Seizure-Induced Neutrophil Adhesion in Brain Capillaries Leads to a Decrease in Postictal Cerebral Blood Flow

Lim, Hyun-Kyoung; Bae, Sungjun; Han, Kayoung; Kang, Bok-Man; Jeong, Yoonyi; Kim, Seong‐Gi; Suh, Minah

doi:10.2139/ssrn.4314153

Cited by 2 publications

(6 citation statements)

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“…The maximum decreases in regional CBF in the postictal state ranged from 9 to 38 mL/100 g/min, corresponding to a maximum of 30–47% decrease from baseline. Similar changes during the postictal state were reported in patients with epilepsy, in a 4‐aminopyridine (4‐AP) seizure model in mice, and computed tomography perfusion measurements in adult patients with refractory epilepsy 3,13,53 . Both Farrell et al.…”

Section: Discussionsupporting

confidence: 53%

“…Similar changes during the postictal state were reported in patients with epilepsy, in a 4-aminopyridine (4-AP) model in mice, and computed perfusion measurements in adult patients refractory epilepsy 3,13,53. Both Farrell et al and Lim et al showed that the early hypoperfusion (30 min postseizure) was mainly induced by arteriolar constriction 3,53. In the 4-AP mouse model, hypoperfusion…”

supporting

confidence: 55%

“…The maximum decreases in regional CBF in the postictal state ranged from 9 to 38 mL/100 g/min, corresponding persisted for >1 h resulted from increased capillary stalling induced by neutrophil adhesion to brain capillar- 53 Similar mechanisms may be involved in the postictal state in our patients; these mechanisms cannot explain the increased perfusion observed in patients with short seizures (cf. Figure 2), of the order of 10 mL/100 g/ min, which suggests that other are also involved.…”

Section: Pathophysiological Considerationsmentioning

confidence: 70%

“…and Lim et al. showed that the early hypoperfusion (30 min postseizure) was mainly induced by arteriolar constriction 3,53 . In the 4‐AP mouse model, hypoperfusion that persisted for >1 h resulted from increased capillary stalling induced by neutrophil adhesion to brain capillaries 53 .…”

Section: Discussionmentioning

confidence: 99%

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Changes in postictal cerebral perfusion are related to the duration of electroconvulsive therapy‐induced seizures

Pottkämper,

Verdijk,

Aalbregt

et al. 2023

Epilepsia

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ObjectivePostictal symptoms may result from cerebral hypoperfusion which is possibly a consequence of seizure‐induced vasoconstriction. Longer seizures have previously been shown to cause more severe postictal hypoperfusion in rats and epilepsy patients. We studied cerebral perfusion after generalized seizures elicited by electroconvulsive therapy (ECT) and its relation to seizure duration.MethodsPatients with a major depressive episode who underwent ECT were included. During treatment, 21‐channel continuous electroencephalogram (EEG) was recorded. Arterial spin labeling magnetic resonance imaging (ASL‐MRI) scans were acquired before the ECT‐course (baseline) and approximately one hour after an ECT‐induced seizure (postictal) to quantify global and regional gray matter cerebral blood flow (CBF). Seizure duration was assessed from the period of epileptiform discharges on the EEG. Healthy controls were scanned twice to assess test‐retest variability. We performed hypothesis‐driven Bayesian analyses to study the relation between global and regional perfusion changes and seizure duration.ResultsTwenty‐four patients and twenty‐seven healthy controls were included. Changes in postictal global and regional CBF were correlated with seizure duration. In patients with longer seizure durations, global decrease in CBF reached values up to 28 ml/100g/min. Regional reductions in CBF were most prominent in the inferior frontal gyrus, cingulate gyrus, and insula (up to ~35 ml/100g/min). In patients with shorter seizures global and regional perfusion increased (up to ~20 ml/100g/min). These perfusion changes were larger than changes observed in healthy controls, with a maximum median global CBF increase of 12 ml/100g/min and a maximum median global CBF decrease of 20 ml/100g/min.SignificanceSeizure duration is a key factor determining postictal perfusion changes. In future studies, seizure duration needs to be considered as confounding factor due to its opposite effect on postictal perfusion. .

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Section: Discussionsupporting

confidence: 53%

supporting

confidence: 55%

Section: Pathophysiological Considerationsmentioning

confidence: 70%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Changes in postictal cerebral perfusion are related to the duration of electroconvulsive therapy‐induced seizures

Pottkämper,

Verdijk,

Aalbregt

et al. 2023

Epilepsia

View full text Add to dashboard Cite

show abstract

“…Research into the mechanisms of reduced CBF has mostly focused on vasoconstriction. 1,3 The study by Lim et al 4 now introduces new players in this process—neutrophils, which enter the game beginning ∼30 minutes after the end of acute seizures in mice and obstruct capillaries. In line with this phenomenon, the investigators identified vascular stalls in the cortex, which were 2.3-fold more abundant than in saline-treated mice.…”

Section: Commentarymentioning

confidence: 99%