Seizures are thought to arise from an imbalance of excitatory and inhibitory neuronal activity. While most classical studies suggest excessive excitatory neural activity plays a generative role, some recent findings challenge this view and instead argue that excessive activity in inhibitory neurons initiates seizures. We investigated this question of imbalance in a zebrafish seizure model with two-photon imaging of excitatory and inhibitory neuronal activity throughout the brain using a nuclear-localized calcium sensor. We found that seizures consistently initiated in circumscribed zones of the midbrain before propagating to other brain regions. Excitatory neurons were both more prevalent and more likely to be recruited than inhibitory neurons in initiation as compared with propagation zones. These findings support a mechanistic picture whereby seizures initiate in a region of hyperexcitation, then propagate more broadly once inhibitory restraint in the surround is overcome.
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http://dx.doi.org/10.1093/brain/awac073 | DOI Listing |
JIMD Rep
January 2025
Genetic and Metabolic Division, Pediatrics Department Tawam Hospital Al Ain UAE.
Background: Tetrahydrobiopterin (BH4) deficiencies comprise a group of five neurometabolic disorders caused by five genetic defects responsible for BH4 biosynthesis and regeneration. Their global prevalence remains unknown, and variance exists among different countries.
Aims: To describe clinical, biochemical, molecular genetic data and follow-up of patients with BH4 deficiency seen in Tawam Hospital.
Nat Med
January 2025
Clinical Epidemiology Center, Research and Development Service, VA St. Louis Health Care System, St. Louis, MO, USA.
Glucagon-like peptide 1 receptor agonists (GLP-1RAs) are increasingly being used to treat diabetes and obesity. However, their effectiveness and risks have not yet been systematically evaluated in a comprehensive set of possible health outcomes. Here, we used the US Department of Veterans Affairs databases to build a cohort of people with diabetes who initiated GLP-1RA (n = 215,970) and compared them to those who initiated sulfonylureas (n = 159,465), dipeptidyl peptidase 4 (DPP4) inhibitors (n = 117,989) or sodium-glucose cotransporter-2 (SGLT2) inhibitors (n = 258,614), a control group composed of an equal proportion of individuals initiating sulfonylureas, DPP4 inhibitors and SGLT2 inhibitors (n = 536,068), and a control group of 1,203,097 individuals who continued use of non-GLP-1RA antihyperglycemics (usual care).
View Article and Find Full Text PDFBrain Behav
January 2025
Technion Faculty of Medicine, Haifa, Israel.
Objective: Medical personnel show difficulty in differentiating psychogenic nonepileptic seizures (PNES) from epileptic seizures (ES). The purpose of this study was to conduct an initial feasibility assessment of the global dynamic impression (GDI) principle and to evaluate its effectiveness in enabling the diagnosis of epileptic versus psychogenic seizures using video footage of events, even by untrained personnel METHODS: We based this study on video footage showing five videos of PNES and five ES videos. We asked physicians and nurses from the emergency department, internal medicine department, neurology department, and medical students to classify the videos before and after learning the GDI principle.
View Article and Find Full Text PDFBackground: Electroconvulsive therapy (ECT) is a well-established and effective treatment for severe depression and other conditions. Though ECT induces a generalized seizure, it is unclear why seizures are therapeutic. This study analyzed relationships between pre-treatment brain morphology, stimulation dose, and seizure duration to better understand ECT-induced seizures.
View Article and Find Full Text PDFJ Emerg Med
October 2024
Department of Emergency Medicine, Cleveland Clinic Akron General, Akron, Ohio; Northeast Ohio Medical University, Rootstown, Ohio. Electronic address:
Background: Behcet disease (BD) is a rare small vessel vasculitis that commonly manifests as recurrent painful oral or genital ulcerations, uveitis, and skin lesions. Some patients with BD develop neurological symptoms termed neuro-Behcet's disease. In the emergency department setting, these symptoms can be mistaken for other common acute issues including stroke, infection, epilepsy, multiple sclerosis, toxin ingestion, or psychiatric conditions.
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