A Possible Causative Role for Blood–Brain Barrier Failure and Reactive Astrocytosis in Acquired Epilepsy

Abstract

Lasting Blood–Brain Barrier Disruption Induces Epileptic Focus in the Rat Somatosensory Cortex Seiffert E, Dreier JP, Ivens S, Bechmann I, Tomkins O, Heinemann U, Friedman A J Neurosci 2004;24:7829–7836 Perturbations in the integrity of the blood–brain barrier have been reported in both humans and animals under numerous pathologic conditions. Although the blood– brain barrier prevents the penetration of many blood constituents into the brain extracellular space, the effect of such perturbations on the brain function and their roles in the pathogenesis of cortical diseases are unknown. In this study, we established a model for focal disruption of the blood–brain barrier in the rat cortex by direct application of bile salts. Exposure of the cerebral cortex in vivo to bile salts resulted in long-lasting extravasation of serum albumin to the brain extracellular space and was associated with a prominent activation of astrocytes with no inflammatory response or marked cell loss. By using electrophysiological recordings in brain slices, we found that a focus of epileptiform discharges developed within 4 to 7 days after treatment and could be recorded up to 49 days postoperatively in more than 60% of slices from treated animals but only rarely (10%) in sham-operated controls. Epileptiform activity involved both glutamatergic and GABAergic neurotransmission. Epileptiform activity also was induced by direct cortical application of native serum, denatured serum, or albumin-containing solution. In contrast, perfusion with serum-adapted electrolyte solution did not induce abnormal activity, thereby suggesting that the exposure of the serum-devoid brain environment to serum proteins underlies epileptogenesis in the blood–brain barrier–disrupted cortex. Although many neuropathologies entail a compromised blood–brain barrier, this is the first direct evidence that it may have a role in the pathogenesis of focal cortical epilepsy, a common neurologic disease.