Reconstruction of the adenosine system by bone marrow-derived mesenchymal stem cell transplantation

In the present study, we transplanted bone marrow-derived mesenchymal stem cells into the CA3 area of the hippocampus of chronic epilepsy rats kindled by lithium chloride-pilocarpine, Immunofluorescence and western blotting revealed an increase in adenosine A1 receptor expression and a decrease in adenosine A2a receptor expression in the brain tissues of epileptic rats 3 months after transplantation. Moreover, the imbalance in the A1 adenosine receptor/A2a adenosine receptor ratio was improved. Electroencephalograms showed that frequency and amplitude of spikes in the hippocampus and frontal lobe were reduced. These results suggested that mesenchymal stem cell transplantation can reconstruct the normal function of the adenosine system in the brain and greatly improve epileptiform discharges.

Post-stroke seizures in consecutive elderly stroke patients

This prospective study sought to investigate the clinical, radiological and electroencephalographic （EEG） characteristics of seizures in elderly stroke patients, and their outcomes. Over a 2-year study period, 158 consecutive elderly patients with stroke were examined and followed up. Of these patients, 32 （20%） developed seizures, primarily related to stroke, within a follow up period between 5 months and 2 years. Of these 32 cases, 20 experienced infarctions, and 12 experienced hemorrhages. Involvement of cortical regions was detected in most of the patients exhibiting seizures. In these patients, 44% of the lesions involved cortical areas exclusively or in addition to subcortical areas observed on computed tomography （CT） images. Twenty-five patients （78%） developed early seizures （within 2 weeks after stroke）, and half exhibited immediate post-stroke seizures. None of the patients exhibiting early onset seizures developed recurrent seizures or epilepsy, while 57% of late onset seizures （four cases） developed epilepsy. No specific EEG pattems were apparent in those who later developed epilepsy. Overall, early onset seizures after stroke were found to be relatively common, and did not affect outcome. Late onset seizures were less common, but were associated with chronic epilepsy.

Neurological diseases associated with autoantibodies targeting the voltage-gated potassium channel complex:immunobiology and clinical characteristics

Voltage-gated potassium channels(VGKCs)represent a group of tetrameric signaling proteins with several functions,including modulation of neuronal excitability and neurotransmitter release.Moreover,VGKCs give a key contribution to the generation of the action potential.VGKCs are complexed with other neuronal proteins,and it is now widely known that serum autoantibodies directed against VGKCs are actually directed against the potassium channel subunits only in a minority of patients.By contrast,these autoantibodies more commonly target three proteins that are complexed with alpha-dendrotoxin-labeled potassium channels in brain extracts.These three proteins are contactin-associated protein-2(Caspr-2),leucine-rich,glioma inactivated 1(LGI-1)protein and the protein Tag-1/contactin-2.Neoplasms are detected only in a minority of seropositive patients for VGKC complex-IgG and do not significantly associate with Caspr-2 or LGI-1.Among all the cancers described in association with VGKC complex-IgG,lung carcinoma,thymoma,and hematologic malignancies are the most commonly detected.We will review all the major neurological conditions associated with VGKC complex-IgG.These include Isaacs’syndrome,Morvan syndrome,limbic encephalitis,facio-brachial dystonic seizures,chorea and other movement disorders,epilepsy,psychosis,gastrointestinal neuromuscular diseases,a subacute encephalopathy that mimics Creutzfeldt-Jakob prion disease both clinically and radiologically and autoimmune chronic pain.The vast majority of these conditions are reversible by immunotherapy,and it is becoming increasingly recognized that early diagnosis and detection of VGKC complex-IgG is critical in order to rapidly start the treatment.As a result,VGKC complex-IgG are now part of the investigation of patients with unexplained subacute onset of epilepsy,memory or cognitive problems,or peripheral nerve hyperexcitability syndromes.