The neurovasculature as a target in temporal lobe epilepsy

Author:

Reiss Yvonne12ORCID,Bauer Sebastian23,David Bastian4,Devraj Kavi12ORCID,Fidan Elif12,Hattingen Elke25,Liebner Stefan12,Melzer Nico6,Meuth Sven G.6,Rosenow Felix23,Rüber Theodor234,Willems Laurent M.23,Plate Karl H.12

Affiliation:

1. Institute of Neurology (Edinger Institute) University Hospital, Goethe University Frankfurt Germany

2. Center for Personalized Translational Epilepsy Research (CePTER) University Hospital, Goethe University Frankfurt Germany

3. Epilepsy Center Frankfurt Rhine‐Main, Department of Neurology, Center of Neurology and Neurosurgery University Hospital, Goethe University Frankfurt Germany

4. Department of Epileptology University Hospital Bonn Bonn Germany

5. Institute of Neuroradiology, Center of Neurology and Neurosurgery University Hospital, Goethe University Frankfurt Germany

6. Department of Neurology Heinrich‐Heine University of Düsseldorf Düsseldorf Germany

Abstract

AbstractThe blood–brain barrier (BBB) is a physiological barrier maintaining a specialized brain micromilieu that is necessary for proper neuronal function. Endothelial tight junctions and specific transcellular/efflux transport systems provide a protective barrier against toxins, pathogens, and immune cells. The barrier function is critically supported by other cell types of the neurovascular unit, including pericytes, astrocytes, microglia, and interneurons. The dysfunctionality of the BBB is a hallmark of neurological diseases, such as ischemia, brain tumors, neurodegenerative diseases, infections, and autoimmune neuroinflammatory disorders. Moreover, BBB dysfunction is critically involved in epilepsy, a brain disorder characterized by spontaneously occurring seizures because of abnormally synchronized neuronal activity. While resistance to antiseizure drugs that aim to reduce neuronal hyperexcitability remains a clinical challenge, drugs targeting the neurovasculature in epilepsy patients have not been explored. The use of novel imaging techniques permits early detection of BBB leakage in epilepsy; however, the detailed mechanistic understanding of causes and consequences of BBB compromise remains unknown. Here, we discuss the current knowledge of BBB involvement in temporal lobe epilepsy with the emphasis on the neurovasculature as a therapeutic target.

Funder

European Commission

DZHK

Uniscientia Foundation

Publisher

Wiley

Subject

Neurology (clinical),Pathology and Forensic Medicine,General Neuroscience

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