GABAergic excitation after febrile seizures induces ectopic granule cells and adult epilepsy

R Koyama, K Tao, T Sasaki, J Ichikawa, D Miyamoto… - Nature medicine, 2012 - nature.com
R Koyama, K Tao, T Sasaki, J Ichikawa, D Miyamoto, R Muramatsu, N Matsuki, Y Ikegaya
Nature medicine, 2012nature.com
Temporal lobe epilepsy (TLE) is accompanied by an abnormal location of granule cells in
the dentate gyrus. Using a rat model of complex febrile seizures, which are thought to be a
precipitating insult of TLE later in life, we report that aberrant migration of neonatal-
generated granule cells results in granule cell ectopia that persists into adulthood. Febrile
seizures induced an upregulation of GABAA receptors (GABAA-Rs) in neonatally generated
granule cells, and hyperactivation of excitatory GABAA-Rs caused a reversal in the direction …
Abstract
Temporal lobe epilepsy (TLE) is accompanied by an abnormal location of granule cells in the dentate gyrus. Using a rat model of complex febrile seizures, which are thought to be a precipitating insult of TLE later in life, we report that aberrant migration of neonatal-generated granule cells results in granule cell ectopia that persists into adulthood. Febrile seizures induced an upregulation of GABAA receptors (GABAA-Rs) in neonatally generated granule cells, and hyperactivation of excitatory GABAA-Rs caused a reversal in the direction of granule cell migration. This abnormal migration was prevented by RNAi-mediated knockdown of the Na+K+2Cl co-transporter (NKCC1), which regulates the excitatory action of GABA. NKCC1 inhibition with bumetanide after febrile seizures rescued the granule cell ectopia, susceptibility to limbic seizures and development of epilepsy. Thus, this work identifies a previously unknown pathogenic role of excitatory GABAA-R signaling and highlights NKCC1 as a potential therapeutic target for preventing granule cell ectopia and the development of epilepsy after febrile seizures.
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