Innovative minimally invasive options to treat drug-resistant epilepsies

International audienceDespite the regular discovery of new molecules, one-third of epileptic patients are resistant to antiepileptic drugs. Only a few can benefit from resective surgery, the current gold standard. Although effective in 50–70% of cases, this therapy remains risky, costly, and can be associated with long-term cognitive or neurological side effects. In addition, patients are increasingly reluctant to have a craniotomy, emphasizing the need for new less invasive therapies for focal drug-resistant epilepsies. Here, we review different minimally invasive approaches already in use in the clinic or under preclinical development to treat drug-resistant epilepsies. Localized thermolesion of the epileptogenic zone has been developed in the clinic using high-frequency thermo-coagulations or magnetic resonance imaging-guided laser or ultrasounds. Although less invasive, they have not yet significantly improved the outcomes when compared with resective surgery. Radiosurgery techniques have been used in the clinic for the last 20 years and have proven efficiency. However, their efficacy is not better than resective surgery, and various side effects have been reported as well as the potential risk of sudden unexpected death associated with epilepsy. Recently, a new strategy of radiosurgery has emerged using synchrotron-generated X-ray microbeams: microbeam radiation therapy (MRT). The low divergence and high-flux of the synchrotron beams and the unique tolerance to MRT by healthy brain tissues, allows a precise targeting of specific brain regions with minimal invasiveness and limited behavioral or functional consequences in animals. Antiepileptic effects over several months have been recorded in animal models, and histological and synaptic tracing analysis suggest a reduction of neuronal connectivity as a mechanism of action. The possibility of transferring this approach to epileptic patients is discussed in this review

How do social status and tree architecture influence radial growth, wood density and drought response in spontaneously established oak forests?

AbstractKey messageDuring the past decades, a multitude of oak stands have spontaneously established across the pine-dominated landscapes of the French Landes de Gascogne. Yet their future performance under modern climate change is unknown. We show that coppiced, dominant trees are most prepared to cope with drought episodes, displaying higher basal area increment and lower sensitivity to extreme events.ContextForest stands dominated by pedunculate oak (Quercus robur L.) have spontaneously established across the pine-dominated landscapes of the French Landes de Gascogne. These oak stands are typically unmanaged and unsystematically coppiced, resulting in mixtures of single- and multi-stemmed (coppiced) trees.AimsTo determine the ability of spontaneous oak forest stands to face climate change–related hazards, by analysing differences in growth (tree-ring width and basal area increment—BAI), wood density and climate sensitivity depending on their tree architecture (single- vs multi-stemmed trees) and their social status in the forest.MethodsWe exhaustively cored 15 oak stands (n = 657 trees). We compared stand characteristics and climate sensitivity between tree architectures considering two sampling designs, either all sampled trees (the exhaustive sampling) or those with a dominant status (dominant sampling). At the tree level, we used linear mixed effects models to compare wood density and growth between tree architectures and the trees’ social status within the canopy layer (dominant- vs non-dominant trees).ResultsMulti-stemmed trees exhibited higher wood density than single-stemmed trees for diameters > 30 cm. Dominant multi-stemmed trees showed lower sensitivity to extreme events (pointer years), higher BAI but lower annual growth rates than dominant single-stemmed trees.ConclusionDominant multi-stemmed trees are potentially the most prepared ones to cope with increasing soil water deficit following drought episodes, at least during the first 60 years of the life of the tree. The vulnerability to face harsher climate conditions for Q. robur stands can be misled when using a dominant sampling design

Field evidence of colonisation by holm oak, at the northern margin of its distribution range, during the anthropocene period

A major unknown in the context of current climate change is the extent to which populations of slowly migrating species, such as trees, will track shifting climates. Niche modelling generally predicts substantial northward shifts of suitable habitats. There is therefore an urgent need for field-based forest observations to corroborate these extensive model simulations. We used forest inventory data providing presence/absence information from just over a century (1880–2010) for a Mediterranean species (Quercus ilex) in forests located at the northern edge of its distribution. The main goals of the study were (i) to investigate whether this species has actually spread into new areas during the Anthropocene period and (ii) to provide a direct estimation of tree migration rate. We show that Q. ilex has colonised substantial new areas over the last century. However, the maximum rate of colonisation by this species (22 to 57 m/year) was much slower than predicted by the models and necessary to follow changes in habitat suitability since 1880. Our results suggest that the rates of tree dispersion and establishment may also be too low to track shifts in bioclimatic envelopes in the future. The inclusion of contemporary, rather than historical, migration rates into models should improve our understanding of the response of species to climate change

Insect – Tree Interactions in Thaumetopoea pityocampa

The pine processionary moth is, by far, the most important insect defoliator of pine forests in Southern Europe and North Africa, both in terms of its temporal occurrence, geographic range and socioeconomic impact. Monitoring and pest management actions are therefore required on a regular basis, to ensure the detection, evaluation and mitigation of potential risks to forest and public health. However, we still lack some of the basic knowledge required for relevant analyses of the risk posed by the pine processionary moth. Pest risk is defined as a combination of three components: (1) pest occurrence, which depends on the spatiotemporal dynamics of populations; (2) plant vulnerability to the pest, resulting in a certain amount of damage; and (3) the socioeconomic impact of damage, depending on the potential value of the plants damaged (Jactel et al. 2012). The population dynamics of the processionary moth has been extensively studied, in particular within the context of climate change (see Battisti et al. 2014, Chap. 2, this volume). Several studies have recently addressed the question of tree and forest vulnerability to pine processionary attacks but a comprehensive review of evidence was missing. This is the first objective of this chapter. In particular we were interested in a better understanding of the ecological mechanisms responsible for the host tree selection, at both the species and individual tree levels. In a second part we show that pine susceptibility to the pine processionary moth could be reduced by improving forest diversity at different spatial scales. In the last part of this chapter we provide quantitative estimate of the growth losses caused by defoliations of the pine processionary moth. Altogether this information paves the way for quantitative risk analyses on pine processionary moth infestations based on forest growth models