Status epilepticus is a major medical emergency associated with a significant morbidity and mortality. Little is known about the mechanisms that terminate seizure activity and prevent the development of status epilepticus. Cannabinoids possess anticonvulsant properties and the endocannabinoid system has been implicated in regulating seizure duration and frequency. Endocannabinoids regulate synaptic transmission and dampen seizure activity via activation of the presynaptic cannabinoid receptor 1 (CB1). This study was initiated to evaluate the role of CB1 receptor-dependent endocannabinoid synaptic transmission towards preventing the development of status epilepticuslike activity in the well-characterized hippocampal neuronal culture model of acquired epilepsy using patch clamp electrophysiology. Application of the CB1 receptor antagonists SR141716A (1 μM) or AM251 (1 μM) to "epileptic" neurons caused the development of continuous epileptiform activity, resembling electrographic status epilepticus. The induction of status epilepticus-like activity by CB1 receptor antagonists was reversible and could be overcome by maximal concentrations of CB1 agonists. Similar treatment of control neurons with CB1 receptor antagonists did not produce status epilepticus or hyperexcitability. These findings suggest that CB1 receptor-dependent endocannabinoid endogenous tone plays an important role in modulating seizure frequency and duration and preventing the development of status epilepticus-like activity in populations of epileptic neurons. The regulation of seizure activity and prevention of status epilepticus by the endocannabinoid system offers an important insight into understanding the basic mechanisms that control the development of continuous epileptiform discharges.
KeywordsCB1 receptor; status epilepticus; cannabinoid; epilepsy; endocannabinoid tone Epilepsy is one of the most common neurological disorders affecting approximately 1-2% of the world population [5]. It is characterized by the occurrence of spontaneous recurrent epileptiform discharges (SREDs) or seizures [9,16]. Status epilepticus (SE) is a majorTo whom correspondence should be addressed: Robert J. DeLorenzo, M.D., Ph.D., M.P.H., Virginia Commonwealth University, School of Medicine, PO Box 980599, Richmond, VA 23298, Phone: 804-828-8969, Fax: 804-828-6432, E-mail: rdeloren@hsc.vcu.edu. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. [2,12,18,19]. The CB1 receptor has been shown to mediate many of the anticonvulsant effects of cannabinoids [20] and to play an important role in regulating synaptic transmissio...