Implication of the lateral hypothalamus in the comorbid sleep disorder of temporal lobe seizure

NIH RePORTER · NIH · R21 · $500,500 · view on reporter.nih.gov ↗

Abstract

Abstract Epilepsy, the occurrence of spontaneous recurrent seizures, is one of the most common neurological disorders. These recurring seizures result in a wide range of comorbidities that further reduce a patient’s quality of life and could interfere with the diagnosis and treatment of their epilepsy. In particular, patients suffering from temporal lobe epilepsy have frequent and severe sleep disorders such as excessive daytime sleepiness. Numerous brain areas are involved in regulation of wakefulness and could be involved in the generation of these comorbid sleep disorders. Among them, the orexinergic neurons of the lateral hypothalamus (LH) have been shown to control arousal and wakefulness but have also been shown to be involved in the modulation of epileptic activity. We hypothesize that temporal lobe seizures may disrupt the normal function of the LH leading to changes in nocturnal sleep architecture and excessive daytime sleepiness. The interaction between sleep and epilepsy is complex and difficult to study in patients due to confounding factors such as medication and environment. While the environment can be controlled in rodent studies, there are distinct differences between the human and rodent circadian cycles and sleep architectures, limiting the translational value. Alternatively, rhesus macaque nonhuman primates have a sleep architecture like humans with four distinct sleep stages, and temporal lobe seizures can be safely induced by injecting penicillin into the temporal lobe. Acute seizures will be induced by local injection of penicillin into the hippocampus which will result in a succession of spontaneous seizures and interictal activity for a period of 4-6 hours. In Aim 1, we will characterize the electrophysiological changes of the LH during these temporal lobe seizures. We will record unit and local field activity and analyze the changes in firing rate and pattern induced by seizures and interictal activity. We expect to find a strong involvement of LH neurons during the seizures. In Aim 2, we will evaluate the comorbid sleep disorders associated with temporal lobe seizures. We will test the excessive daytime sleepiness and evaluate the changes in the nocturnal sleep architecture at different timepoints following seizure induction, and how normal sleep architecture can be restored with administration of an orexin antagonist. Following seizure induction, we expect to find a disruption of sleep architecture, reduction of REM duration, and an increase of daytime sleepiness, which can be ameliorated with administration of suvorexant, an orexin antagonist. This work will provide key preliminary data for a subsequent study to investigate more extensively the involvement of the LH neurons and orexin activity in the control of seizures and the comorbid sleep disorders associated with temporal lobe seizures.

Key facts

NIH application ID
10593766
Project number
1R21NS125287-01A1
Recipient
EMORY UNIVERSITY
Principal Investigator
Annaelle Devergnas
Activity code
R21
Funding institute
NIH
Fiscal year
2022
Award amount
$500,500
Award type
1
Project period
2022-09-01 → 2025-02-28