Mapping progressive loss of intracortical inhibition by TMS and EEG in posttraumatic epileptogenesis

通过 TMS 和 EEG 绘制创伤后癫痫发生过程中皮质内抑制的逐渐丧失

基本信息

批准号：
8888294
负责人：
Alexander Rotenberg
金额：
$ 36.92万
依托单位：
BOSTON CHILDREN'S HOSPITAL
依托单位国家：
美国
项目类别：
财政年份：
2015
资助国家：
美国
起止时间：
2015-03-01 至 2020-02-29
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8888294
关键词：
Acetylcysteine Adult Anatomy Animals Antiepileptogenic Antioxidants Biological Assay Biological Markers Biological Process Brain Brain Injuries Calcium-Binding Proteins Ceftriaxone Cells Cerebrum Cessation of life Clinical Clinical Trials Contralateral Data Depressed mood Detection Development Diagnostic Diagnostic Procedure Electroencephalography Epilepsy Epileptogenesis Frequencies Functional disorder Glutamates Goals Harvest Health Heterogeneity Human Individual Injury Interneurons Intervention Lateral Lead Limb structure Liquid substance Maps Measures Mediating Methods Modeling Motor Cortex Motor Evoked Potentials Muscle Neurologic Outcome Parvalbumins Pathologic Patients Percussion Physiologic pulse Post-Traumatic Epilepsy Process Protocols documentation Rattus Research Personnel Risk Seizures Skin Sorting - Cell Movement Stimulus Stress Tests Testing Time Tissues Transcranial magnetic stimulation Translating Traumatic Brain Injury Work base conditioning fluid percussion injury gamma-Aminobutyric Acid improved insight magnetic field new therapeutic target outcome forecast prevent prophylactic public health relevance research study response tool young adult

项目摘要

DESCRIPTION (provided by applicant): Cerebral injury often leads to epilepsy via epileptogenesis, the process by which the brain is transformed into an enduring state (epilepsy) characterized by repeated unprovoked seizures. Severe traumatic brain injury (TBI) is the most common example of epiletogenesis in young adults, and leads to epilepsy in 20-50% of instances. This epileptogenic period provides a window of opportunity where patients at risk for developing seizures may be identified, and where anti-epileptogenic therapy may be administered. Yet, there is no reliable clinical biomarker for epileptogenesis to identify whether epileptogenesis has started and how far it has advanced. Accordingly, the long-term goal of the proposed experiments is to use a rat epileptogenic TBI model to develop a safe, inexpensive and noninvasive electrophysiologic biomarker of epileptogenesis that is based on measures of cortical excitability by transcranial magnetic stimulation (TMS). As a secondary goal, we will test if similar measures can be obtained by cortical EEG. We recently developed methods for focal motor cortex TMS in rats, demonstrated that these reliably reflect the magnitude of GABA-mediated cortical inhibition, and showed that such inhibition is depressed in rat seizure models, including a model of posttraumatic epilepsy. Here we propose to use the rat lateral fluid percussion (LFP) possttraumatic epilepsy model to test (1) whether the loss of cortical inhibition is progressive in time during epileptogenesis, (2) whether loss of intracortical inhibition after injury can predict seizure onset, and (3) whether potentially reversible cellular changes such as loss of GABA-ergic interneurons underlie the TMS-derived measures of cortical inhibition loss. Although the proposed experiments are limited to a rat model of post-TBI epileptogenesis, we anticipate that the results will inform studies of TMS as a biomarker in other forms of epileptogenesis. Further, as we will record EEG in all animals, we will test whether gamma frequency EEG power, which also reflects the integrity of GABA-mediated cortical inhibition, can serve as an epileptogenesis biomarker. Since TMS and EEG are already in wide human use, we anticipate that favorable data from the proposed experiments will be rapidly translated to clinical trials in human TBI.

描述（由申请人证明）：脑损伤通常导致TOA癫痫发生，N持续状态（癫痫）的过程以重复未证实的癫痫发作为特征可以识别出有癫痫发作的癫痫病，并且抗癫痫病疗法可能会鉴定出癫痫发作支撑的经验用于开发癫痫生成的安全，廉价的电物质，该电源基于经颅磁刺激（TMS）的皮质兴奋性测量。如果可以通过皮质脑电图获得类似的措施，我们最近开发了大鼠焦点TMS的方法，反映了GABA介导的皮质抑制作用的大幅度，并表明这种厌食症，包括创伤后抑制作用的模型。在癫痫发生过程中，（2）丧失心脏内部损伤是否可以预测癫痫发作，以及（3）潜在的CERLAR是否会改变GABA-RGIC中间神经元的屁股，尽管提出的实验是皮质抑制的TMS衍生的ES。限于TBI癫痫发生的大鼠模型可以迅速转化为人类TBI的临床试验。