Summary: Researchers have identified a circuit within the brain that may be responsible for respiratory dysfunction and sudden death associated with Dravet syndrome.
Source: Vanderbilt University
Risk of sudden unexpected death in epilepsy (SUDEP)ย isย among comorbiditiesย present inย Dravet Syndromeย (DS), aย rare,ย catastrophic form of epilepsyย in whichย seizures begin in infancy,ย withย mostย casesย dueย to mutations inย a single gene,ย SCN1A.ย ย
Breathing issues have been reported in patients and in mouse models of DS, and a recent study implicated respiratory decline in SUDEP in DS mice.
In the journalย eNeuro,ย William Nobis, MD, PhD,ย Wen Wei Yan, MD,ย Maya Xiaย and colleaguesย reportย experimentsย in DS miceย showingย altered excitability inย a complex ofย neuronsย deep in the brain,ย theย bed nucleus of the stria terminalisย (BNST), andย significantย under-excitability ofย neurons projecting fromย the BNST to the parabrachial nucleus,ย which is located atopย the brainstemย andย isย involved in respiration.
Noting thatย thisย circuitย mightย be driving respiratory dysfunction and sudden death in DS, the authorsย call for further study of the role of deep brain structures in epilepsy models.
Also on the study from Vanderbilt University Medical Center wereย Jeremy Chiang,โฏAlyssa Levittย andย Daneย Chetkovich, MD, PhD. They were joined by researchers fromย Northwestern University.ย This work was supported by the American Epilepsy Society, NINDS Center for SUDEP Research, and Vanderbilt Faculty Research Scholars award.ย
About this neuroscience research news
Author: Paul Govern
Source: Vanderbilt University
Contact: Paul Govern – Vanderbilt University
Image: The image is in the public domain
Original Research: Open access.
“Enhanced Synaptic Transmission in the Extended Amygdala and Altered Excitability in an Extended Amygdala to Brainstem Circuit in a Dravet Syndrome Mouse Model” by William Nobis et al. eNeuro
Abstract
Enhanced Synaptic Transmission in the Extended Amygdala and Altered Excitability in an Extended Amygdala to Brainstem Circuit in a Dravet Syndrome Mouse Model
Dravet syndrome (DS) is a developmental and epileptic encephalopathy with an increased incidence of sudden death. Evidence of interictal breathing deficits in DS suggests that alterations in subcortical projections to brainstem nuclei may exist, which might be driving comorbidities in DS.
The aim of this study was to determine whether a subcortical structure, the bed nucleus of the stria terminalis (BNST) in the extended amygdala, is activated by seizures, exhibits changes in excitability, and expresses any alterations in neurons projecting to a brainstem nucleus associated with respiration, stress response, and homeostasis.
Experiments were conducted using F1 mice generated by breeding 129.Scn1a+/โย mice with wild-type C57BL/6J mice. Immunohistochemistry was performed to quantify neuronal c-fosย activation in DS mice after observed spontaneous seizures.
Whole-cell patch-clamp and current-clamp electrophysiology recordings were conducted to evaluate changes in intrinsic and synaptic excitability in the BNST. Spontaneous seizures in DS mice significantly enhanced neuronal c-fosย expression in the BNST. Further, the BNST had altered AMPA/NMDA postsynaptic receptor composition and showed changes in spontaneous neurotransmission, with greater excitation and decreased inhibition.
BNST to parabrachial nucleus (PBN) projection neurons exhibited intrinsic excitability in wild-type mice, while these projection neurons were hypoexcitable in DS mice. The findings suggest that there is altered excitability in neurons of the BNST, including BNST-to-PBN projection neurons, in DS mice.
These alterations could potentially be driving comorbid aspects of DS outside of seizures, including respiratory dysfunction and sudden death.

