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Laboratoire de Neurophysiologie, Faculté de Médecine, Université Laval, Québec, Canada
Submitted 14 July 2005; accepted in final form 17 October 2005
| ABSTRACT |
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| INTRODUCTION |
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The origin of these seizures is unclear. Computational models of posttraumatic epileptogenesis in isolated cortical islands concluded that paroxysmal discharges possibly arise from changes in intrinsic properties of pyramidal cells and enhanced excitatory synaptic conductances without altering synaptic inhibition (Bush et al. 1999
; Houweling et al. 2005
). In vitro experimental studies on models of acute and chronic cortical deafferentation revealed an increased synaptic and intrinsic neuronal responsiveness after decrease in input signal (Prince and Tseng 1993
; Prince et al. 1997
; Turrigiano et al. 1998
), which may favor the development of epileptogenesis. After a few days of pharmacological blockade of activity in cortical cell cultures, the amplitudes of excitatory postsynaptic currents (EPSCs) and miniature EPSCs (mEPSCs) in pyramidal cells increase (Turrigiano et al. 1998
; Watt et al. 2000
) as well as the quantal release probability (Murthy et al. 2001
). Synaptic scaling occurs in part postsynaptically by changes in the number of open channels (Turrigiano et al. 1998
; Watt et al. 2000
), although all synaptic components may increase (Murthy et al. 2001
), including the numbers of postsynaptic glutamate receptors (Liao et al. 1999
; Lissin et al. 1998
; O'Brien et al. 1998
; Rao and Craig 1997
).
There is a similar activity-dependent regulation of N-methyl-D-aspartate (NMDA) currents (Watt et al. 2000
). Interestingly, miniature inhibitory postsynaptic currents (mIPSCs) are scaled down with activity blockade, in the opposite direction to excitatory currents. This effect is reversible (Rutherford et al. 1997
) and is accompanied by a reduction in the number of open
-aminobutyric acid type A (GABAA) channels and GABAA receptors clustered at synaptic sites (Kilman et al. 2002
). Not only synaptic but also intrinsic excitability is regulated by activity. After chronic activity blockade, Na+ currents increase and K+ currents decrease in size, resulting in an enhanced responsiveness of pyramidal cells to current injections (Desai et al. 1999b
). These observations suggest that homeostatic mechanism may regulate the average levels of neuronal activity. Some of these processes, collectively termed "homeostatic plasticity" (Turrigiano 1999
), may also occur in vivo (Desai et al. 2002
). Thus we hypothesized that deafferentation caused by the trauma may upregulate neuronal and network excitability, leading to seizures.
Acute experiments performed in vivo showed that partially deafferented neocortex displays increased local cortical synchrony in areas surrounding the undercut cortex, leading to paroxysmal activity that occurs 23 h after the undercut and arises from enhanced intrinsic and synaptic neuronal responsiveness, increased incidence of intrinsically bursting neurons, and slight reduction of inhibitory influences (Topolnik et al. 2003a
,b
). We have now investigated the evolution of electrical paroxysms after cortical deafferentation (induced by penetrating wound piercing the dural membrane)
5 wk after the undercut, to determine the spatiotemporal development of posttraumatic seizures with respect to the initial cortical insult, and to quantify at different stages the transformation from the normal sleeplike slow oscillation (0.51 Hz) to increased amplitudes of phases building up this cortical rhythm, eventually reaching the level of paroxysmal activity.
| METHODS |
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Experiments were performed on 33 adult cats of both sexes. Surgical procedures were carried out under sterile conditions, after a premedication with acepromazine [0.3 mg/kg, administered intramuscularly (im)], butorphanol (0.3 mg/kg im), atropine (0.05 mg/kg im), and ketamine (20 mg/kg im), under isoflurane anesthesia (12%). The level of anesthesia was continuously monitored by the EEG, heart rate, oxygen saturation of the arterial blood (aiming over 90%), and end-tidal CO2 (about 3.5%). Isoflurane concentration was adjusted correspondingly to maintain a cardiac frequency at 90110 beats/min. General surgical procedures included: cephalic vein cannulation for systemic liquid delivery (lactated Ringer solution 510 ml · kg1 · h1) and lidocaine (0.5%), infiltration of all pressure points or incision lines. Body temperature was maintained at 3739°C with a heating pad.
A craniotomy was used to expose the cerebral cortex and a large undercut of the white matter below the suprasylvian gyrus (1315 mm posteroanteriorly and 34 mm mediolaterally) was used to produce partial cortical deafferentation (Fig. 1). A custom-designed knife was inserted in the posterior part of suprasylvian gyrus perpendicular to its surface for a depth of 34 mm, then rotated 90° and advanced rostrally along the gyrus parallel to its surface for a total distance of 1315 mm, then moved back, rotated 90°, and removed from the same place where it was entered. Thus the anterior part of the undercut cortex was relatively intact because it had preserved intracortical connectivity and ascending and descending connections were only partially damaged, whereas the white matter below the posterior part of the gyrus was completely transected, creating conditions of partial cortical deafferentation. The skull was reconstituted using acrylic dental cement and the skin of the scalp sutured. Animals were kept under observation up to full recovery and they received analgesic medication (anafen 2 mg/kg, subcutaneously) for the next 4872 h.
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At different time intervals after the initial surgery, the different subgroups of animals were anesthetized with ketamine and xylazine (1015 mg/kg and 23 mg/kg, respectively, im) and recorded at 1 wk from the undercut (W1, n = 5), 2 wk (W2, n = 5), 3 wk (W3, n = 5), 4 wk (W4, n = 5), and 5 wk (W5, n = 5). Control recordings were performed under ketamine and xylazine anesthesia in cats with no deafferentation of the suprasylvian gyrus (n = 4) at W1 after the sham surgical procedures. In addition, electrophysiological experiments were done on two cats at W1 and two cats at W5 anesthetized with sodium pentobarbital (30 mg/kg). EEG and heart rate were monitored continuously to maintain the anesthesia, and additional doses of anesthetic were given at the slightest tendency toward an activated EEG pattern or accelerated heart rate. All pressure points to be incised were infiltrated with lidocaine (0.5%). Muscle paralysis was induced with gallamine triethiodide and artificial ventilation (2030 cycles/min) maintained the end-tidal CO2 concentration around 3.5 ± 0.4%. The craniotomy holes exposed the cerebral cortex and allowed the insertion of recording electrodes. Cisternal drainage, hip suspension, pneumothorax, and filling of the hole in the skull with a 4% solution of agar were used to enhance the stability of the intracellular recordings. Body temperature was maintained at 3739°C and glucose (5% solution) was administered intravenously (iv) every 34 h during experiments. At the end of experiments, the cats were given a lethal dose of sodium pentobarbital (50 mg/kg, iv). After experiments brains were removed and the extension of the undercut was verified on Nissl-stained (thionine) 80-µm brain sections (Fig. 1B). The location of recording electrodes relative to the undercut was evaluated using electrolytic lesions produced by a 20-mA continuous DC current for 1 min applied at the end of the experiments (Fig. 1C). All experimental procedures were approved by the committee for animal care of Laval University and in accordance with the guidelines published in the National Institutes of Health Guide for the Care and Use of Laboratory Animals.
Extracellular recordings
Field potential (EEG) recordings were obtained by means of an array of eight monopolar tungsten electrodes (impedance 812 M
), about 2.5 mm apart, placed on the whole length of the suprasylvian gyrus at a depth of about 1.5 mm (Fig. 1A). The reference electrode was fixed to the neck muscles. We stereotaxically positioned the array of electrodes to have two electrodes in the relatively intact cortex, two electrodes over the area corresponding to the anterior limit of the undercut, and four electrodes in the deafferented cortex.
Intracellular recordings
Intracellular recordings in the partially deafferented area 21 and relatively intact area 5 of the suprasylvian gyrus were obtained with glass micropipettes (tip diameter <0.5 µm) filled with potassium acetate (3 M, in situ impedance 3550 M
). Only stable recordings with resting membrane potentials more negative than 60 mV and overshooting action potentials were accepted for analysis. The intracellular signals were passed through a high-impedance amplifier with an active bridge circuitry (bandwidth DC to 9 kHz). All signals were digitized (20-kHz sampling rate) and stored for off-line analysis.
Data analysis
Data analysis was performed using Wavemetrics's Igor Pro software. To estimate changes in slow-wave activities after cortical undercut, the power in the 0- to 4-Hz range was quantified by the area under the graph of the fast Fourier transform (FFT) of field EEGs. The EEG amplitude was estimated from 1-min artifact-free periods as a difference between the most positive and most negative values. Means of comparative data were statistically evaluated with paired Student's t-test. Differences between means were considered significant at P < 0.05. Auto- and cross-correlograms of different EEG channels were computed from periods of 23 min of stable activity and averaged for each different group (see Fig. 7B). The electrode where the seizures first occurred was taken as time reference. Time delays extracted from serial cross-correlograms between EEG electrodes, computed on successive 1-s epochs of filtered EEG (010 Hz), were averaged for each experiment and between experiments and used to calculate the speed of propagation.
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| RESULTS |
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The normal slow cortical oscillation (<1 Hz) constitutes two different activity levels: an active ("up") state in which cortical neurons are depolarized and tonically fire action potentials, and a silent ("down") state in which cortical neurons are hyperpolarized by a disfacilitation process (Contreras et al. 1996
; Steriade et al. 1993
).
All cats with chronic cortical deafferentation displayed a paroxysmal pattern of the slow oscillation, different from the one observed in cats with intact suprasylvian gyrus (Fig. 2A). More than 90% of animals anesthetized with ketaminexylazine (23 out of 25) displayed low-frequency SW and polyspike-wave (PSW) complexes (34 Hz), intermingled with fast runs (1020 Hz), which were similar to the waveforms seen in humans with severe epileptic encephalopathies (Fig. 2B). One of the two cats that did not develop seizures was part of the W1 group and the other part of the W2 group.
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It is known that ketaminexylazine anesthesia favors development of seizures (Steriade and Contreras 1995
; Steriade et al. 1998
); however, the proportion of anesthetized animals with acute undercut (Topolnik et al. 2003b
) and chronic undercut (present study) displaying seizures is much higher. To completely avoid the influence of ketaminexylazine anesthesia on the development of paroxysmal activities, we recorded electrical activities from four cats with cortical undercut, anesthetized with barbiturates (two on them at W1 and the other two at W5). Barbiturates enhance GABAergic inhibition by prolongation of time of opening of Cl channels (Twyman et al. 1989
). Similarly to our previous study (Topolnik et al. 2003b
), we did not expect to see the development of full-scale seizures in those experiments, but we expected to see an enhanced activity in areas surrounding the undercut cortex. This was indeed the case in W1 animals (not shown). W5 animals revealed some different patterns (Fig. 3). During the early phases of anesthesia, in the relatively intact anterior part of suprasylvian gyrus, spindle activity was prominent, whereas it was absent in the partially deafferented areas. In the partially deafferented areas field potentials demonstrated aperiodic, asynchronous EEG "spikes" (see arrowheads in expended parts of Fig. 3A). Five to 8 h later, when the level of anesthesia decreased, the activity in the relatively intact areas was dominated by 2- to 3-Hz paroxysmal discharges that merged with spindle oscillations (Fig. 3B). Probably, the barbiturate-related enhancement of inhibition prevented propagation of paroxysmal activities into partially deafferented cortical areas. Isolated EEG spikes still persisted in the partially deafferented cortex (Fig. 3B, EEG7).
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Out of 38 neurons recorded intracellularly, 12 were recorded from the anterior part of the undercut, before the occurrence of overt SW/PSW seizures. The intracellular recording in the chronic deafferented cortex (Fig. 6) contained normal periods of slow oscillation (expanded in left) alternating with periods of paroxysmal slow activities. During paroxysmal-like activities the Vm of neurons revealed slight (2.6 ± 1.4 mV) depolarization calculated from the maximum of membrane potential distribution (Fig. 6E). This depolarization was accompanied with increased firing rates and reduction in action potential amplitudes. The other two distinct features were the presence of brisk hyperpolarizing waves (100300 ms) and spontaneous bursts action potential generated by regular-spiking neurons (see Fig. 6, inset). The cell's bursts were revealed by short intervals (510 ms) in the interspike histogram (see Fig. 6D) and were absent during normal spontaneous activities.
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In all cases the seizures started, and their amplitudes were most conspicuous, in the anterior part of the suprasylvian gyrus (electrodes EEG1 to EEG4), and propagated to the deafferented cortex (Fig. 7A). Usually, seizures started with SW/PSW complexes at 23 Hz, followed by episodes of fast runs at 1020 Hz. Cross-correlation between activities recorded through different electrodes indicated a distinctive time-lag range between the electrodes during slow oscillation, as compared with SW/PSW discharges (Fig. 7B). The time lags between activities recorded from different cortical sites ranged from about 6 to nearly 190 ms and were shorter during SW/PSW seizures than during propagation of the cortical slow oscillation (Fig. 7B). Pooled data from all animals (five cats in each week, from W1 to W5) showed that the velocity in activity propagation for 0- to 10-Hz frequencies in the undercut cortex increased from W1 to W5, both during the slow oscillation (from 0.063 ± 0.004 to 0.3257 ± 0.0404 m/s between EEG4 and EEG8) and seizures (from 0.1182 ± 0.006 to 0.7751 ± 0.3107 m/s between EEG4 and EEG8); and the time lag of propagation was persistently shorter during SW/PSW seizures compared with that during the slow oscillation (Fig. 8). The level of correlation between the electrodes followed the same rule: it increased for both condition from W1 to W5 and it was steadily greater during SW/PSW seizures than during the slow oscillation (not shown).
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The average membrane resistances of recorded neurons were 19.3 ± 7.5 M
(ranging from 13.5 to 32.7 M
) in W1, 20.2 ± 9.6 M
(ranging from 16.2 to 37.3 M
) in W2, 18.5 ± 8.2 M
(ranging from 14.9 to 40.4 M
) in W3, 21.3 ± 5.7 M
(ranging from 15.5 to 28.6 M
) in W4, and 23.1 ± 9.4 M
(ranging from 15.1 to 33.2 M
) in W5. The differences were not statistically significant (Student t-test, P < 0.05) either between the different groups or compared with previously reported values from in vivo acute preparations (Topolnik et al. 2003a
).
| DISCUSSION |
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The ketaminexylazine anesthesia used in this study induced a sleeplike slow oscillation, which is similar to that recorded during natural sleep in cats and humans (Achermann and Borbély 1997
; Amzica and Steriade 1997
; Massimini et al. 2004
; Mölle et al. 2002
; Steriade et al. 1993
). Under this type of anesthesia, 2030% of animals can spontaneously develop seizures with SW/PSW complexes (Steriade and Contreras 1995
; Steriade et al. 1998
). However, the present and previous data rule out the main contribution of ketaminexylazine anesthesia in the generation of seizures that followed cortical deafferentation, based on: 1) the much higher percentage (>90%) of seizures after the undercut, compared with the incidence of such paroxysms previously observed in the nonlesioned cortex (2030%); 2) the presence in all recorded animals of a peculiar pattern of slow oscillation, containing alternating periods of normal activity and periods with paroxysmal oscillation in the 0- to 4-Hz domain (Fig. 2B, W5), which was never observed in previous experiments conducted under the same anesthesia, but without chronic cortical deafferentation; and 3) the highly increased amplitudes and sharp waves after cortical undercut in animals under barbiturate anesthesia (Fig. 3), whereas barbiturates normally prevent the occurrence of seizures by enhancing GABAergic inhibitory processes. The transformation of the slow oscillation into SW/PSW seizures was shown by the preferential occurrence of these paroxysms during slow-wave sleep and by similar relations between field and intracellular activities during slow oscillation and epochs with SW/PSW seizures (see also Fig. 4).
Several factors may account for the increased propensity to seizures after the cortical insult produced by undercut. Although acute epileptogenesis arising from increased [K+]o (Moody et al. 1974
) may be partially explained by the K+-mediated increase in the hyperpolarization-activated depolarizing current (IH) that leads to paroxysmal activity in neocortical networks (Timofeev et al. 2002
), the progressively increased power of seizures over time, up to 5 wk after undercut (present data), would not favor the same mechanism. The same reasoning may apply to changes in extracellular glutamate that is increased after cortical trauma and was reported to promote epileptogenesis (Sakowitz et al. 2002
). The changes in intrinsic neuronal properties after cortical injury or undercut, leading to seizures, have been first studied in vitro and some of these results have been corroborated in vivo. Prince and Tseng (1993)
compared layer V neurons of epileptogenic slices with those in control slices and found no significant differences in action potential characteristics and resting Vm, but the value of input resistance (Rin) was more than double in injured than in control slices. The increased Rin of neurons recorded from epileptogenic slices is likely behind the increased intrinsic and synaptic responsiveness found in neurons recorded from the relatively intact suprasylvian cortex, at which level seizures are initiated after acute deafferentation in vivo (Topolnik et al. 2003a
). This result fits in well with injury-induced enhanced responsiveness of corticospinal neurons after their axotomy (Tseng and Prince 1996
) and with the increased synaptic and intrinsic responses of cultured cortical neurons during chronic absence of spontaneous activity (Desai et al. 1999a
; Turrigiano et al. 1998
). Trauma-induced chronic hyperexcitability and focal epileptogenesis could occur when homeostatic plasticity mechanisms upregulate processes leading to increased excitability (Houweling et al. 2005
). The high Rin, shown to characterize neurons in epileptogenic slices (Prince and Tseng 1993
), is probably a factor promoting seizures by favoring transformation of regular-spiking into intrinsically bursting neurons whose incidence is much higher in disconnected cortical slabs in vivo (Timofeev et al. 2000
) and in cortical slices in vitro (Nishimura et al. 2001
) than that in the intact cortex (Steriade et al. 2001
). Besides the above-mentioned changes in intrinsic properties, a shift in the balance between inhibitory and excitatory processes may be changed toward excitation because, in parallel experiments using immunohistochemical staining with GAD65 and 67 and anti-GABA antibodies, we detected an apparent reduction in GABAergic neurons in disconnected cortical areas (unpublished data). The presence of normal inhibitory connectivity in more intact cortical areas may favor spatial localization of excitatory neuronal networks and thus prevent generalized epileptogenesis (Traub and Wong 1982
).
The above changes explain, at least partially, the increased synchrony and shorter time-delay propagation of low-frequency (slow oscillation and seizure) activities after cortical undercut. High-density EEG recordings of the slow sleep oscillatory waves in the human cortex indicate a wide range of conduction velocities, 1.2 to 7 m/s (Massimini et al. 2004
). The present data indicate that, after deafferentation, the slow oscillation propagates with progressively shorter time lags from W1 to W5 (see Fig. 7B). The increased velocity of signal propagation indicates an increased neuronal excitability. Multisite field potential and intracellular recordings have shown that cortically generated SW seizures propagate from one to another area in the suprasylvian gyrus through mono-, oligo-, and multisynaptic linkages (Amzica and Steriade 1995
; Neckelmann et al. 1998
). After cortical undercut, the propagation of paroxysmal activity is also progressively shorter from W1 to W5 (Fig. 7B).
In summary, after partial deafferentation the neocortex displays progressively increased signs of paroxysmal activity, reflected in paroxysmal-like patterns of the slow oscillation and progressively enhanced amplitudes and synchrony of SW/PSW seizures, which are however relatively localized within disconnected territories adjacent to the relatively intact cortex.
| GRANTS |
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| ACKNOWLEDGMENTS |
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| FOOTNOTES |
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Address for reprint requests and other correspondence: M. Steriade, Laboratoire de Neurophysiologie, Faculté de Médecine, Université Laval, Québec, Canada G1K 7P4 (E-mail: mircea.steriade{at}phs.ulaval.ca)
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