Abstract
Epilepsy is a common neurological disorder, about 1% population worldwide suffered from this disease. In 1989, the International League Against Epilepsy (ILAE) classified anterior cingulate epilepsy as a form of frontal lobe epilepsy (FLE). FLE is the second most common type of epilepsy. Previous clinical studies showed that FLE account an important cause in refractory epilepsy, therefore to find alternative approach to modulate FLE is very important. Basic research using animal models and brain slice have revealed some insights on the epileptogenesis and modulation of seizure in anterior cingulate cortex (ACC). Interneurons play an important role in the synchronization of cingulate epilepsy. Research has shown that the epileptogenesis of seizure originated from mesial frontal lobe might be caused by a selective increase in nicotine-evoked γ-aminobutyric acid (GABA) inhibition, because the application of the GABAA receptor antagonist picrotoxin inhibited epileptic discharges. Gap junctions are also involved in the regulation of cingulate epilepsy. Previous studies have shown that the application of gap junction blockers could attenuate ACC seizures, while gap junction opener could enhance them in an in vitro preparation. μ-Opioid receptors have been shown to be involved in the epileptic synchronization mechanism in ACC seizures in a brain slice preparation. Application of the μ-opioid agonist DAMGO significantly abolished the ictal discharges in a 4-aminopyridine induced electrographic seizure model in ACC. Basic research has also found that thalamic modulation has an inhibitory effect on ACC seizures. Studies have shown that the medial thalamus may be a target for deep brain stimulation to cure ACC seizures.
Highlights
Seizure is a common neurological disorder that affects approximately 1% of the population worldwide
Previous studies showed that the hypersynchrony of GABAergic transmission is involved in anterior cingulate cortex (ACC) seizures (Panuccio et al, 2009). These results indicate that the balance between excitatory and inhibitory transmission is very important in seizure control, and the dysregulation of GABAergic transmission is one of the factors of the epileptogenesis of ACC seizures
Spontaneous seizures are caused by excessive GABAergic transmission, such as in the case of the autosomal-dominant frontal lobe epilepsy (ADFLE) and 4-AP-induced epilepsy models
Summary
Seizure is a common neurological disorder that affects approximately 1% of the population worldwide. Limbic seizures are difficult to study because the symptoms in these patients are usually related to alterations in motivational, social, and cognitive function (Csernansky et al, 1990; Levin and Duchowny, 1991) These subtle symptoms are sometimes difficult to detect unless the seizure activity spreads to other brain regions. The ACC is considered a part of the limbic cortex, and the ACC is one of the most difficult brain regions in which to detect seizure onset This is because the ACC is not readily accessible for routine electrographic investigations using scalp electrodes (Quesney, 1986), and the close proximity between the right and left ACC increases the difficulty in identifying where seizures initiate (Mazars, 1970; Geier et al, 1977; Nadkarni and Devinsky, 2009).
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