Cognitive dysfunction in TLEMemory deficits have long been associated with temporal lobe epilepsy (TLE) (1-4). In particular, episodic memory deficits in individuals with TLE are prominent and progressive (3-5). Though seizure control has been correlated with improved cognition, it is clear that anticonvulsants can cause additional memory impairments (6). Possibly due partly to the cognitive deficits associated with it, TLE can be accompanied by setbacks in school and occupational performance (7). Therefore, there is a clear need for finding specific treatments not only for seizures but also for cognitive disability in TLE. Many factors likely contribute to cognitive dysfunction in individuals with TLE. Studies in both humans and animals show that extensive cell death in hippocampal and extrahippocampal structures results in loss and reorganization of circuits essential for encoding of memories (8-10). In addition, interictal epileptiform activity may interfere with encoding or retrieval of information (11,12).In this review, we will focus on a potentially treatable cause of cognitive dysfunction: disruption to theta rhythms and theta-related synchronization in the hippocampus.
Hippocampal Theta Rhythm in RodentsThe rodent hippocampal theta rhythm is a 4-12 Hz, large amplitude local field potential oscillation that is prominent during exploration and rapid eye movement (REM) sleep (13-15). While theta-band local field potentials and phase locked firing to the theta rhythm can be recorded in a large number of extrahippocampal structures-including cingulate, perirhinal, entorhinal cortices and amygdala (reviewed in [16])-the medial septum and the supramammillary nucleus (which projects to the medial septum) have been posited to be theta generators, as lesions to these regions abolishes hippocampal and extrahippocampal theta rhythms (17, 18). The supramammillary nucleus may not by itself generate theta rhythmicity but rather have theta rhythmicity imposed on it by the ventral tegmental nucleus of Gudden (19) and the median raphe (20). Lesions, or pharmacological or optogenetic manipulations that impair the theta rhythm severely degrade spatial and nonspatial learning and memory (16,(21)(22)(23), and electrical stimulation at theta frequency can restore behavioral deficits (23). Therefore, theta rhythms and the plasticity mechanisms enabled by these oscillations (24) are critical for hippocampal function; they are not just epiphenomena. Any disease process that alters these oscillations will impact a range of cognitive hippocampaldependent behaviors. Finally, gamma oscillations (30-120 Hz) are also present in a highly theta phase-specific manner, a phenomenon known as "theta-gamma coupling" or nesting (25-28). Higher frequency gamma (60-120 Hz) is recruited close to the trough of theta (as measured in CA1), while slower gamma (25-50 Hz) occurs at the falling phase of theta (28). Fast and slow gamma oscillations occur not only during different phases of theta but also occur mostly on different theta cycles (28). Ther...