Correlation between GABAA receptor density and vagus nerve stimulation in individuals with drug-resistant partial epilepsy

被引:144
作者
Marrosu, F
Serra, A
Maleci, A
Puligheddu, M
Biggio, G
Piga, M
机构
[1] Univ Cagliari, Policlin Univ, Dipartimento Sci Neurol & Cardiovasc, I-09042 Monserrato, Italy
[2] Univ Cagliari, Dipartimento Biol Sperimentale, I-09042 Monserrato, Italy
[3] Univ Cagliari, Policlin Univ, Dipartimento Diagnost Immagini, I-09123 Cagliari, Italy
关键词
intractable partial epilepsy; vagus nerve stimulation; GABA(A) receptor density (GRD); I-123 ]iomazenil brain SPECT;
D O I
10.1016/S0920-1211(03)00107-4
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Vagus nerve stimulation (VNS) is an important option for the treatment of drug-resistant epilepsy. Through delivery of a battery-supplied intermittent current, VNS protects against seizure development in a manner that correlates experimentally with electrophysiologcal modifications. However, the mechanism by which VNS inhibits seizures in humans remains unclear. The impairment of gamma-aminobutyric acid (GABA)-mediated neuronal inhibition associated with epilepsy has suggested that GABA(A) receptors might contribute to the therapeutic efficacy of VNS. We have now applied single photon emission computed tomography (SPECT) with the benzodiazepine receptor inverse agonist [I-123]iomazenil to examine cortical GABA(A) receptor density (GRD) before and 1 year after implantation of a VNS device in 10 subjects with drug-resistant partial epilepsy. VNS therapeutic responses resulted significantly correlated with the normalization of GRD. Moreover, a comparable control group, scheduled for a possible VNS implant, failed to show significant GRD variations after 1 year of a stable anti-epileptic treatment. These results suggest that VNS tray modulate the cortical excitability of brain areas associated with epileptogenesis and that GABA(A) receptor plasticity contributes to this effect. (C) 2003 Published by Elsevier B.V.
引用
收藏
页码:59 / 70
页数:12
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