Predicting the spatiotemporal diversity of seizure propagation and termination in human focal epilepsy

Recent studies have shown that seizures can spread and terminate across brain areas via a rich diversity of spatiotemporal patterns. In particular, while the location of the seizure onset area is usually in-variant across seizures in a same patient, the source of traveling (2-3 Hz) spike-and-wave discharges (SWDs) during seizures can either move with the slower propagating ictal wavefront or remain stationary at the seizure onset area. In addition, although most focal seizures terminate quasi-synchronously across brain areas, some evolve into distinct ictal clusters and terminate asynchronously. To provide a unifying perspective on the observed diversity of spatiotemporal dynamics for seizure spread and termination, we introduce here the Epileptor neural field model. Two mechanisms play an essential role. First, while the slow ictal wavefront propagates as a front in excitable neural media, the faster SWDs propagation results from coupled-oscillator dynamics. Second, multiple time scales interact during seizure spread, allowing for low-voltage fast-activity (>10 Hz) to hamper seizure spread and for SWD propagation to affect the way a seizure terminates. These dynamics, together with variations in short and long-range connectivity strength, play a central role on seizure spread, maintenance and termination. We demonstrate how Epileptor field models incorporating the above mechanisms predict the previously reported diversity in seizure spread patterns. Furthermore, we confirm the predictions for synchronous or asynchronous (clustered) seizure termination in human seizures recorded via stereotactic EEG. Our new insights into seizure spatiotemporal dynamics may also contribute to the development of new closed-loop neuromodulation therapies for focal epilepsy.Comment: 10 pages + 9 pages Supporting Information (SI), 7 figures, 1 SI table, 7 SI figure

Underlying Mechanisms of Epilepsy

This book is a very provocative and interesting addition to the literature on Epilepsy. It offers a lot of appealing and stimulating work to offer food of thought to the readers from different disciplines. Around 5% of the total world population have seizures but only 0.9% is diagnosed with epilepsy, so it is very important to understand the differences between seizures and epilepsy, and also to identify the factors responsible for its etiology so as to have more effective therapeutic regime. In this book we have twenty chapters ranging from causes and underlying mechanisms to the treatment and side effects of epilepsy. This book contains a variety of chapters which will stimulate the readers to think about the complex interplay of epigenetics and epilepsy

Role of the cotransporter KCC2 in cortical excitatory synapse development and febrile seizure susceptibility

Le co-transporteur KCC2 spécifique au potassium et chlore a pour rôle principal de réduire la concentration intracellulaire de chlore, entraînant l’hyperpolarisation des courants GABAergic l’autorisant ainsi à devenir inhibiteur dans le cerveau mature. De plus, il est aussi impliqué dans le développement des synapses excitatrices, nommées aussi les épines dendritiques. Le but de notre projet est d’étudier l’effet des modifications concernant l'expression et la fonction de KCC2 dans le cortex du cerveau en développement dans un contexte de convulsions précoces. Les convulsions fébriles affectent environ 5% des enfants, et ce dès la première année de vie. Les enfants atteints de convulsions fébriles prolongées et atypiques sont plus susceptibles à développer l’épilepsie. De plus, la présence d’une malformation cérébrale prédispose au développement de convulsions fébriles atypiques, et d’épilepsie du lobe temporal. Ceci suggère que ces pathologies néonatales peuvent altérer le développement des circuits neuronaux irréversiblement. Cependant, les mécanismes qui sous-tendent ces effets ne sont pas encore compris. Nous avons pour but de comprendre l'impact des altérations de KCC2 sur la survenue des convulsions et dans la formation des épines dendritiques. Nous avons étudié KCC2 dans un modèle animal de convulsions précédemment validé, qui combine une lésion corticale à P1 (premier jour de vie postnatale), suivie d'une convulsion induite par hyperthermie à P10 (nommés rats LHS). À la suite de ces insultes, 86% des rats mâles LHS développent l’épilepsie à l’âge adulte, au même titre que des troubles d’apprentissage. À P20, ces animaux presentent une augmentation de l'expression de KCC2 associée à une hyperpolarisation du potentiel de réversion de GABA. De plus, nous avons observé des réductions dans la taille des épines dendritiques et l'amplitude des courants post-synaptiques excitateurs miniatures, ainsi qu’un déficit de mémoire spatial, et ce avant le développement des convulsions spontanées. Dans le but de rétablir les déficits observés chez les rats LHS, nous avons alors réalisé un knock-down de KCC2 par shARN spécifique par électroporation in utero. Nos résultats ont montré une diminution de la susceptibilité aux convulsions due à la lésion corticale, ainsi qu'une restauration de la taille des épines. Ainsi, l’augmentation de KCC2 à la suite d'une convulsion précoce, augmente la susceptibilité aux convulsions modifiant la morphologie des épines dendritiques, probable facteur contribuant à l’atrophie de l’hippocampe et l’occurrence des déficits cognitifs. Le deuxième objectif a été d'inspecter l’effet de la surexpression précoce de KCC2 dans le développement des épines dendritiques de l’hippocampe. Nous avons ainsi surexprimé KCC2 aussi bien in vitro dans des cultures organotypiques d’hippocampe, qu' in vivo par électroporation in utero. À l'inverse des résultats publiés dans le cortex, nous avons observé une diminution de la densité d’épines dendritiques et une augmentation de la taille des épines. Afin de confirmer la spécificité du rôle de KCC2 face à la région néocorticale étudiée, nous avons surexprimé KCC2 dans le cortex par électroporation in utero. Cette manipulation a eu pour conséquences d’augmenter la densité et la longueur des épines synaptiques de l’arbre dendritique des cellules glutamatergiques. En conséquent, ces résultats ont démontré pour la première fois, que les modifications de l’expression de KCC2 sont spécifiques à la région affectée. Ceci souligne les obstacles auxquels nous faisons face dans le développement de thérapie adéquat pour l’épilepsie ayant pour but de moduler l’expression de KCC2 de façon spécifique.The potassium-chloride cotransporter KCC2 decreases intracellular Cl- levels and renders GABA responses inhibitory. In addition, it has also been shown to modulate excitatory synapse development. In this project, we investigated how alterations of KCC2 expression levels affect these two key processes in cortical structures of a normal and/or epileptic developing brain. First, we demonstrate that KCC2 expression is altered by early-life febrile status epilepticus. Febrile seizures affect about 5% of children during the first year of life. Atypical febrile seizures, particularly febrile status epilepticus, correlate with a higher risk of developing cognitive deficits and temporal lobe epilepsy as adults, suggesting that they may permanently change the developmental trajectory of neuronal circuits. In fact, the presence of a cerebral malformation predisposes to the development of atypical febrile seizures and temporal lobe epilepsy. The mechanisms underlying these effects are not clear. Here, we investigated the functional impact of this alteration on subsequent synapse formation and seizure susceptibility. We analyzed KCC2 expression and spine density in the hippocampus of a well-established rodent model of atypical febrile seizures, combining a cortical freeze lesion at post-natal day 1 (P1) and hyperthermia-induced seizure at P10 (LHS rats). 86% of these LHS males develop epilepsy and learning and memory deficits in adulthood. At P20, we found a precocious increase in KCC2 protein levels, accompanied by a negative shift of the reversal potential of GABA (EGABA) by gramicidin-perforated patch. In parallel, we observed a reduction in dendritic spine size by DiI labelling and a reduction of miniature excitatory postsynaptic current (mEPSC) amplitude in CA1 pyramidal neurons, as well as impaired spatial memory. To investigate whether the premature expression of KCC2 played a role in these alterations in the LHS model, and on seizure susceptibility, we reduced KCC2 expression in CA1 pyramidal neurons by in utero electroporation of shRNA using a triple-probe electrode. This approach lead to reduced febrile seizure susceptibility, and rescued spine size shrinkage in LHS rats. Our results show that an increase of KCC2 levels induced by early-life insults affect seizure susceptibility and spine development and may be a contributing factor to the occurrence of hippocampal atrophy and associated cognitive deficits in LHS rats. Second, we investigated whether KCC2 premature overexpression plays a role in spine alterations in the hippocampus. We overexpressed KCC2 in hippocampal organotypic cultures by biolistic transfection and in vivo by in utero electroporation. In contrast to what was previously published, we observed that both manipulations lead to a decrease in spine density in the hippocampus, as well as an increase in spine head size in vivo. In fact, it has been previously shown that overexpressing KCC2 leads to an increase of spine density in the cortex in vivo. To prove that this discrepancy is due to brain regional differences, we overexpressed KCC2 in the cortex by in utero electroporation, and similarly found an increase in spine density and length. Altogether, our results demonstrate for the first time, that alterations of KCC2 expression are brain circuit-specific. These findings highlights the obstacles we will face to find adequate pharmacological treatment to specifically modulate KCC2 in a region-specific and time-sensitive manner in epilepsy

Astrocytic regulation of seizure-like behavior

Astrocytes are emerging as important regulators of neural circuit function and behavior in the healthy and diseased nervous system. In a screen for astrocyte molecules that modulate neuronal hyperexcitability we identified multiple components of focal adhesion complexes (FAs) as potent suppressors of genetically- or pharmacologically-induced seizure-like activity. Depletion of astrocytic Tensin, b-integrin, Talin, Focal adhesion kinase (FAK), or matrix metalloproteinase 1 (Mmp1), which degrades extracellular matrix to activate b-integrin receptors, resulted in enhanced recovery from, or resistance to seizure activity. Reciprocally, promoting FA signaling by overexpression of Mmp1 in astrocytes led to enhanced-seizure severity. Blockade of FA signaling in astrocytes led to reduced-astrocytic coverage of the synaptic neuropil and reduced expression of the excitatory amino acid transporter EAAT1. However, upon seizure induction, depletion of FA signaling components resulted in enhanced astrocyte coverage of the synaptic neuropil and a ~2-fold increase in EAAT1 levels compared to controls. Our data indicate that FAs promote astrocyte coverage in neuropil and EAAT1 expression under normal physiological conditions, but in the context of hyperexcitability, FAs negatively regulate the extent of astrocytic processes within neuropil and EAAT1 expression, thereby inhibiting a more rapid recovery from conditions of excessive neuronal activity

29th Annual Computational Neuroscience Meeting: CNS*2020

Meeting abstracts This publication was funded by OCNS. The Supplement Editors declare that they have no competing interests. Virtual | 18-22 July 202

Multiscale Modelling of Neuronal Dynamics and Their Dysfunction in the Developing Brain

Over the last few decades, an increasing number of neurodevelopmental disorders has been associated with molecular causes – such as genetic mutations, or autoantibodies affecting synaptic transmission. Yet understanding the pathophysiology that leads from particular molecular disruptions at the synapse to patients’ signs and symptoms remains challenging, even today. The work presented in this thesis illustrates how computational models can help bridge the explanatory gap between disruptions at the molecular scale and brain dysfunction at the level of integrated circuits. I utilise computational models at different scales of neuronal function, ranging from the neuronal membrane, to integrated cortical microcircuits and whole-brain sensory processing networks. These computational models are informed with, and further constrained by both empirical data derived from a number of model systems of neurodevelopmental disorders, and clinical patient data. The worked examples in this thesis include the biophysical characterisation of an epilepsy-causing mutation in the voltage-gated sodium channel gene SCN1A, calcium imaging in a larval zebrafish model of epileptic seizures in the immature brain, electrophysiological recordings from patients with NMDA receptor antibody encephalitis as well as from a mouse model of the disorder, and pharmacologically induced NMDA receptor blockade in young adults that captures features of acute psychosis and schizophrenia. The combination of this diverse range of empirical data and different computational models offers a mechanistic, multi-scale account of how specific phenotypic features in neurodevelopmental disorders emerge. This provides novel insights both in regard to the specific conditions included here, but also concerning the link between molecular determinants and their neurodevelopmental phenotypes more broadly

GABA signaling in the thalamus

Inhibition of neuronal activity in networks of the mammalian central nervous system is essential for all fundamental brain functions, ranging from perception, to consciousness, to action. Both exacerbation and diminution of inhibition dramatically affect our behavioral capacities, indicating that, in the healthy brain, strength and dynamics of inhibition must be precisely balanced. Inhibitory functions are primarily accomplished by neurons releasing the neurotransmitter GABA. According to their wide variety of functions, GABAergic neurons show a tremendous diversity in morphological, biochemical and functional characteristics. The combination of these diverse properties allows the brain to generate interneurons acting as, for examples, filters, co-incidence detectors or contrast enhancers. GABAergic signaling in thalamus plays an essential role in controlling sensory information flow from the periphery to the cortical processing centers, and in generating sleep-related neuronal rhythms. Surprisingly, however, the diversity of GABAergic neurons is remarkably limited in thalamic networks. Both functions mentioned have been tightly associated with two homogeneous groups of GABAergic neurons arising within thalamic nuclei or within the nucleus reticularis, a shell of inhibitory nuclei surrounding the dorsal thalamus. The results arising from the present thesis challenge the view that the diversity of GABAergic signaling in thalamus is comparatively limited and proposes that, to fully understand GABAergic signaling in thalamus, at least two additional aspects have to be considered. First, it shows that GABAergic signaling arising from the nucleus reticularis can have a profound effect on the synthesis of second messenger compounds that are important in the control of neuronal rhythmicities and in the statedependent control of gene expression. Second, it demonstrates the functional relevance of a previously undescribed extrathalamic and extrareticular inhibitory pathway that arises within the anterior pretectal nuclei, indicating that the architecture of GABAergic signaling in thalamus has to be complemented by a conceptually novel, powerful afferent pathway. The first part investigates the modulation of cAMP synthesis by GABA in thalamocortical neurons through the activation of the Gi-coupled GABAB receptors. GABAB receptors can provide two different cAMP signals in the neurons. First, GABAB receptor activation depresses the level of cAMP inside thalamocortical neurons. However, a large and long cAMP signal is observed when GABAB receptors are activated concomitantly with b-adrenergic receptors, which are Gscoupled receptors. In the presence of GABAB receptor agonists, the moderate cAMP increase produced by b-adrenergic receptor activation is transformed into a large synthesis of cAMP. Remarkably, the activation of the GABAB receptors at the synapses between reticular neurons and thalamocortical neurons also potentiates the effects of b-adrenergic receptors. Thus, GABAB receptors modulate cAMP signals at synapses that are important for the regulation of the state of arousal. The second part provides the first electrophysiological description of synaptic connections between the anterior pretectum group and the thalamic higher-order nuclei. Electric stimulation in the anterior pretectum group evoked inhibitory postsynaptic responses (IPS) in the thalamocortical neurons of the higher-order nuclei. We showed that the IPS responses were mediated via the GABAA receptors activated through monosynaptic connections between the APT and the higher-order nuclei. Functionally, the anterior pretectum modulated the discharge properties of the thalamocortical neurons, suggesting an important role of this nucleus in the dialogue between the thalamus and the cortex