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Epilepsia
Article . 2021 . Peer-reviewed
License: CC BY NC
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Epilepsia
Article
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Apollo
Article . 2021
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Apollo
Article . 2021
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The effect of lamotrigine and other antiepileptic drugs on respiratory rhythm generation in the pre‐Bötzinger complex

Authors: Janine Brandes; Janine Brandes; Nikolas Layer; Henner Koch; Henner Koch; Philipp Justus Lührs; Thomas V. Wuttke;

The effect of lamotrigine and other antiepileptic drugs on respiratory rhythm generation in the pre‐Bötzinger complex

Abstract

AbstractObjectiveLamotrigine and other sodium‐channel blocking agents are among the most commonly used antiepileptic drugs (AEDs). Because other sodium channel blockers, such as riluzole, can severely alter respiratory rhythm generation during hypoxia, we wanted to investigate if AEDs can have similar effects. This is especially important in the context of sudden unexpected death in epilepsy (SUDEP), the major cause of death in patients suffering from therapy‐resistant epilepsy. Although the mechanism of action is not entirely understood, respiratory dysfunction after generalized tonic‐clonic seizures seems to play a major role.MethodsWe used transverse brainstem slice preparations from neonatal and juvenile mice containing the pre‐Bötzinger complex (PreBötC) and measured population as well as intracellular activity of the rhythm‐generating network under normoxia and hypoxia in the presence or absence of AEDs.ResultsWe found a substantial inhibition of the gasping response induced by the application of sodium channel blockers (lamotrigine and carbamazepine). In contrast, levetiracetam, an AED‐modulating synaptic function, had a much smaller effect. The inhibition of gasping by lamotrigine was accompanied by a significant reduction of the persistent sodium current (INap) in PreBötC neurons. Surprisingly, the suppression of persistent sodium currents by lamotrigine did not affect the voltage‐dependent bursting activity in PreBötC pacemaker neurons, but led to a hypoxia‐dependent shift of the action potential rheobase in all measured PreBötC neurons.SignificanceOur results contribute to the understanding of the effects of AEDs on the vital respiratory functions of the central nervous system. Moreover, our study adds further insight into sodium‐dependent changes occurring during hypoxia and the contribution of cellular properties to the respiratory rhythm generation in the pre‐Bötzinger complex. It raises the question of whether sodium channel blocking AEDs could, in conditions of extreme hypoxia, contribute to SUDEP, an important issue that warrants further studies.

Country
Germany
Keywords

SUDEP, Sodium, 610, Lamotrigine, pacemaker, Mice, Animals, pre-Bötzinger complex, Anticonvulsants, lamotrigine, persistent sodium current, Sudden Unexpected Death in Epilepsy, Hypoxia, info:eu-repo/classification/ddc/610, Sodium Channel Blockers

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
7
Top 10%
Average
Top 10%
Green
hybrid