GluN2A NMDA Receptor Enhancement Improves Brain Oscillations, Synchrony, and Cognitive Functions in Dravet Syndrome and Alzheimer's Disease Models.

NMDA receptors (NMDARs) play subunit-specific roles in synaptic function and are implicated in neuropsychiatric and neurodegenerative disorders. However, the in vivo consequences and therapeutic potential of pharmacologically enhancing NMDAR function via allosteric modulation are largely unknown. We examine the in vivo effects of GNE-0723, a positive allosteric modulator of GluN2A-subunit-containing NMDARs, on brain network and cognitive functions in mouse models of Dravet syndrome (DS) and Alzheimer's disease (AD). GNE-0723 use dependently potentiates synaptic NMDA receptor currents and reduces brain oscillation power with a predominant effect on low-frequency (12-20 Hz) oscillations. Interestingly, DS and AD mouse models display aberrant low-frequency oscillatory power that is tightly correlated with network hypersynchrony. GNE-0723 treatment reduces aberrant low-frequency oscillations and epileptiform discharges and improves cognitive functions in DS and AD mouse models. GluN2A-subunit-containing NMDAR enhancers may have therapeutic benefits in brain disorders with network hypersynchrony and cognitive impairments.

A New Computational Model for Neuro-Glio-Vascular Coupling: Astrocyte Activation Can Explain Cerebral Blood Flow Nonlinear Response to Interictal Events.

Developing a clear understanding of the relationship between cerebral blood flow (CBF) response and neuronal activity is of significant importance because CBF increase is essential to the health of neurons, for instance through oxygen supply. This relationship can be investigated by analyzing multimodal (fMRI, PET, laser Doppler…) recordings. However, the important number of intermediate (non-observable) variables involved in the underlying neurovascular coupling makes the discovery of mechanisms all the more difficult from the sole multimodal data. We present a new computational model developed at the population scale (voxel) with physiologically relevant but simple equations to facilitate the interpretation of regional multimodal recordings. This model links neuronal activity to regional CBF dynamics through neuro-glio-vascular coupling. This coupling involves a population of glial cells called astrocytes via their role in neurotransmitter (glutamate and GABA) recycling and their impact on neighboring vessels. In epilepsy, neuronal networks generate epileptiform discharges, leading to variations in astrocytic and CBF dynamics. In this study, we took advantage of these large variations in neuronal activity magnitude to test the capacity of our model to reproduce experimental data. We compared simulations from our model with isolated epileptiform events, which were obtained in vivo by simultaneous local field potential and laser Doppler recordings in rats after local bicuculline injection. We showed a predominant neuronal contribution for low level discharges and a significant astrocytic contribution for higher level discharges. Besides, neuronal contribution to CBF was linear while astrocytic contribution was nonlinear. Results thus indicate that the relationship between neuronal activity and CBF magnitudes can be nonlinear for isolated events and that this nonlinearity is due to astrocytic activity, highlighting the importance of astrocytes in the interpretation of regional recordings.

Interneurons contribute to the hemodynamic/metabolic response to epileptiform discharges.

Interpretation of hemodynamic responses in epilepsy is hampered by an incomplete understanding of the underlying neurovascular coupling, especially the contributions of excitation and inhibition. We made simultaneous multimodal recordings of local field potentials (LFPs), firing of individual neurons, blood flow, and oxygen level in the somatosensory cortex of anesthetized rats. Epileptiform discharges induced by bicuculline injections were used to trigger large local events. LFP and blood flow were robustly coupled, as were LFP and tissue oxygen. In a parametric linear model, LFP and the baseline activities of cerebral blood flow and tissue partial oxygen tension contributed significantly to blood flow and oxygen responses. In an analysis of recordings from 402 neurons, blood flow/tissue oxygen correlated with the discharge of putative interneurons but not of principal cells. Our results show that interneuron activity is important in the vascular and metabolic responses during epileptiform discharges.

Neural adaptation to responsive stimulation: a comparison of auditory and deep brain stimulation in a rat model of absence epilepsy.

BACKGROUND: Responsive deep brain stimulation (rDBS) has been recently proposed to block epileptic seizures at onset. Yet, long-term stability of brain responses to such kind of stimulation is not known. OBJECTIVE: To quantify the neural adaptation to repeated rDBS as measured by the changes of anti-epileptic efficacy of bilateral DBS of the substantia nigra pars reticulata (SNr) versus auditory stimulation, in a rat model of spontaneous recurrent absence seizures (GAERS). METHODS: Local field potentials (LFP) were recorded in freely moving animals during 1 h up to 24 h under automated responsive stimulations (SNr-DBS and auditory). Comparison of seizure features was used to characterise transient (repetition-suppression effect) and long-lasting (stability of anti-epileptic efficacy, i.e. ratio of successfully interrupted seizures) effects of responsive stimulations. RESULTS: SNr-DBS was more efficient than auditory stimulation in blocking seizures (97% vs. 52% of seizures interrupted, respectively). Sensitivity to minimal interstimulus interval was much stronger for SNr-DBS than for auditory stimulation. Anti-epileptic efficacy of SNr-DBS was remarkably stable during long-term (24 h) recordings. CONCLUSIONS: In the GAERS model, we demonstrated the superiority of SNr-DBS to suppress seizures, as compared to auditory stimulation. Importantly, we found no long-term habituation to rDBS. However, when seizure recurrence was frequent, rDBS lack anti-epileptic efficacy because responsive stimulations became too close (time interval < 40 s) suggesting the existence of a refractory period. This study thus motivates the use of automated rDBS in patients having transient seizures separated by sufficiently long intervals.

Manipulating the epileptic brain using stimulation: a review of experimental and clinical studies.

Neurostimulation represents an interesting alternative therapy for patients resistant to drug treatment or who cannot benefit from resective surgery. Theoretically, neurostimulation allows the control of seizures to be tailored to the individual patient and specific form of epilepsy. Here, we review both experimental and clinical studies that have reported the possible control of epileptic seizures by means of different approaches using electrical stimulation (vagus nerve stimulation, deep brain stimulation and repetitive transcranial magnetic stimulation). The rationale for targeting specific areas that have thus far been considered (i.e., vagus nerve, cerebellum, anterior or centromedial thalamus, basal ganglia, cortex and temporal lobe) is addressed in the light of experimental data and clinical effectiveness in different models and forms of epilepsy. The type of seizures that can be considered for neurostimulation, as well as the optimal parameters such as stimulation frequency and modes of stimulation (chronic, continuous or adaptative), are discussed to determine the best candidates for such a therapeutic strategy. This review points out the need for improved knowledge of neural circuits that generate seizures and/or allow their propagation, as well as a better understanding of the mechanisms of action of neurostimulation.

Identifying neural drivers with functional MRI: an electrophysiological validation.

Whether functional magnetic resonance imaging (fMRI) allows the identification of neural drivers remains an open question of particular importance to refine physiological and neuropsychological models of the brain, and/or to understand neurophysiopathology. Here, in a rat model of absence epilepsy showing spontaneous spike-and-wave discharges originating from the first somatosensory cortex (S1BF), we performed simultaneous electroencephalographic (EEG) and fMRI measurements, and subsequent intracerebral EEG (iEEG) recordings in regions strongly activated in fMRI (S1BF, thalamus, and striatum). fMRI connectivity was determined from fMRI time series directly and from hidden state variables using a measure of Granger causality and Dynamic Causal Modelling that relates synaptic activity to fMRI. fMRI connectivity was compared to directed functional coupling estimated from iEEG using asymmetry in generalised synchronisation metrics. The neural driver of spike-and-wave discharges was estimated in S1BF from iEEG, and from fMRI only when hemodynamic effects were explicitly removed. Functional connectivity analysis applied directly on fMRI signals failed because hemodynamics varied between regions, rendering temporal precedence irrelevant. This paper provides the first experimental substantiation of the theoretical possibility to improve interregional coupling estimation from hidden neural states of fMRI. As such, it has important implications for future studies on brain connectivity using functional neuroimaging.

Activity of ventral medial thalamic neurons during absence seizures and modulation of cortical paroxysms by the nigrothalamic pathway.

Absence seizures are characterized by bilaterally synchronous spike-and-wave discharges (SWDs) in the electroencephalogram, which reflect abnormal oscillations in corticothalamic networks. Although it was suggested that basal ganglia could modulate, via their feedback circuits to the cerebral cortex, the occurrence of SWDs, the cellular and network mechanisms underlying such a subcortical control of absence seizures remain unknown. The GABAergic projections from substantia nigra pars reticulata (SNR) to thalamocortical neurons of the ventral medial (VM) thalamic nucleus provide a potent network for the control of absence seizures by basal ganglia. The present in vivo study provides the first description of the activity of VM thalamic neurons during seizures in the genetic absence epilepsy rats from Strasbourg, a well established model of absence epilepsy. Cortical paroxysms were accompanied in VM thalamic neurons by rhythmic bursts of action potentials. Pharmacological blockade of excitatory inputs of nigrothalamic neurons led to a transient interruption of SWDs, correlated with a change in the activity of thalamic cells, which was increased in frequency and converted into a sustained arrhythmic firing pattern. Simultaneously, cortical neurons exhibited a decrease in their firing rate that was associated with an increase in membrane polarization and a decrease in input resistance. These new findings demonstrate that an inhibition of SNR neurons changes the activity of their thalamic targets, which in turn could affect cortical neurons excitability and, consequently, the generation of cortical epileptic discharges. Thus, the nigro-thalamo-cortical pathway may provide an on-line system control of absence seizures.