# Epileptogenic Changes in Local Network Structure Following Injury (Project 2)

> **NIH NIH P01** · MASSACHUSETTS GENERAL HOSPITAL · 2024 · $273,976

## Abstract

Severe traumatic brain injury (TBI) results in post-traumatic epilepsy (PTE), following a latent period of no
seizures, in approximately 20% of the civilian population. The factors that influence whether a person develops
epilepsy following TBI include severity of injury, patient demographic, and a wide swath of poorly characterized
cellular and molecular processes that take place during the latent period. Developing effective interventional
therapies to prevent PTE will depend critically on identifying the earliest molecular pathways that are specifically
epileptogenic. Acquiring such data in biophysically relevant models has been technically challenging.
Neuroinflammatory processes following TBI in rodents have been widely studied, but clinical translatability of
findings has been poor. Studies in humans and large gyrencephalic animals have been largely confined to large-
scale electrographic recordings and ex vivo physiological and histological analysis. Four findings stand out from
these studies as hallmarks of an epileptic brain: 1) gliosis at the site of injury, 2) GABA-mediated synaptic activity
that is excitatory rather than inhibitory, 3) a prevalence of non-ictal hypersynchronous electrical activity, and 4)
disruption of functional network connectivity at the macro (whole-brain) level. Several lines of published and
preliminary data suggest that gliotic tissue resulting from TBI produces an extracellular matrix that stably lowers
extracellular chloride. This, in turn, depolarizes the GABA reversal potential (EGABA).
We hypothesize that the resulting disinhibition will increase the synchronicity of neuronal activity, beginning at
the site of injury, where the gliotic scar forms. We have recently developed a porcine model of neocortical post-
traumatic epilepsy and the imaging tools (fluorophores, large-animal 2-photon microscope, and supporting
technologies) to longitudinally study the epileptic focus with single-neuron precision and multimodal (chloride
and calcium) fluorescence data. In this project, we will simultaneously image intra or extracellular chloride and
calcium activity before injury, during the latent period, and after the emergence of spontaneous seizures. We
will also chemically alter the extracellular matrix (which in turn alters extracellular chloride) to test for a causal
link between extracellular chloride and functional connectivity. We will use these data to evaluate the
hypothesis that depolarizing changes in EGABA produces epileptogenic changes in functional network connectivity
and that these changes correlate with clinically measurable epileptic phenotypes.
This rich dataset will inform development of anti-PTE treatments as follows. If a decrease in extracellular
chloride is associated with increased neuronal activity and network connectivity, then treatments that alter the
formation of gliotic extracellular matrix (e.g. matrix metalloproteinases) may prevent neuronal synchronization
during the latent period and...

## Key facts

- **NIH application ID:** 10896230
- **Project number:** 5P01NS127769-02
- **Recipient organization:** MASSACHUSETTS GENERAL HOSPITAL
- **Principal Investigator:** Kyle Patrick Lillis
- **Activity code:** P01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $273,976
- **Award type:** 5
- **Project period:** 2023-08-01 → 2028-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10896230

## Citation

> US National Institutes of Health, RePORTER application 10896230, Epileptogenic Changes in Local Network Structure Following Injury (Project 2) (5P01NS127769-02). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10896230. Licensed CC0.

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