The stability of fish populations: how changes in the environment may affect people with epilepsy

Universidade Presbiteriana Mackenzie Centro de Ciências Biológicas e da Saúde Programa de Pós-Graduação em Distúrbios do DesenvolvimentoUniversidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Departamento de FisiologiaUniversidade de São Paulo Faculdade de Medicina de Ribeirão Preto Departamento de Neurociências e Ciências do ComportamentoUniversidade Federal de São Paulo (UNIFESP) Escola Paulista de MedicinaUNIFESP, EPM, Depto. de FisiologiaUNIFESP, EPMSciEL

Baixas temperaturas e risco de morte súbita cardíaca na esquizofrenia: desvendando um novo calcanhar de Aquiles?

Universidade Federal de São Paulo (UNIFESP) Laboratory of Experimental NeurologyUniversidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Department of PhysiologyUniversidade de São Paulo School of Medicine Department and Institute of PsychiatryUNIFESP, Laboratory of Experimental NeurologyUNIFESP, EPM, Department of PhysiologySciEL

Thalamic nuclear abnormalities as a contributory factor in sudden cardiac deaths among patients with schizophrenia

Patients with schizophrenia have a two- to three-fold increased risk of premature death as compared to patients without this disease. It has been established that patients with schizophrenia are at a high risk of developing cardiovascular disease. Moreover, an important issue that has not yet been explored is a possible existence of a “cerebral” focus that could trigger sudden cardiac death in patients with schizophrenia. Along these lines, several structural and functional alterations in the thalamic complex are evident in patients with schizophrenia and have been correlated with the symptoms manifested by these patients. With regard to abnormalities on the cellular and molecular level, previous studies have shown that schizophrenic patients have fewer neuronal projections from the thalamus to the prefrontal cortex as well as a reduced number of neurons, a reduced volume of either the entire thalamus or its subnuclei, and abnormal glutamate signaling. According to the glutamate hypothesis of schizophrenia, hypofunctional corticostriatal and striatothalamic projections are directly involved in the pathophysiology of the disease. Animal and post-mortem studies have provided a large amount of evidence that links the sudden unexpected death in epilepsy (SUDEP) that occurs in patients with schizophrenia and epilepsy to thalamic changes. Based on the results of these prior studies, it is clear that further research regarding the relationship between the thalamus and sudden cardiac death is of vital importance

The brain-heart connection: Implications for understanding sudden unexpected death in epilepsy

Epilepsy is one of the commonest neurological problems worldwide. Approximately 3% of the general population will suffer from epilepsy at some point in their lives. Unfortunately, individuals with epilepsy are at a higher risk of death than the general population, and sudden unexpected death in epilepsy (SUDEP) is the most important direct epilepsy-related cause of death. Information concerning risk factors for SUDEP is conflicting, but potential risk factors include young age, early onset of epilepsy, duration of epilepsy, uncontrolled seizures, seizure frequency, antiepileptic drug number and winter temperatures. Although the cause of SUDEP is still unknown, its most commonly suggested mechanisms are cardiac abnormalities during and between seizures. As the anatomical substrate of epileptic activity in the central nervous system shows a direct relation to cardiovascular alterations, this may suggest that patients with epilepsy associated with focal central nervous system lesions may face a particular risk of SUDEP. Currently, experimental and clinical data supports the importance of specific brain structures in the behavioural manifestation, the initiation and the propagation of seizures. Regarding the above findings, our research group focused on this review article that SUDEP could be related to the occurrence of specific brain structure dysfunction or anatomical change, at least in some cases

Epilepsia e morte súbita?: Coma mais peixe! A hipótese de um grupo

Epilepsy is the commonest serious neurological disorder and individuals with epilepsy are at higher risk of death than the general population and sudden unexpected death in epilepsy (SUDEP) is the most important direct epilepsy-related cause of death. Potential pathomechanisms for SUDEP are unknown, but it is very probable that cardiac arrhythmias during and between seizures play a potential role. The ultimate goal of SUDEP research is to develop methods to prevent it and nutritional aspects such as omega-3 fatty acid deficiency may have an interesting role in this scenario. Omega-3 fatty acids reduce the risk of cardiovascular mortality and are important for treating or preventing some neurological diseases, including epilepsy. A dietary modification or nutritional supplements increasing the ingestion of omega-3 fatty acids may help to ''save the brain".A epilepsia é uma das doenças neurológicas sérias mais comuns e está associada a um maior risco de morte do que o observado na população geral e a morte súbita em epilepsia é uma importante causa de morte relacionada à epilepsia. Os potenciais patomecanismos da morte súbita em epilepsia são desconhecidos, mas é bastante provável que arritmias cardíacas durante ou entre as crises tenham um papel preponderante. O objetivo final das pesquisas em morte súbita em epilepsia é o desenvolvimento de métodos que levem à sua prevenção e aspectos nutricionais, como a deficiência de ômega-3 pode ter um papel interessante neste contexto. A suplementação com ômega-3 reduz o risco de mortalidade de origem cardiovascular e é importante no tratamento e prevenção de algumas doenças neurológicas, incluindo a epilepsia. A modificação dietética ou a suplementação nutricional aumentando a ingesta de ômega-3 pode ajudar a "salvar o cérebro".FAPESPCInAPCe-FAPESPINCT/MCT Ministério de Ciência e TecnologiaCNP

Consumo de álcool e morte súbita em epilepsia: uma abordagem experimental

Using the pilocarpine model of epilepsy, we investigated the effects of alcohol consumption on the frequency of seizures in animals with epilepsy as well the underlying a possible association between alcohol intake and sudden unexpected death in epilepsy (SUDEP) occurrence. Rats were divided randomly into two groups: (A) rats with epilepsy and (B) rats with epilepsy that received a daily dose of ethanol solution (350 mg kg-1, i.p.) for 30 days. The basal frequency of seizures observed in the A and B groups during the first 30 days were 3.4±1.5 and 3.2±1.9 seizures per week per animal, respectively. In B group, it was observed a significant seizure increase (11.6±5.3) during the first 2 weeks of alcohol administration and quite interesting, one rat died suddenly after a generalized tonic-clonic seizure during this period. We concluded in our experimental study that exist a possible association between alcohol abuse and SUDEP occurrence.Utilizando o modelo de epilepsia induzido pela pilocarpina, investigamos os efeitos do consumo de álcool sobre a frequência de crises epilépticas em animais com epilepsia, como também uma possível associação entre a ingestão de álcool e ocorrência de morte súbita e inesperada nas epilepsias (SUDEP). Os animais foram randomicamente divididos em dois grupos: (A) ratos com epilepsia e (B) ratos com epilepsia que receberam uma dose diária de etanol (350 mg kg-1, i.p.) por 30 dias consecutivos. A frequência basal de crises epilépticas observadas nos grupos A e B durante os primeiros 30 dias foram de 3,4±1,5 e 3,2±1,9 crises por semana/animal, respectivamente. No grupo B, ocorreu aumento significativo na frequência de crises (11,6±5,3) durante as duas primeiras semanas de administração do álcool e de forma interessante, um animal morreu subitamente após uma crise generalizada tônico-clonica durante esse período. Concluímos em nossa abordagem experimental que existe uma possível associação entre o consumo de álcool e a ocorrência de SUDEP