Abstract

Dravet Syndrome (DS) is a genetic, infantile-onset epilepsy with refractory seizures and severe cognitive impairment. While network level pathophysiology is poorly understood, work in genetic mouse models of DS reveals selective reduction of inhibitory interneuron excitability, a likely mechanism of seizures and comorbidities. Consistent with the critical role of interneurons in timing and recruitment of network activity, hippocampal sharp wave ripples (SPW-R)—interneuron dependent compound brain rhythms essential for spatial learning and memory—are less frequent and ripple frequency is slower in DS mice, both likely to impair cognitive performance. Febrile seizures are characteristic of DS, reflecting a temperature-dependent shift in excitation–inhibition balance. DS interneurons are sensitive to depolarization block and may fall silent with increased excitation precipitating epileptic transformation of ripples. To determine the temperature dependence of SWP-R features and relationship of SPW-R to hippocampal interictal activity, we recorded hippocampal local field potentials in a DS mouse model and wildtype littermate controls while increasing core body temperature. In both genotypes, temperature elevation speeds ripple frequency, although DS ripples remain consistently slower. The rate of SPW-R also increases in both genotypes but subsequently falls in DS mice as interictal epileptic activity simultaneously increases preceding a thermally-evoked seizure. Epileptic events occur intermixed with SPW-R, some during SPW-R burst complexes, and transiently suppress SPW-R occurrence suggesting shared network elements. Together these data demonstrate a temperature dependence of SPW-R rate and ripple frequency and suggest a pathophysiologic mechanism by which elevated temperature transforms a normal brain rhythm into epileptic event.

Highlights

  • MATERIALS AND METHODSMutations in SCN1A, the gene encoding the type I voltagegated sodium channel Nav1.1, are associated with a family of epilepsies in which febrile seizures are the minimum epileptic phenotype (Catterall et al, 2010; Scheffer and Nabbout, 2019)

  • Our findings demonstrate that temperature elevation increases the rate of occurrence and internal ripple frequency of sharp wave ripples (SPW-R) in both wild-type and Dravet Syndrome (DS) networks, with DS sharp wave (SPW)-R consistently slower

  • In this situation, interictal events can suppress sharp wave ripples (SPW-R) activity and directly contribute to the cognitive comorbidities in Dravet Syndrome (DS)

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Summary

Introduction

MATERIALS AND METHODSMutations in SCN1A, the gene encoding the type I voltagegated sodium channel Nav1.1, are associated with a family of epilepsies in which febrile seizures are the minimum epileptic phenotype (Catterall et al, 2010; Scheffer and Nabbout, 2019). In vitro electrophysiologic studies in DS mice reveal reduced excitability and decreased firing of inhibitory interneurons, while excitatory pyramidal cells are largely unaffected (Yu et al, 2006; Kalume et al, 2007; Tai et al, 2014). These deficits in inhibitory neurons impair network oscillations both in vivo and in vitro (Schlingloff et al, 2014; Cheah et al, 2019). Nav1.1 is the primary sodium channel in inhibitory neurons and haploinsufficiency in DS makes inhibitory neurons susceptible to entering depolarization block following a build-up of inactivated sodium channels during trains of impulses (Catterall, 2000; Yu et al, 2006; Tai et al, 2014) and complete failure of inhibition could lead to an avalanche of recurrent excitation among highly interconnected pyramidal cells, transforming SPW-R into epileptic discharges (Ziburkus et al, 2006)

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