Listen as Basic Science Editor Sloka Iyengar PhD finishes up her series on catamenial epilepsy by reviewing the results of recent research.
Kindling and Neurosteriod Withdrawal
- As mentioned earlier, a neurotransmitter named GABA is the primary inhibitory neurotransmitter in the brain, and it acts via GABA receptors (GABAR).
- The GABAR is made up of different subunits; one of the subunits is the delta (δ) subunit.
- GABARs with the delta subunit are abundant in the hippocampus (a structure of the brain critical for seizure generation and propagation).
- In addition, GABARs with the delta subunit have been shown to change during menstruation and pregnancy.
- Kindling is a method in which normal rodents are administered electrical stimulation in a part of the brain called the hippocampus. Eventually, this leads to spontaneous seizures, i.e., epilepsy.
- Since neurosteroid withdrawal has been shown to be a potential mechanism for catamenial epilepsy in humans, scientists in a recent study used both kindling and neurosteroid withdrawal to study seizure activity in mice.
- In this study, scientists took animals with neurosteroid withdrawal and subjected them to kindling to see if the brain is more susceptible to kindling following a sudden decrease in neurosteroids.
- The current study found that there was an increase in delta subunit containing GABARs in the dentate gyrus of the hippocampus in mice that underwent neurosteroid withdrawal. Because of this increase in delta subunit containing GABARs, the neurons were more sensitive to allopregnanolone - a natural neurosteroid.
- Mice that were administered neurosteroid withdrawal were more susceptible to kindling.
- Replacement of neurosteroid produced an anticonvulsant effect.
Hence, replenishment of neurosteroid may be a potential therapy for at least some kinds of catamenial epilepsies.
Triglycerides and the Modified Atkins Diet
- It has been observed that some women can have catamenial seizures even if they are on the modified Atkins diet.
- An ongoing clinical trial is investigating the use of medium chain triglycerides in addition to the modified Atkins diet for women with catamenial epilepsy.
- In this study, the investigators are trying to see if addition of medium chain triglycerides helps.
This particular study is to test compliance and tolerability. Hopefully, in the future, the effect of this diet on seizures can be determined.