Formation Of New Synapses Research Articles

Could chronic pain and spread of pain sensation be induced and maintained by glial activation?

An injury often starts with acute physiological pain, which becomes inflammatory or neuropathic, and may sometimes become chronic. It has been proposed recently that activated glial cells, astrocytes and microglia within the central nervous system could maintain the pain sensation even after the original injury or inflammation has healed, and convert it into chronic by altering neuronal excitability. Glial cell activation has also been proposed to be involved in the phenomenon of spread of pain sensation ipsilaterally or to the contralateral side (i.e. mirror image pain). Substance P and calcitonin gene-related peptide, released due to an inflammatory process, interact with the endothelial cells of the blood-spinal cord and blood-brain barriers. The barriers open partially and substances may influence adjacent glial cells. Such substances are also released from neurones carrying the 'pain message' all the way from the injury to the cerebral cortex. Pro-inflammatory cytokines may be released from the microglial cells, and astroglial Ca2+-transients or oscillations may spread within the astroglial networks. One theory is that Ca2+-oscillations could facilitate the formation of new synapses. These new synapses could establish neuronal contacts for maintaining and spreading the pain sensation. If this theory holds true, it is possible that Ca2+ waves, production of cytokines and growth factors could be modified by selective anti-inflammatory drugs to achieve a balance in the activities of the different intercellular and intracellular processes. This paper reviews current knowledge about glial mechanisms underlying the phenomena of chronic pain and spread of the pain sensation.

Synapse disassembly and formation of new synapses in postnatal muscle upon conditional inactivation of MuSK

The muscle-specific-kinase MuSK is required for the formation of acetylcholine receptor clusters during embryonic development, but its physiological role in adult muscle is not known. We used the loxP/Cre system in mice to conditionally inactivate MuSK whereby expression of Cre recombinase increases during postnatal development. The MuSK-inactivated mice develop myasthenic symptoms and die prematurely due to severe muscle weakness. The postnatal inactivation of MuSK causes loss of acetylcholine receptors and disassembly of the postsynaptic organization and innervating axons retract but start to grow and branch extensively. Due to the mosaic expression of Cre recombinase, MuSK is not globally inactivated and new synapses are formed aberrantly patterned across the diaphragm. Our findings demonstrate that MuSK kinase activity is required throughout postnatal development to hold up MuSK and AChR levels at endplates. Thus, MuSK and AChR together maintain the functional and structural integrity of the postsynaptic architecture and prevent axon growth.

649. Effects of GIT1on Human Neuronal (NT2N) Cells

Top of pageAbstract Mature mammalian neurons, except for olfactory neurons, are incapable of cell division. Promoting the regeneration of degenerated adult neurons is a major goal in neurological science. The human teratocarcinoma cell line (NTera 2 or NT2) is capable of neuronal differentiation following treatment with retinoic acid. These neurons (NT2N cells) have a stable neuronal phenotype. The effect of GIT1 overexpression in human NT2N cells was evaluated using an adenoviral vector. A recombinant GIT1 and GFP adenoviral vector (AdEGFP-GIT1) was constructed. The biologic activities of GIT1 were assessed according to the induction of neuronal spine formation, cell migration, and the amounts of GAP-43 and active Cdc42. Cells treated with AdEGFP-GIT1 were compared to untreated cells and to cells treated with AdEGFP. NT2N cells in the AdEGFP-GIT1 group demonstrated more spine formation and higher numbers of migrating cells than that either cells treated with AdEGFP or untreated NT2N cells. GAP-43 and active Cdc42 were quantified by dot ELISA method. The results showed that the amount of GAP-43 and active Cdc42 in the AdEGFP-GIT1 group was much higher than in AdEGFP and untreated NT2N groups. In conclusion, GIT1 overexpression promotes spine formation, migration, and expression of the growth factor GAP-43 and active Cdc42. The GIT1/|[beta]|-PIX/Cdc42/PAK pathway may play an important role in the biological activities of neurons. GIT1 also stimulates GAP-43 expression which may help promote regeneration of damaged axons and formation of new synapses. Therefore, GIT1 may have potential in the treatment of nerve injury.

Repetition of mGluR-dependent LTD causes slowly developing persistent reduction in synaptic strength accompanied by synapse elimination

Synaptic plasticity, the cellular basis of memory, operates in a bidirectional manner. LTP (long-term potentiation) is followed by structural changes that may lead to the formation of new synapses. However, little is known whether LTD (long-term depression) is followed by morphological changes. Here we show that the repetitive induction of metabotropic glutamate receptor (mGluR)-dependent LTD in stable cultures of rat hippocampal slices led to a slowly developing persistent (ranging over weeks) reduction in synaptic strength that was accompanied by the loss of synaptic structures. LTD was induced pharmacologically 1–3 times at 24-h intervals by applying aseptically ACPD (1-aminocyclopentane-1,3-dicarboxylic acid), an agonist of group I/II mGluR, and APV (2-amino-5-phosphonovalerate), an antagonist of the NMDA ( N-methyl- d-aspartate) receptor. One ACPD/APV application induced LTD that lasted less than 24 h. After three LTD inductions, however, a gradual attenuation of the fEPSP (field excitatory postsynaptic potential) amplitude and a decrease in the number of pre- and postsynaptic structures were observed. The blockade of LTD by an mGluR antagonist or a protein phosphatase 2B inhibitor abolished the development of the synaptic attenuation. In contrast to our previous finding that the repetitive LTP induction triggered a slowly developing persistent synaptic enhancement, the incremental and decremental forms of synaptic plasticity appeared to occur symmetrically not only on the minutes–hours time order but also on the days–weeks time order.

Switching of NMDA receptor 2A and 2B subunits at thalamic and cortical synapses during early postnatal development.

Switching of the NMDA receptor 2A (NR2A) and NR2B subunits at NMDA receptors is thought to underlie the functional changes that occur in NMDA receptor properties during the developmental epoch when neural plasticity is most pronounced. The cellular expression of NR2A and NR2B and the NR2 synaptic binding protein postsynaptic density-95 (PSD-95) was examined in the mouse somatosensory cortex and thalamus from postnatal day 2 (P2) to P15 using reverse transcription-PCR, in situ hybridization histochemistry, and immunocytochemistry. The localization of NR2A and NR2B subunits and PSD-95 was then studied at synapses in layer IV of somatosensory cortex and in the ventral posterior nucleus of the thalamus using high-resolution immunoelectron microscopy. At both cortical and thalamic synapses, a quantitative switch in the dominant synaptic subunit from NR2B to NR2A was accompanied by a similar change in the cellular expression of NR2A but not of NR2B. Synaptic PSD-95 developed independently, although both NR2A and NR2B colocalized with PSD-95. Displacement of NR2B subunits from synapses was not accompanied by an increase in an extrasynaptic pool of this subunit. Thus, the switch in synaptic NR2 subunit predominance does not occur by changes in expression or displacement from synapses and may reflect the formation of new synapses from which NR2B is lacking.

The role of proteoglycans in regeneration and plasticity

Chondroitin sulfate proteoglycans (CSPGs) are up‐regulated in glial scar tissue and inhibit axon regeneration. Not only are the protein cores up‐regulated, but also there is more glycosaminoglycan (GAG) attached to them. The final stage of GAG synthesis is sulfation, which can occur in three positions. Both 6‐sulfated GAG and the sulfotransferase that sulfates N‐acetylgalactosamine in the 6 position is specifically up‐regulated in glial scar tissue, in inhibitory glial cells and in astrocytes treated with tumour growth factor α (TGF‐α) and TGF‐β. Removal of GAG chains by digestion with chondroitinase or inhibition of GAG synthesis with chlorate or β‐D‐xylosides, removes much of the inhibition from CSPGs in vitro. We therefore tested to see whether GAG digestion by chondroitinase would promote axon regeneration in vivo. We first treated mechanical lesions of the nigrostriatal tract and saw regeneration of about 4% of axons back to their target. Next, dorsal column lesions of the spinal cord at C4 were treated. Both sensory and corticospinal axons regenerated in treated cords, and there was rapid return of function in beam and grid walking tests. The return of function was so rapid that we hypothesized that some of it might be due to enhanced plasticity. Many neuronal cell bodies and dendrites are coated in thick perineuronal nets of inhibitory CSPGs and tenascin‐R, which would certainly be expected to prevent the formation of new synapses. We therefore tested the effects of chondroitinase treatment in a plasticity model: ocular dominance shift in the visual cortex following monocular deprivation. Monocular deprivation in adult animals normally produces no ocular dominance shift. However, in adult animals in which the cortex was treated with chondroitinase, there was a large shift in response to monocular deprivation.

A synthetic neural cell adhesion molecule mimetic peptide promotes synaptogenesis, enhances presynaptic function, and facilitates memory consolidation.

The neural cell adhesion molecule (NCAM) plays a critical role in development and plasticity of the nervous system and is involved in the mechanisms of learning and memory. Here, we show that intracerebroventricular administration of the FG loop (FGL), a synthetic 15 amino acid peptide corresponding to the binding site of NCAM for the fibroblast growth factor receptor 1 (FGFR1), immediately after training rats in fear conditioning or water maze learning, induced a long-lasting improvement of memory. In primary cultures of hippocampal neurons, FGL enhanced the presynaptic function through activation of FGFR1 and promoted synapse formation. These results provide the first evidence for a memory-facilitating effect resulting from a treatment that mimics NCAM function. They suggest that increased efficacy of synaptic transmission and formation of new synapses probably mediate the cognition-enhancing properties displayed by the peptide.

Assay system for synapse formation between primary cultured neurons

Synapse plasticity, in particular, formation of new synapses, plays crucial roles in learning and memory. We have developed a convenient assay system for measuring the number of newly formed synapses between cultured rat cerebrocortical neurons using the multisite fluorometry system of intracellular calcium. We found that cultured neurons exhibited spontaneous oscillatory changes in intracellular calcium levels and that the frequency of the oscillation was strongly correlated with synaptic density. Combined with immunohistochemical studies, this assay system enables us to study the molecular mechanism of synapse formation, in particular, the involvement of ecto-protein kinase. Other applications of the assay system are discussed here.

Cambios morfológicos asociados a la memoria

It has been suggested that storing information in the brain takes place by means of changes in synaptic communication efficiency, which is known as neuronal plasticity. Plastic events include changes in the function, structure, distribution and number of synapses, and it has been suggested that these plastic events could be related to learning and memory. In this work we will review some studies that report structural changes in which experience and learning intervene. In particular, structural changes have been observed in a region of the brain called the hippocampus, which plays a crucial role in the learning and memory of spatial tasks. It has been claimed that the appearance of new synapses after learning a spatial task is linked to the formation of long-term memory and that the functioning of NMDA-type glutamate receptors is needed for both learning and the formation of new synapses to take place. Understanding the cellular mechanisms involved in the formation of memory is of utmost importance to be able to check the memory deficiencies that arise from injuries or as a consequence of old age and neurodegenerative diseases.

Glucose/oxygen deprivation induces the alteration of synapsin I and phosphosynapsin

Synapsin I is believed to be involved in regulating neurotransmitter release and in synapse formation. Its interactions with the actin filaments and synaptic vesicles are regulated by phosphorylation. Because exocytosis and synapsin I phosphorylation are a Ca 2+-dependent process, it is possible that an ischemic insult modifies the presynaptic proteins. However, the neuronal damage and the changes in synapsin I as well as its phosphorylation level as a result of glucose/oxygen deprivation (GOD) and reperfusion in organotypic hippocampal slice cultures have not been established. In this study, the level of synapsin I and phosphosynapsin was measured in organotypic hippocampal slice cultures in order to determine the role of synapsin I in the presynaptic nerve terminals during GOD/reperfusion. Propidium iodide fluorescence was observed in the CA1 area after GOD for 30 min, which could be detected in the whole pyramidal cell layer during reperfusion for 24 h. The immunofluorescence of the neuron specific nuclear protein, NeuN, showed a negative correlation with the PI fluorescence. During GOD/reperfusion, the immunofluorescence of synapsin I increased in the stratum radiatum and the stratum oriens of the CA1 area and the stratum lucidum and the stratum oriens of the CA3 area. The phosphosynapsin level evidently increased in the stratum lucidum of the CA3 area after GOD for 30 min, which was reduced to the control level after reperfusion. These results suggested that the neuronal damage and degenerations were observed as a result of GOD/reperfusion and the increase in synapsin I and its phosphorylation might play a role in modulating the release of neurotransmitters via exocytosis and in the formation of new synapses after brain ischemia.

Synapse replacement in the striatum of the adult rat following unilateral cortex ablation.

Defining the selective pattern of synapse replacement that occurs in different areas of the damaged brain is essential for predicting the limits of functional compensation that can be achieved after various types of brain injury. Here we describe the time course of dendritic reorganization, spine loss and recovery, and synapse replacement in the striatum following a unilateral cortex ablation. We found that the time course for the transient loss and recovery of dendritic spines on medium spiny I (MSI) neurons, the primary postsynaptic target for corticostriatal axons, paralleled the time course for the removal of degenerating axon terminals from the neuropil and the formation of new synapses on MSI neurons. Reinnervation of the deafferented striatum occurred chiefly by axon terminals that formed asymmetric synapses with dendritic spines of MSI neurons, and the mean density of asymmetric synapses recovered to 86% of the sham-operated rat value by 30 days postlesion. In addition, the synaptic circuitry of the reconstructed striatum was characterized by an increase in the number of multiple synaptic boutons (MSBs), i.e., presynaptic axon terminals that make contact with more than one dendritic spine. Whether the postsynaptic contacts of MSBs are formed with the dendritic spines of the same or a different parent dendrite in the striatum is unknown. Nevertheless, these data suggest that the formation of MSBs is an essential part of the compensatory response to the loss of input from the ipsilateral cortex following the aspiration lesion and may serve to modulate activity-dependent adaptive changes in the reconstructed striatum that can lead to functional recovery.

Brain Reorganization After Stroke

After a stroke, recovery that continues beyond 3 or 4 weeks has been attributed to plasticity, a reorganization of the brain in which functions previously performed by the ischemic area are assumed by other ipsilateral or contralateral brain areas. Neuronal plasticity has been variously attributed to redundancy (parallel distributed pathways), changes in synaptic strength, axonal sprouting with formation of new synapses, assumption of function by contralateral homologous cortex, and substitution of uncrossed pathways. Transcranial magnetic stimulation, positron emission tomography (PET), functional magnetic resonance imaging (fMRI), and 128-electrode high-resolution electroencephalography have been successfully applied to demonstrate cortical reorganization after hemiplegia. Recording the motor potential is a promising noninvasive method for the localization of motor control after hemispheric lesions. Most patients with hemiparetic stroke show some improvement, usually during the first 3 to 6 months after the ictus. Improvement and prognosis depend on a number of variables including volume and location of the infarction, age of the patient, and the elimination of risk factors to avoid future episodes (i.e., dietary control of lipids, the elimination of tobacco, and the control of diabetes and hypertension). Currently, emphasis has been placed on fibrinolytic treatment in the first 3 hours to prevent or minimize neurological deficit. Aside from the above listed factors, improvement after stroke may be due to reorganization of the brain, particularly the cerebral cortex, and repair of damaged tissue and recanalization. It is also important to relate such changes to functional improvement and successful rehabilitation.

Quantitation of contacts among sensory, motor, and serotonergic neurons in the pedal ganglion of aplysia.

Present models of long-term sensitization in Aplysia californica indicate that the enhanced behavioral response is due, at least in part, to outgrowth of sensory neurons mediating defensive withdrawal reflexes. Presumably, this outgrowth strengthens pre-existing connections by formation of new synapses with follower neurons. However, the relationship between the number of sensorimotor contacts and the physiological strength of the connection has never been examined in intact ganglia. As a first step in addressing this issue, we used confocal microscopy to examine sites of contact between sensory and motor neurons in naive animals. Our results revealed relatively few contacts between physiologically connected cells. In addition, the number of contact sites was proportional to the amplitude of the EPSP elicited in the follower motor neuron by direct stimulation of the sensory neuron. This is the first time such a correlation has been observed in the central nervous system. Serotonin is the neurotransmitter most closely examined for its role in modulating synaptic strength at the sensorimotor synapse. However, the structural relationship of serotonergic processes and sensorimotor synapses has never been examined. Surprisingly, serotonergic processes usually made contact with sensory and motor neurons at sites located relatively distant from the sensorimotor synapse. This result implies that heterosynaptic regulation is due to nondirected release of serotonin into the neuropil.

Stimulus generalization of conditioned eyelid responses produced without cerebellar cortex: implications for plasticity in the cerebellar nuclei.

In Pavlovian eyelid conditioning and adaptation of the vestibulo-ocular reflex, cerebellar cortex lesions fail to completely abolish previously acquired learning, indicating an additional site of plasticity in the deep cerebellar or vestibular nucleus. Three forms of plasticity are known to occur in the deep cerebellar nuclei: formation of new synapses, plasticity at existing synapses, and changes in intrinsic excitability. Only a cell-wide increase in excitability predicts that learning should generalize broadly from a training stimulus to other stimuli capable of supporting learning, whereas the alternatives predict that learning should be relatively specific to the training stimulus. Here we show that deep nucleus plasticity, as assessed by conditioned eyelid responses produced without input from the cerebellar cortex, is relatively specific to the training conditioned stimulus (CS). We trained rabbits to a tone or light CS with periorbital stimulation as the unconditioned stimulus (US), and pharmacologically disconnected the cerebellar cortex during a posttraining generalization test. The short-latency conditioned responses unmasked by this treatment showed strong decrement along the dimension of auditory frequency and did not generalize across stimulus modalities. These results cannot be explained solely by a cell-wide increase in the excitability of deep nucleus neurons, and imply that an input-specific mechanism in the deep cerebellar nucleus operates as well.

The dendritic layer-specific persistent enhancement of synaptic transmission induced by repetitive activation of protein kinase A

Synaptic plasticity, the cellular basis of brain memory, is established through at least two phases: short-term and long-term plasticity. It is assumed that the short-term plasticity instantaneously provoked in pre-existing synapses, as represented by a long-term potentiation (LTP) in the mammalian hippocampus, is converted to the long-term plasticity that develops slowly accompanying the formation of new synapses. However, this conversion has scarcely been analyzed primarily because of the lack of the model system. Recently, we found that a repeated activation of protein kinase A (PKA), but not a single activation of PKA, led to a slowly-developing long-lasting enhancement of synaptic strength coupled with synaptogenesis in cultured rat hippocampus and proposed that this phenomenon would serve as the required model system. In the present study, we investigated the geographical aspect of this phenomenon using a high-speed voltage-sensitive dye (VSD) imaging methodology. Before doing this, we had to overcome the difficulties in applying this methodology to the quantitative analysis on the cultured hippocampal slices. Those difficulties are multiple types of signal decay and a large variance in the number of cells among specimens. After resolving these problems we found that the enhancement of synaptic efficacy in the CA1 stratum radiatum occurred predominantly in the proximal dendritic layer.

Altered synaptophysin expression in the rat spinal cord after chronic constriction injury of sciatic nerve

Injury to the peripheral nervous system can lead to spontaneous pain, hyperalgesia and allodynia. Previous studies have shown sprouting of Aβ-fibres into lamina II of the spinal cord dorsal horn after nerve injury and the formation of new synapses by these sprouts. Synaptophysin is a presynaptic vesicle protein, useful in the identification of synaptogenesis. Here we investigated whether synaptogenesis as measured by the expression of synaptophysin protein correlates with symptoms of neuropathic pain in rats with a chronic constriction injury (CCI) of the sciatic nerve. We used immunohistochemistry, Western immunoblotting and densitometry to study the distribution of synaptophysin and to quantify relative protein. Synaptophysin was increased in the ipsilateral dorsal horn with a peak level on day 14 and returned to baseline on day 21 post-CCI. Synaptophysin levels temporally correlated with thermal hyperalgesia but not with tactile allodynia. Our results indicate that thermal hyperalgesia in CCI significantly correlates with synaptogenesis within the superficial layers of the dorsal horn.

Intrinsic determinants of synaptic phenotype: an experimental study of abducens internuclear neurons connecting with anomalous targets

The present experiments investigate the role of postsynaptic neurons in the morphological differentiation of presynaptic terminals that are formed de novo in the adult CNS. Abducens internuclear neurons in the adult cat were chosen as the experimental model. These neurons project onto the contralateral medial rectus motoneurons of the oculomotor nucleus. Abducens internuclear axon terminals were identified by their anterograde labeling with biocytin and analyzed at the electron microscopic level. To promote the formation of new synapses, two different experimental approaches were used. First, after the selective ablation of medial rectus motoneurons with ricin, abducens internuclear neurons reinnervated the neighboring oculomotor internuclear neurons. Second, after axotomy followed by embryonic cerebellar grafting, abducens internuclear axons invaded the implanted tissue and established synaptic connections in both the molecular and granule cell layer. Boutons contacting the oculomotor internuclear neurons developed ultrastructural characteristics that resembled the control synapses on medial rectus motoneurons. In the grafted cerebellar tissue, abducens internuclear axons and terminals did not resemble climbing or mossy fibers but showed similarities with control boutons. However, labeled boutons analyzed in the granule cell layer established a higher number of synaptic contacts than controls. This could reflect a trend towards the mossy fiber phenotype, although labeled boutons significantly differed in every measured parameter with the mossy fiber rosettes found in the graft. We conclude that at least for the abducens internuclear neurons, the ultrastructural differentiation of axon terminals reinnervating novel targets in the adult brain seems to be mainly under intrinsic control, with little influence by postsynaptic cells.

Grow-your-own synapses

Many neuroscientists are convinced that learning and experience rewire the brain, but they have never been able to observe the process. For the first time, a team of researchers has seen the formation of new synapses by using a novel technique for exciting individual neurons in culture. Figure Actin (green) moves closer to the synapse after stimulation. To show that learning changes brain circuitry, scientists have relied on indirect evidence—before and after counts of the number of synapses in particular regions. To nab direct evidence of neural remodeling, Yukiko Goda (University of California, San Diego, CA) and colleagues used light to trigger a current through coupled neurons resting on a silicon chip. Then they observed the response of the actin cytoskeleton of the presynaptic and postsynaptic terminals, and were able to detect changes in individual synapses. Repeated stimulation triggered action on both sides of the synapse. On the presynaptic side, actin networks changed shape to form projections, or puncta, some of which developed into functional presynaptic terminals with vesicles for recycling neurotransmitters. The postsynaptic side also sent out extensions that cozied up to the puncta that formed on the presynaptic side, thus completing the new synapses. This is the first direct demonstration of neural remodeling of brain synapses at the cellular level, says Goda. “We have a very conclusive demonstration of activity-induced remodeling,” she says. “We were able to capture it as it happened.” One of the key mysteries left to solve, she says, is how the electrical signal gets translated into morphological change. ▪ Reference: Colicos, M.A., et al. 2001. Cell. 107:605–616. [PubMed]

Cerebello-thalamic synapses and motor adaptation.

The cerebellum's influence on voluntary movement is mediated, in large part, through the cerebello-thalamo-cortical (CTC) pathway. Of particular relevance here are those neurons in the cerebellar nuclei that project, via thalamus, to pyramidal tract neurons in primary motor cortex. Several lines of evidence implicate cerebello-thalamic (CT) synaptic plasticity as a neural substrate underlying movement adaptation in adult animals. CT synapses exhibit a number of structural characteristics suggestive of a capacity for both formation of new synapses, and alterations in efficacy of transmission across existing synapses. Long-term potentiation can be evoked across CT synapses in vitro by high frequency stimulation, albeit in young animals. Evidence regarding the contribution of CT synaptic plasticity to two different types of movement adaptation in adult animals is conflicting. Adaptation involving a strengthening and re-coordination of voluntary movement is associated with an increase in density of CT synaptic boutons and an increase in number of synaptic vesicles available for immediate neurotransmitter release within each bouton. On the other hand, adaptation involving associative conditioning of a reduced sensorimotor neural circuit is associated with plasticity at thalamo-cortical but not CT synapses. These conflicting findings may reflect differences in the extent of synaptic re-organization that occurs at thalamic versus cortical levels, differences in the neural circuitry mediating each behavior, and/or differences in the spatio-temporal convergence of activity in the thalamus during the adaptive processes. It is concluded that CT synaptic plasticity can underlie movement adaptation if the adaptation requires reorganization of the cerebellum's influence on cerebral cortex.

Neuropatología de la epilepsia del lóbulo temporal: alteraciones primarias y secundarias de los circuitos corticales y epileptogenicidad

Temporal lobe epilepsy is associated to many disorders localized to the neocortex, the hippocampal formation or both (dual pathology). The most common pathologies are mesial sclerosis, tumours, malformations and scars. However, these alterations are not intrinsically epileptogenic, as they are also seen in patients who do not develop epilepsy. Thus, the cortical tissue in the damaged brain undergoes changes that may become a primary epileptogenic region. This region, in turn, may induce the formation of secondary epileptogenic regions situated at some distance from the primary focus. In this paper we consider the possibility that in both the primary and secondary epileptogenic regions there are similar changes in the neuronal circuits which induce epileptic activity. In the case of the primary epileptogenic regions, these changes occur non specifically following an initial lesion or precipitating factor (e.g. a tumour) which induces gliosis and neuronal loss around the lesion. These changes give rise to a perilesional synaptic reorganization (elimination of connections with or without the formation of new synapses) which causes the onset and continuation of epileptic activity. However, the changes in the circuits in the secondary epileptogenic regions are the result of epileptic activity originated in the primary epileptogenic region which is propagated by specific anatomical connections. This anomalous activity causes changes in the target region (gliosis and neuronal loss) which leads to epileptogenic synaptic reorganization similar to that occurring in the primary perilesional areas.