Review: Molecular characteristics of long-term epilepsy-associated tumours (LEATs) and mechanisms for tumour-related epilepsy (TRE).

Brain tumours are the second most common cause of seizures identified in epilepsy surgical series. While any tumour involving the brain has the potential to cause seizures, specific subtypes are more frequently associated with epilepsy. Tumour-related epilepsy (TRE) has a profound impact on patients with brain tumours and these seizures are often refractory to anti-epileptic treatments, resulting in long-term disability and patient morbidity. Despite the drastic impact of epilepsy-associated tumours on patients, they have not traditionally enjoyed as much attention as more malignant neoplasms. However, recently a number of developments have been achieved towards further understanding of the molecular and developmental backgrounds of specific epilepsy-associated tumours. In addition, the past decade has seen an expansion in the literature on the pathophysiology of TRE. In this review, we aim to summarize the mechanisms by which tumours may cause seizures and detail recent data regarding the pathogenesis of specific developmental epilepsy-associated tumours.

Neuronal metabolism governs cortical network response state.

The level of arousal in mammals is correlated with metabolic state and specific patterns of cortical neuronal responsivity. In particular, rhythmic transitions between periods of high activity (up phases) and low activity (down phases) vary between wakefulness and deep sleep/anesthesia. Current opinion about changes in cortical response state between sleep and wakefulness is split between neuronal network-mediated mechanisms and neuronal metabolism-related mechanisms. Here, we demonstrate that slow oscillations in network state are a consequence of interactions between both mechanisms. Specifically, recurrent networks of excitatory neurons, whose membrane potential is partly governed by ATP-modulated potassium (K(ATP)) channels, mediate response-state oscillations via the interaction between excitatory network activity involving slow, kainate receptor-mediated events and the resulting activation of ATP-dependent homeostatic mechanisms. These findings suggest that K(ATP) channels function as an interface between neuronal metabolic state and network responsivity in mammalian cortex.

Dendrotoxin sensitive potassium channels modulate GABA but not glutamate release in the rat entorhinal cortex in vitro.

We have previously shown that the anticonvulsant drug, phenytoin, increases the frequency and amplitude of spontaneous inhibitory postsynaptic currents at GABA synapses on principal neurones in the rat entorhinal cortex. This effect is similar to that seen at other GABA synapses following blockade of voltage-gated potassium channels (Kv1.1, 1.2 and 1.6) with alpha-dendrotoxin. In the present study we examined whether dendrotoxins can alter GABA release at synapses in the entorhinal cortex. We recorded spontaneous inhibitory postsynaptic currents using whole cell voltage clamp techniques in slices of rat entorhinal cortex in vitro. alpha-Dendrotoxin evoked an increase in frequency and amplitude of spontaneous inhibitory postsynaptic currents, an effect that was blocked by prior perfusion with tetrodotoxin. The effect of the toxin did not occlude the increase in spontaneous inhibitory postsynaptic currents seen with phenytoin. Indeed, the effect of the two drugs together was, at least, additive on GABA release. Perfusion with the specific Kv1.1 blocker, dendrotoxin-K had no effect on GABA release. In addition, alpha-dendrotoxin had no effect on frequency or amplitude of spontaneous excitatory postsynaptic currents at glutamate synapses on entorhinal cortex neurones. We conclude that K-channels containing the Kv1.2 and/or 1.6 subunits modulate the release of GABA, but not glutamate in the entorhinal cortex. The modulation of GABA release by phenytoin is unlikely to be due to an effect on these channels.