建议将局部运动映射到双侧强直阵挛发作（FMBS），这是最常见的 危险的癫痫发作这些癫痫发作会增加癫痫患者突然意外死亡的风险 （SUDEP），并导致骨折和脱位，由于暴力福尔斯。SUDEP是最常见的原因 癫痫病人的死亡。我们提出，在Kandel的神经元原理中发表的规范电路 Science（2013），该研究假设局灶性癫痫发作涉及间脑丘脑皮层回路，这导致 其次，全身性强直阵挛发作过于简单化。这与已知的神经解剖学不一致。 运动皮层和皮层下结构对癫痫发作的调节。我们建议， 额叶皮层通过纹状体扩散到苍白球、黑质和丘脑， 间接途径，除了直接传播到丘脑。我们从三个目标来检验这个假设。目的 1：绘制中尺度的FMBS分布图，并将其与癫痫发作病灶的解剖学连接进行比较， 使用组织清除和3D成像结合束追踪和电生理的TRAP小鼠 技术）。目的2在显微镜下绘制FMBS在大脑皮层的直接和间接分布 使用免疫组织化学方法研究TRAP小鼠的基底神经节回路。在目标3中，我们将研究2型多巴胺 受体调节癫痫发作在中尺度和微电路水平使用的技术组合。 我们在实验室中采用了由BRAIN倡议开发的工具和技术， 癫痫电路映射研究进展。我们使用了TRAP小鼠，高分辨率， 高通量成像和图像的3D重建以可视化激活的神经元通路。我们有 建立了一个高度协作的团队，具有解剖学，电生理学和计算机科学方面的专业知识， 成像，这使我们能够生成和分析大量的数据，并建立在彼此的创造力。 我们已经获得了足够的设备来进行这些研究。这些研究将产生新的目标， 通过脑深部电刺激调节癫痫发作目前，这种方法用于前丘脑 刺激和反应性神经刺激，但在未来，多个皮层下结构可以为 神经调节已知调节基底神经节电路的受体和离子通道可能会出现新的 抗惊厥药物开发的目标。如果我们的研究证实癫痫发作是通过纹状体的， 对理解潜在的细胞机制很重要

We propose to map focal motor to bilateral tonic-clonic seizures (FMBSs), which are the most dangerous epileptic seizures. These seizures increase the risk of sudden unexpected death in epilepsy (SUDEP) and lead to fractures and dislocations due to violent falls. SUDEP is the most common cause of death in patients with epilepsy. We propose that the canonical circuit published in Kandel's Principles of Neural Science (2013), which posits that focal seizures engage diencephalic thalamocortical circuits, which leads to secondarily generalized tonic-clonic seizures is too simplistic. It is not consistent with known neuroanatomy of the motor cortex, and modulation of seizures by subcortical structures. We propose that FMBSs originating in the frontal cortex spread through the striatum to the globus pallidus, substantia nigra and thalamus via the indirect pathway, in addition to spreading directly to the thalamus .. We test this hypothesis in three aims. Aim 1: to map FMBS spread at the mesoscale and compare it to anatomical connections of the seizure focus in TRAP mice using tissue clearing and 3D imaging combined with tract tracing and electrophysiological techniques). Aim 2 to map FMBS spread at the microscopic scale through the cortex and direct and indirect basal ganglia circuits in TRAP mice using immunohistochemistry. In aim 3, we will study dopamine type 2 receptor modulation of seizures at the mesoscale and microcircuit levels using a combination of techniques. We incorporated tools and techniques developed by the BRAIN initiative in our laboratory to move seizure circuit mapping research forward. We have used TRAP mice, the CLARITY technique, high resolution, high-throughput imaging, and 3D reconstruction of images to visualize activated neuronal pathways. We have constructed a highly collaborative team with expertise in anatomy, electrophysiology and computer science of imaging, which allows us to generate and analyze large volumes of data and build on each other's creativity. We have acquired sufficient equipment to perform these studies. These studies will generate new targets for the modulation of seizures by deep brain stimulation. Currently, this method is used for anterior thalamic stimulation and responsive neurostimulation, but in the future, multiple subcortical structures could sites for neuromodulation. Receptors and ion channels known to modulate basal ganglia circuits may emerge as novel targets for anticonvulsant development. If our studies confirm seizure passage through the striatum, then ii would be important to understand the underlying cellular mechanisms.