Long-term increase of glutamate decarboxylase mRNA in a rat model of temporal lobe epilepsy.

Behavioral changes following injury, neural degeneration, and aging partly reflect the synaptic plasticity of the nervous system. Such long-term plastic changes are likely to depend on alterations in the production of proteins involved in synaptic structures and neurotransmission. We have studied the regulation of the mRNA encoding one such protein, glutamate decarboxylase (GAD), the rate limiting enzyme of GABA synthesis, after a unilateral lesion in the hippocampus that leads to increased seizure susceptibility. Quantitative in situ hybridization reveals a long-term increase in GAD mRNA in several bilateral structures, as well as in specific neurons in the ipsilateral dentate gyrus. Our data do not support the often stated hypothesis that seizure susceptibility depends on the malfunction of GABA neurons.

Two genes encode distinct glutamate decarboxylases.

gamma-Aminobutyric acid (GABA) is the most widely distributed known inhibitory neurotransmitter in the vertebrate brain. GABA also serves regulatory and trophic roles in several other organs, including the pancreas. The brain contains two forms of the GABA synthetic enzyme glutamate decarboxylase (GAD), which differ in molecular size, amino acid sequence, antigenicity, cellular and subcellular location, and interaction with the GAD cofactor pyridoxal phosphate. These forms, GAD65 and GAD67, derive from two genes. The distinctive properties of the two GADs provide a substrate for understanding not only the multiple roles of GABA in the nervous system, but also the autoimmune response to GAD in insulin-dependent diabetes mellitus.

Comparative distribution of messenger RNAs encoding glutamic acid decarboxylases (Mr 65,000 and Mr 67,000) in the basal ganglia of the rat.

Glutamic acid decarboxylase, the enzyme required for GABA synthesis, exists as distinct isoforms, which have recently been found to be encoded by different genes. The relative expression of messenger RNAs encoding two isoforms of glutamic acid decarboxylase (Mr 67,000 and Mr 65,000) was measured at the single-cell level in neurons of the rat basal ganglia with in situ hybridization histochemistry. Both messenger RNAs were expressed in neurons of the striatum, pallidum, and substantia nigra pars reticulata, but marked differences in the relative level of labelling were observed with the two probes. In striatum, efferent neurons were more densely labelled for the messenger RNA encoding glutamic acid decarboxylase (Mr 65,000) than for the messenger RNA encoding glutamic acid decarboxylase (Mr 67,000), whereas the reverse was observed for GABA-ergic interneurons. Neurons of the entopeduncular nucleus were much more densely labelled for messenger RNA encoding glutamic acid decarboxylase (Mr 65,000) than for messenger RNA encoding glutamic acid decarboxylase (Mr 67,000). In addition, labelling for messenger RNA encoding glutamic acid decarboxylase (Mr 65,000) was higher in the entopeduncular nucleus (internal pallidum) than in the globus pallidus (external pallidum), a structure which expressed similar levels of both mRNAs. In contrast to neurons of the internal pallidum, efferent neurons of the substantia nigra pars reticulata expressed slightly more messenger RNA encoding glutamic acid decarboxylase (Mr 67,000) than that encoding the other isoform of the enzyme. The results suggest a differential expression of the messenger RNAs encoding the two isoforms of glutamic acid decarboxylase in subpopulations of basal ganglia neurons in rats.

Efficacy of a new neuroprotective agent, gacyclidine, in a model of rat spinal cord injury.

Prevention of the immediate excitotoxic phase occurring in response to spinal cord injury (SCI) is a major issue to reduce the neuronal damage responsible for any ensuing motor deficits. The present study evaluated the neuroprotective efficacy of three noncompetitive NMDA receptor antagonists: Gacyclidine (GK-11), a new compound, Dizocilpine (MK-801), and Cerestat (CNS-1102) in a rat spinal cord contusion model. To mimic human SCI, a standardized model of rat spinal cord closed contusion in which animals spontaneously and progressively recover from the induced paraplegia was employed. Such model, characterized by a slow recovery of hindlimb locomotor function enables easy quantification of the neuroprotection at both the behavioral and cellular level. The animals were treated intravenously with the respective drugs 10 min after the spinal contusion. The dose range study suggested that 1 mg/kg of Gacyclidine was the most effective dose to promote functional recovery in reducing by half the time needed to reach full locomotor recovery. Racemate and enantiomers of Gacyclidine showed similar neuroprotective effects, but treatment with the enantiomers were not as efficacious in promoting full functional recovery. Similarly, a prolonged treatment with the racemate was not as efficious as a single dose, suggesting that a prolonged blockade of the amino-excitatory neurotransmission may be deleterious. Finally, Dizocilpine and Cerestat treatments induced only a partial and delayed neuroprotective effect compared to Gacyclidine. Neuroprotection characterized by a reduction of the cystic cavity and of the astrogliosis was observed with all treatments. As Gacyclidine is already in clinical trials, the present findings suggest the premise that it is a promising agent for limiting the initial neuronal damage induced by CNS trauma leading to better functional recovery.

Astrocytes and oligodendrocytes reactions after a total section of the rat spinal cord.

Regeneration after an injury in the Central Nervous System is dependent on intrinsic and extrinsic factors. Among the latter are the reactions of glial cells. Using the model of total section of adult rat spinal cord, we have studied the spatial and temporal responses of astrocytes and oligodendrocytes to the lesion of spinal cord axons. We studied at molecular and cellular levels the specific markers GFAP (glial fibrillary acidic protein) for the astrocytes, CNP (2'-3' cyclic 3' nucleotide phosphodiesterase) which is principally expressed by immature oligodendrocytes, and MBP (myelin basic protein) implicated later in the myelin compaction, and which is more specific of mature oligodendrocytes. After injury, all astrocytes, but more markedly those of the grey matter, reacted by an increase of GFAP messenger and protein. This increase was very rapid for messenger, and peaked at 3 days. This increase was more protracted for the protein and persisted after 3 weeks. Messenger increase is more marked and more protracted below than above the lesion. Oligodendrocytes also reacted quickly by an increase of CNP and MBP messengers. For CNP, both messenger and protein increased rapidly and returned to control level after 1 week. MBP showed the same time course of changes, with lower and slower decrease above the lesion. Counts of oligodendrocytes showed that the percentage of the less mature form (light oligodendrocytes) increased dramatically above and below the lesion. After 1 week, above the lesion, this percentage was well below that of the control, whereas below the lesion, it reverted to control value. These results indicate that, following a lesion, astrocytes react quickly and intensely, but more so below the lesion; oligodendrocytes resume a sequence of maturation which is eventually completed above the lesion where remyelinisation can occur and which is prematurely interrupted below the lesion. However, intact oligodendrocytes persist below the lesion, where they constitute a potential for remyelinisation of regenerated and/or transplanted axons.

Amygdaloid lesion increases the toxicity of intrahippocampal kainic acid injection and reduces the late occurrence of spontaneous recurrent seizures in rats.

Spontaneous recurrent seizures (SRS) following intrahippocampal kainic acid (KA) injection have been described in a previous paper from our laboratory. The SRSs are clinically similar to the seizures induced by kindling the amygdala and we suggested that the amygdala plays a role in initiating the SRSs. Accordingly, the present paper examines the effect of amygdaloid lesions on intrahippocampal KA-treated rats. There were short- and long-term effects. (1) Short-term: the toxicity of KA was increased in lesioned animals. Status epilepticus followed by death of the animals was evoked with half of the dose required to cause the same effect in intact rats. Moreover, a gross haematuria was encountered 6-12 h after KA injection. This was not observed in non-lesioned rats even following the highest KA doses. (2) Long-term: amygdaloid lesions delayed the occurrence of the SRSs, reduced their incidence and modified their expression. In lesioned animals seizures began with a period of tonic immobility with no sign of the masticatory movements seen in intact animals. Histological examination of the KA-induced lesions did not show any major differences between lesioned and intact animals. It is suggested that the short-term effects are due to an unspecific effect on homeostatic mechanisms, whereas the long-term ones reflect a specific involvement of the amygdala in the late appearing seizures.

Reversal of the anticonvulsant effects of diazepam on amygdaloid-kindled seizures by a specific benzodiazepine antagonist: RO 15-1788.

The benzodiazepine antagonist RO 15-1788 was tested in an animal model of experimental epilepsy, the kindling effect. In animals fully kindled from repeated electrical amygdaloid stimulation, RO 15-1788 reversed the anticonvulsant effects of diazepam (2 mg/kg) from doses of 0.4-0.5 mg/kg. Doses up to 20 mg/kg also antagonized the preventive action of diazepam. RO 15-1788 alone had neither proconvulsant effects on the amygdaloid afterdischarges nor benzodiazepine-like activity on the kindled seizures.

Abortive amygdaloid kindled seizures following microinjection of gamma-vinyl-GABA in the vicinity of substantia nigra in rats.

The effects of microinjection of a GABA-elevating substance (gamma-vinyl-GABA) in the substantia nigra were assessed on kindled convulsive seizures induced by daily appropriate amygdaloid stimulation in the rat. Bilateral administration of 20 micrograms of gamma-vinyl-GABA strongly reduced the afterdischarge duration of the seizures without significantly modifying the motor convulsions. This effect was noted 24 h after injection and lasted for up to 48 h. Administration of gamma-vinyl-GABA in structures 1.5 mm distant from the substantia nigra had no effect on kindled seizures. It is suggested that the substantia nigra may intervene in a negative feedback system that tends to suppress the paroxysmal activity initiated from the amygdala.

Recovery of decreased glutamate decarboxylase immunoreactivity after rat hippocampal kindling.

The present study was designed to test the hypothesis that chronic gamma-aminobutyric acid (GABA) disinhibition of granule cells could explain permanent kindled epileptogenicity. Quantitative and statistical comparisons of glutamate decarboxylase immunoreactivity (GAD-IR), the synthesizing enzyme for GABA, were made of GAD-IR cells and puncta in stratum granulosum of the fascia dentata. The use of GAD immunocytochemistry in kindled and control tissue was used to allow direct anatomic confirmation that we were measuring changes in GAD-IR which would represent GABA synthesis for release by the recurrent inhibitory system of the fascia dentata. Immediately after the last kindled seizure, optically detected GAD-IR puncta densities were significantly reduced in stratum granulosum. At 3 or 7 days after the last kindled seizure, GAD-IR was normal in puncta, indicating that the transient GAD-IR loss was probably a metabolic response to the recent seizure represented by over-use of GAD needed for synthesis of GABA after a prolonged kindled seizure. When the prolonged kindled seizures were discontinued GAD-IR recovered in the puncta. This transient effect did not occur in other areas such as Ammon's horn (CA3) or substantia nigra. The extent of the GAD-IR loss showed no correlation with the severity of the final behavioral seizure (R = 0.23), or the final afterdischarge (AD) duration in entorhinal cortex (R = 0.17) or motor cortex (R = 0.53). A massed stimulation control group given 19 shorter-duration ADs every 10 min (non-kindling) did not reduce GAD-IR. These findings support the hypothetical model that prolonged kindled seizures release excessive GABA which depletes GAD in axon terminals for 1 day after the seizure. However, such a transient suppression of GAD-IR provides no evidence that disinhibition contributes to the kindling process, because kindling proceeds normally with inter-seizure intervals as long as 1 week. The finding of full recovery of GAD-IR within 1 week does not support the model of loss of GABA inhibition to explain the permanency of kindled epileptogenesis.

Increased susceptibility to hippocampal and amygdala kindling following intrahippocampal kainic acid.

The effects of unilateral intrahippocampal injection of kainic acid, a potent neuroexcitant and neurotoxin, on subsequent susceptibility to kindling of the contralateral hippocampus or contralateral amygdala were investigated in albino rats. At the chosen doses (0.20 to 1.25 micrograms dissolved in physiologic saline), the kainic acid-induced lesion was confined to the injected hippocampus and in two cases the ipsilateral entorhinal cortex; never were there contralateral lesions. Approximately 2 to 6 weeks post-injection, each animal received daily afterdischarge-producing electrical stimulations until stage 5 kindled limbic seizures occurred. Kindling in pretreated animals was significantly accelerated compared with controls; the hippocampal kindling rate decreased from 13.2 stimulations to 3.7, the amygdala kindling rate from 7.8 stimulations to 3.0. Many treated animals had first-stimulation stage 5 seizures, compared with none for controls. Importantly, this facilitation of kindling was not reversed by suppression of the acute, induced seizures with the anticonvulsants, diazepam and phenobarbital, which have repeatedly been demonstrated to effectively suppress limbic kindling. Such results, considered together with findings from the literature, suggest that partial kindling does not occur during kainic acid-induced seizures, and that the observed susceptibility to kindling and other epileptogenic agents subsequent to kainic acid treatment may in fact be related to neurophysiologic and neurochemical consequences of kainic acid-induced lesions.

Matrix metalloproteinases: potential therapeutic target in spinal cord injury.

Mediators of extracellular matrix proteins degradation, the matrix metalloproteinases (MMPs), involved in inflammation as well as facilitation of process outgrowth of oligodendrocytes are interesting targets for neural repair. Recent data reported their activation after seizures, cerebral ischemia and spinal cord injury. The present study was designed to localize at cellular level the gelatinase activity by in situ zymography in a rat spinal cord contusion model. The kinetic of gelatinase activation was monitored by in situ zymography on 20 microm cryostat sections. The fluorescein-quenched DQ gelatin digestion yielded cleaved fluorescent peptides enabling the detection of gelatinase activity at cellular level. Twenty four hours and 48 h after injury, a strong gelatinase activity was detected at the lesion site in and around vascular structures and infiltrated cells. A preincubation with either MMP-2 or MMP-9 antibodies significantly decreases the gelatinase activity pattern, suggesting the involvement of at least both MMPs. Our results are consistent with a role for MMPs in the blood spinal barrier disruption, the leukocytes infiltration, the disruption of the extracellular matrix and the clearance of debris.

Role of the amygdala in development of hippocampal kindling in the rat.

The influence that the amygdala may exert on the development of hippocampal kindling was investigated using three different approaches: (i) after uni- or bilateral amygdalectomy by thermocoagulation, (ii) after prestimulation of the amygdala until the appearance of masticatory movements, and (iii) after increasing the GABA concentration in the amygdala with gamma-vinyl GABA. Hippocampal kindling was not significantly modified in amygdalectomized animals. On the contrary, prestimulation of the ipsilateral amygdala facilitated the subsequent hippocampal kindling. Finally, microinjection of gamma-vinyl GABA in both amygdalae either reduced the seizures to a prekindled level or strongly delayed the appearance of the motor signs of kindling. It is suggested that hippocampal kindling may develop preferentially through the amygdala.

Biphasic response of spinal GABAergic neurons after a lumbar rhizotomy in the adult rat.

The expression of gamma-aminobutyric acid (GABA) and of the isoforms of the enzyme involved in its synthesis, glutamic acid decarboxylase (GAD), is modified in several rat brain structures in different injury models. The aim of the present work was to determine whether such plasticity of the GABAergic system also occurred in the deafferented adult rat spinal cord, a model where a major reorganization of neural circuits takes place. GABAergic expression following unilateral dorsal rhizotomy was studied by means of non-radioactive in situ hybridization to detect GAD67 mRNA and by immunohistochemistry to detect GAD67 protein and GABA. Three days following rhizotomy the number of GAD67 mRNA-expressing neurons was decreased in the superficial layers of the deafferented horn, while GABA immunostaining of axonal fibres located in this region was highly increased. Seven days after lesion, on the other hand, many GAD67 mRNA-expression neurons were bilaterally detected in deep dorsal and ventral layers, this expression being correlated with the increased detection of GAD67 immunostained somata and with the reduction of GABA immunostaining of axons. GABA immunostaining was frequently found to be associated with reactive astrocytes that exhibited intense immunostaining for glial fibrillary acidic protein (GFAP) but remained GAD67 negative. These results indicate that degeneration of afferent terminals induces a biphasic response of GABAergic spinal neurons located in the dorsal horn and show that many spinal neurons located in deeper regions re-express GAD67, suggesting a possible participation of the local GABAergic system in the reorganization of disturbed spinal networks.

Different distributions of GAD65 and GAD67 mRNAs suggest that the two glutamate decarboxylases play distinctive functional roles.

Two genes encode two forms of glutamate decarboxylase, GAD65 and GAD67. Because the two GADs differ in subcellular distribution and interactions with the cofactor pyridoxal phosphate, the two enzymes may play different roles in gamma-aminobutyric acid (GABA) production. In this study we have used in situ hybridization to compare the regional and cellular distributions of the two GAD mRNAs in rat brain. Both GAD mRNAs are abundant in olfactory bulb, olfactory tubercle, zona incerta, reticular nucleus of the thalamus, oculomotor nuclei, and pontine tegmental area. GAD65 mRNA is more abundant in several structures of the visual system, including the lateral geniculate nuclei, superior colliculi, and olivary pretectal nucleus, as well as in several hypothalamic and pontine nuclei. In contrast, GAD67 mRNA is more abundant in neocortex, the granular layer of olfactory bulb, lateral and medial septum, globus pallidus, inferior colliculi, and cerebellar cortex. Both GAD mRNAs are present in interneurons as well as in projection neurons, and both are present in neurons with different types of synapses, including dendrodendiritic, axosomatic, and axodendritic synapses. GAD65 mRNA predominates in the visual and the neuroendocrine systems, which are more subject to phasic changes, while GAD67 is present at relatively higher concentrations in many tonically active neurons. GAD65 and GAD67 together may provide more flexibility in the regulation of GABA synthesis than either could alone.

[Role of the hippocampus, amygdala and the substantia nigra in the evolution of status epilepticus induced by systemic injection of kainic acid in the rat]. / Rôle de l'hippocampe, de l'amygdale et de la substance noire dans l'évolution des états de mal épileptiques induits par injection systémique d'acide kaïnique chez le rat.

The effects of bilateral microinjection of gamma-vinyl GABA (GVG, an irreversible inhibitor of GABA-T) were tested during the development of seizures induced by i.p. administration of 10 mg/kg of kainic acid. Intrahippocampal injection of GVG prevents the development of the seizures at an early stage in about half of the cases. In the remaining animals status epilepticus comparable to that of controls develops. Intra-amygdaloid injection reduces the severity of the seizures from the first motor limbic signs. Finally, intranigral injection prevents the appearance of convulsive status epilepticus or, when it develops, reduces its duration. The role that these three structures could play in the electro-clinical development of kainic acid-induced seizures is discussed.

Transient increase in expression of a glutamate decarboxylase (GAD) mRNA during the postnatal development of the rat striatum.

We recently reported that the mammalian brain has two forms of the GABA synthetic enzyme glutamate decarboxylase (GAD, E.C. 4.1.1.15), which are the products of two genes. The two forms, which we call GAD65 and GAD67, differ from each other in sequence, molecular size, subcellular distribution, and interactions with the cofactor pyridoxal phosphate (PLP), with GAD65 activity more dependent than that of GAD67 on the continued presence of exogenous PLP. The existence of two GAD genes suggests that individual GABA neurons may be subject to differential regulation of GABA production. We have examined the expression of these two forms of GAD during postnatal development of the rat striatum to determine whether different classes of GABA neurons selectively express different amounts of the two GAD mRNAs. Here we present evidence for a dramatic developmental difference in the expression of the two mRNAs during postnatal development of the rat striatum. Using in situ hybridization to the two GAD mRNAs, we observed a selective increase in GAD65 mRNA during the second postnatal week, at the time when striatal matrix neurons innervate the substantia nigra (SN). PLP-dependent enzyme activity in the midbrain increases in parallel with increased expression of GAD65 mRNA in the striatum. We hypothesize that the innervation of the SN by striatal neurons triggers an increase in GAD65. The changing ratios of GAD65 and GAD67 in the striatum may contribute to the well-documented changes in seizure susceptibility that occur in early life.

Partial deafferentation of the developing rat spinal cord delays the spontaneous repression of GAD67 mRNAs in spinal cells.

Early and ubiquitous detection of GABA in the rat spinal cord before the occurrence of synaptogenesis has led to the concept of a neurotrophic role of GABA, in addition to a promoting effect on neurite extension and neurodevelopment. The aim of this study was to further establish, in vivo, evidence for a link between the maturation of spinal cord innervation and the regulation of several isoforms of the synthetic enzymes of GABA, the glutamic acid decarboxylases GAD65, GAD67, and EP10, the embryonic truncated form of GAD67. Neonatal capsaicin treatment was used to induce a specific loss of afferent fibers (unmyelinated C fibers, thin myelinated fibers A delta) to the dorsal horn. The regulation of various GAD mRNAs was investigated using sensitive techniques such as RT-PCR and in situ hybridization. The sensitivity of the methods was further enhanced by the use of a gaseous detector (beta-imager) to quantitate the mRNAs species. After neonatal capsaicin treatment, higher levels of GAD67 mRNA were detected transiently during the postnatal development of the rat spinal cord. A maximum two-fold increase of GAD67 mRNA was found on the day following the capsaicin injection and reached control values within 3 weeks. In contrast, GAD65 mRNA levels remained low and were unaffected by the treatment, and EP10 was not detected. In addition, we have found a similar upregulation, with the same time course, of the cytoskeletal protein beta-actin. The capsaicin-induction of mRNA synthesis was, however, two-fold greater for beta-actin than for GAD67. Moreover, since this upregulation of GAD67 mRNA coincides with the sprouting of unaffected afferent fibers and of 5HT axons, one can hypothesize that GAD67 participates in the structural plasticity occurring in reaction to the capsaicin-induced partial deafferentation.

Comparative distribution of GAD65 and GAD67 mRNAs and proteins in the rat spinal cord supports a differential regulation of these two glutamate decarboxylases in vivo.

Gamma-aminobutyric acid (GABA) synthesis can result from the action of at least two glutamic acid decarboxylase (GAD) isoforms, GAD65 and GAD67, possibly involved in distinct mechanisms. We have made the hypothesis that GAD65 may respond to short-term changes and is present in neurons with a phasic activity, while GAD67 may rather provide GABA for the metabolic pool and for supporting tonic levels of synaptic transmission (Erlander et al.: Neuron 7:91-100, 1991; Feldblum et al.: J Neurosci Res 34:689-706, 1993). In the present work we have tested this hypothesis in the rat spinal cord where both types of activities have been identified. The correlation of GABA immunodetection with the distribution of GAD65 and GAD67 mRNAs and proteins has evinced in the dorsal horn a differential regulation of the two isoforms. In situ hybridization has revealed, in the dorsal horn, relatively higher levels of GAD67 mRNA than of GAD65, while immunodetection of the proteins demonstrated numerous punctate profiles with both GAD antisera. Reverse transcription-polymerase chain reaction (RT-PCR) data confirmed the abundance of the GAD67 transcripts compared to GAD65 in the rat spinal cord. In contrast, within the ventral horn, there was a greter number of GAD67-immunoreactive (IR) profiles mostly located around motoneurons. The paucity of GAD65 immunoreactivity in the ventral horn cannot be related to a different accessibility of the antigens to the epitopes since on the same section a dense GAD65 staining was detected in the dorsal horn. Hence, a number of biochemical and electrophysiological data support the concept of the involvement of glycine as the major inhibitory system within the ventral horn which may explain the low levels of GAD transcription in this region. The paucity of GAD65 in the ventral horn may also reflect a functional difference, suggesting a predominance of GAD67 in neurons under tonic activity. In the dorsal horn, where neurons with phasic and tonic firing patterns have been disclosed, GAD65 may, in addition, provide GABA for responses to short-term changes.

Studies of wet-dog shake behavior induced by septohippocampal stimulation in the rat.

Stimulation of the septum and the hippocampus were found to elicit a great number of "wet-dog" shakes (WDS). Their occurrence is strongly related to the evocation and to the time course of the afterdischarges elicited by the stimulation. Morphine, apomorphine, diazepam, and antiserotoninergic drugs greatly reduce the incidence of these WDS but do not alter the afterdischarge duration. Based on electroencephalographic and pharmacological data we propose that WDS induced by stimulation of the septohippocampal system may share some common mechanisms with many other models inducing WDS and offer a useful method to study further the neuroanatomical substrate of this behavior.

Quinolinic-phosphoribosyl transferase activity is decreased in epileptic human brain tissue.

The presence of the excitotoxic and convulsant agent quinolinic acid (QUIN) in human brain has led to the hypothesis that an increase of this tryptophan metabolite could serve as an endogenous epileptogen. A possible mechanism for a pathological accumulation of QUIN being a deficiency in its degradation, we have measured the activity of quinolinic-phosphoribosyl transferase (QPRTase) (its first degradative enzyme) in stereo-EEG identified biopsies of human brain tissue. A specific reduction of QPRTase activity was observed in tissue primarily involved in the epileptic discharge compared to values from postmortem human brain tissue with no neurological disorders or nonpathological tissue from epileptic brains. A more severe decrease was noticed in the frontal and temporal cortices as compared to the amygdala or Ammon's horn. We suggest that this local deficit may contribute to the establishment or maintenance of an epileptic focus.