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- W2562266950 abstract "Video Podcast: https://youtu.be/irqLF8mtzN8 Abnormal synchronization of firing in large neuronal ensembles is considered the cardinal mechanism underlying epilepsy. It is classically ascribed to an imbalance between excitation and inhibition in the cerebral cortex due to enhanced excitatory or decreased inhibitory transmission. This perspective currently provides the main basis for pharmacological management of epilepsy, and many effective antiepileptic drugs are known to act on chemical synapses. However, many non-synaptic mechanisms are also known to be able to affect the synchronization of neuronal firing in the context of epilepsy. They include local changes in the concentration of extracellular ions (e.g. K+) and local electrical field resulting from repetitive firing, referred to as ephaptic coupling, which increase the membrane excitability of adjacent neurons. In addition, the role of non-chemical synapses (i.e. electrical synapses or gap junctions) have attracted fluctuating interest in the study of the pathophysiology of epileptic activity onset, maintenance, and termination, with a view to better treatments. There is still some debate about the exact distribution of gap junctions in the human brain. In mammals, they seem to be preferentially expressed in the cortex and the thalamus, where they may play a role in thalamo-cortical networks.1 Gap junctions are present in relatively high numbers in neurons during early development, and decrease progressively with the maturation of neuronal networks until these rely almost entirely on chemical synapses. Gap junctions between adjacent cells connect their cytoplasm, thereby allowing diffusion of small molecules and ions, providing both chemical and electrical communication. This may result in coupling of membrane voltage between neighbouring cells, and thereby ensure rapid propagation of electric signals through large networks of neurons coupled by few gap junctions, at least in computational models.2 Although the physiological function of gap junctions in information processing is uncertain, they might be expected to enhance synchronized activity in networks of neurons and, if that activity is excitatory, promote epileptogenesis. If confirmed, this hypothesis of gap junctions’ proconvulsive role might lead to using gap junction blockers as antiepileptic drugs. Both experimental and empirical data are available with regard to various compounds that have been documented to block gap junctions,3 such as carbenoxolone, quinidine, retinoic acid, or halogenated inhalation anaesthetic agents (e.g. halothane and isoflurane). However, adverse effects may be a major limitation and markedly inconsistent effects are observed on epileptic activity in function of the paradigm or clinical situation. This may be due to the fact that many of the compounds that impair gap junction conductance have multiple mechanisms of actions – from blocking ion channels to direct antagonism of receptors with either excitatory (e.g. NMDA receptor) or inhibitory (GABAA receptor) effect. It may also be due to other possible roles of gap junctions with regard to epileptogenesis. Gap junctions between glial cells (astrocytes) are also thought to be able to modulate the synchronization of neuronal activity.4 Animal studies suggest that they help sustain coordinated epileptic bursts, making these gap junctions a potential target for treatment. In addition, gap junctions appear to be susceptible to plasticity, which may change their function within neuronal networks. Finally, there is emerging evidence that gap junction signalling and related neuronal synchrony depend on the state (bursting pattern) of the network.5 As a result, according to the state of the network, gap junctional activity might result in either triggering, maintaining, aborting, or reducing the risk of seizure. This is a fast-moving topic, which is becoming increasingly complex. Hopefully, better understanding of the properties and functional implications of gap junctions in the developing human brain may soon create novel opportunities for targeted intervention against epilepsy and possibly other conditions involving neuronal synchronization and desynchronization." @default.
- W2562266950 created "2017-01-06" @default.
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- W2562266950 date "2016-12-08" @default.
- W2562266950 modified "2023-10-18" @default.
- W2562266950 title "Gap junctions in epilepsy: for better or worse" @default.
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- W2562266950 doi "https://doi.org/10.1111/dmcn.13290" @default.
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