Warren symposium follows legacy of geneticist giant

If we want to understand how the brain creates memories, and how genetic disorders distort the brain’s machinery, then the fragile X gene is an ideal place to start. That’s why the Stephen T. Warren Memorial Symposium, taking place November 28-29 at Emory, will be a significant event for those interested in neuroscience and genetics. Stephen T. Warren, 1953-2021 Warren, the founding chair of Emory’s Department of Human Genetics, led an international team that discovered Read more

Mutations in V-ATPase proton pump implicated in epilepsy syndrome

Why and how disrupting V-ATPase function leads to epilepsy, researchers are just starting to figure Read more

Tracing the start of COVID-19 in GA

At a time when COVID-19 appears to be receding in much of Georgia, it’s worth revisiting the start of the pandemic in early 2020. Emory virologist Anne Piantadosi and colleagues have a paper in Viral Evolution on the earliest SARS-CoV-2 genetic sequences detected in Georgia. Analyzing relationships between those virus sequences and samples from other states and countries can give us an idea about where the first COVID-19 infections in Georgia came from. We can draw Read more

epilepsy

Mutations in V-ATPase proton pump implicated in epilepsy syndrome

Proton pumps are important enzymes, not only for the stomach, where they maintain the acidity needed to digest food, but elsewhere in the body. Genetic mutations perturbing one type of proton pump have been implicated in several diseases, including myopathy, osteopetrosis and hearing loss.

Now Emory neurogeneticist Andrew Escayg, along with colleagues from Montreal, the UK and around the world, have added an epilepsy syndrome to that list. It doesn’t really have a name yet, besides the gene involved: ATP6V0C. Their findings were recently published in Brain.

Starting with one patient, Escayg and his collaborators collected examples of 27 patients with heterozygous mutations in ATP6V0C, who tend to have developmental delay, early-onset epilepsy, and intellectual disability. 

V-ATPase structure. ATP6V0C encodes a protein forming the c ring (red)

“What’s distinctive about this group of patients is that they often have cardiac abnormalities or structural alterations in the brain visible on MRI,” Escayg says. “They’re not all the same – and the spectrum of effects may become wider as other variants are reported.”

ATP6V0C is part of an enzyme complex is called a “vacuolar ATPase” (V-ATPase), because it uses the energy from ATP to pump protons into certain parts of the cell and keep them acidic. Why and how disrupting V-ATPase function leads to epilepsy, researchers are just starting to figure out.

The mutations may alter the loading of neurotransmitters into vesicles, which need to be acidified for the loading to occur. Or they may affect other aspects of brain development. Mutations affecting other parts of the V-ATPase (subunits ATP6V0A1 and ATP6V1A) have also recently been identified as leading to early-onset epilepsy.

Read more

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Oxytocin delivery via nanoparticles

The neuropeptide oxytocin, known for promoting social interactions, has attracted interest as a possible treatment for autism spectrum disorder. A challenge is getting the molecule past the blood-brain barrier. Many clinical studies have used delivery via nasal spray, but even then, oxytocin doesn’t last long in the body and shows inconsistent effects.

Emory neuroscientist Andrew Escayg has been collaborating with Mercer/LSU pharmacologist Kevin Murnane on a nanoparticle delivery approach that could get around these obstacles. One of Escayg’s primary interests is epilepsy — specifically Dravet syndrome, a severe genetic form of epilepsy — and oxytocin has previously displayed anti-seizure properties in animal models.

Escayg and Murnane’s recent paper in Neurobiology of Disease shows that when oxytocin is packaged into nanoparticles, it can increase resistance to induced seizures and promote social behavior in a mouse model of Dravet syndrome.

This suggests properly delivered oxytocin could have benefits on both seizures and behavior. In addition to seizures, children and adults with Dravet syndrome often have autism – see this Spectrum News article on the connections.

Escayg reports he is planning a collaboration with oxytocin expert Larry Young at Yerkes, who Tweeted “This is a promising new area of oxytocin research” when the paper was published. Senior postdoc Jennifer Wong has already been working on extending the findings to other mouse models of epilepsy and adding data on spontaneous seizure frequency.

The nanoparticle approach could be used for other neuropeptides such as neuropeptide Y, proposed as a treatment mode for anxiety disorders/PTSD, and hypocretin, the missing molecule in narcolepsy. Murnane formed a company when he was at Mercer to develop the technology.

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Two birds with one stone: amygdala ablation for PTSD and epilepsy

The amygdala is a region of the brain known for its connections to emotional responses and fear memories, and hyperreactivity of the amygdala is associated with symptoms of PTSD (post-traumatic stress disorder). That said, it’s quite a leap to design neurosurgical ablation of the amygdala to address someone’s PTSD. This type of irreversible intervention could only be considered because of the presence of another brain disorder: epilepsy.

In a case series published in Neurosurgery, Emory investigators describe how for their first patient with both refractory epilepsy and PTSD, observations of PTSD symptom reduction were fortuitous. However, in a second patient, before-and-after studies could be planned. In both, neurosurgical ablation of the amygdala significantly reduced PTSD symptoms as well as reducing seizure frequency.

Read more

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Laughter may be best medicine for brain surgery

Neuroscientists at Emory University School of Medicine have discovered a focal pathway in the brain that when electrically stimulated causes immediate laughter, followed by a sense of calm and happiness, even during awake brain surgery. The effects of stimulation were observed in an epilepsy patient undergoing diagnostic monitoring for seizure diagnosis. These effects were then harnessed to help her complete a separate awake brain surgery two days later.

The behavioral effects of direct electrical stimulation of the cingulum bundle, a white matter tract in the brain, were confirmed in two other epilepsy patients undergoing diagnostic monitoring. The findings are scheduled for publication in the Journal of Clinical Investigation.

Emory neurosurgeons see the technique as a “potentially transformative” way to calm some patients during awake brain surgery, even those who are not especially anxious. For optimal protection of critical brain functions during surgery, patients may need to be awake and not sedated, so that doctors can talk with them, assess their language skills, and detect impairments that may arise from resection. Read more

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Fermentation byproduct suppresses seizures in nerve agent poisoning

A compound found in trace amounts in alcoholic beverages is more effective at combating seizures in rats exposed to an organophosphate nerve agent than the current recommended treatment, according to new research published in eNeuro.

This work comes from Asheebo Rojas, Ray Dingledine and colleagues in Emory’s Department of Pharmacology. Just as an aside, we don’t know the nature of the recent alleged chemical attack in Syria, and the chemical used in the Emory experiments is not a “weaponized” nerve agent such as Sarin. Organophosphates were also widely used as insecticides, but their use has been declining.

Left untreated, organophosphate poisoning can lead to severe breathing and heart complications, because of the inhibition of acetylcholinesterase. It also causes seizures. Some patients are resistant to treatment with the anti-anxiety drug diazepam (Valium), a standard first-line treatment for such poisoning, and its effectiveness decreases the longer the seizure lasts.

The researchers compared the ability of two treatments — diazepam and the anesthetic urethane (ethyl carbamate), commonly formed in trace amounts during fermentation of beer and wine from the reaction of urea and ethanol — to interrupt seizures in rats exposed to the organophosphate diisopropyl fluorophosphate. The researchers found urethane to be more effective than diazepam, suppressing seizures for multiple days and accelerating recovery of weight lost while protecting the rats from cell loss in the hippocampus.

Urethane/ethyl carbamate is a carcinogen in animals, which led to concerns over its presence in alcoholic beverages in the 1980s. It was also used as a sedative for many years in Japan. The researchers did not observe any evidence of lung tumors in the urethane-treated animals seven months later, suggesting that the dose used in this study is not carcinogenic. The findings point to urethane or a derivative as a potential therapeutic for preventing organophosphate-triggered seizures from developing into epilepsy. Read more

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An exceptional electrical thrill ride #CNS2018

A recent paper in Neuropsychologia got a lot of attention on Twitter and at the Cognitive Neuroscience Society meeting in Boston over the weekend. It discusses what can happen when the amygdala, a region of the brain known for regulating emotional responses, receives direct electrical stimulation. A thrill ride – but for only one study participant. Two of nine people noticed the electrical stimulation. One individual reported (a video is included in the paper):

“It was, um, it was terrifying, it was just…it was like I was about to get attacked by a dog. Like the moment, like someone unleashes a dog on you, and it’s just like it’s so close…

He also spontaneously reported “this is fun.” He further explained that he could distinguish feelings in his body that would normally be associated with fear recognized and the absence of an actual threat, making the experience “fun”.

But wait, why were Emory neuroscientists Cory Inman, Jon Willie and Stephan Hamann and colleagues doing this? Read more

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Give a zap to Emory brain research for #STATMadness

Next week, we will be asking the Emory research community to support Emory’s entry in a contest. It’s like “Battle of the Bands.” Whoever gets the loudest cheers wins. We have some intriguing neuroscience research. Please help!

STAT Madness is a “March Madness” style bracket competition, but with biomedical research advances as competitors. Universities or research institutes nominate their champions, research that was published the previous year.

Our entry for 2018:

Direct amygdala stimulation can enhance human memory

The findings, from Cory Inman, Jon Willie and colleagues from the Department of Neurosurgery and Joe Manns from Psychology, were the first published example of electrical brain stimulation in humans giving an event-specific boost to memory lasting overnight. The research was conducted with epilepsy patients undergoing an invasive procedure for seizure diagnosis. However, the technology could one day be incorporated into a device aimed at helping those with memory impairments, such as people with traumatic brain injury or neurodegenerative diseases.

Extra note: you may have seen similar neuroscience research in a recent Nature Communications paper, which was described in the New York Times. Cory Inman had some comments below — he and neurosurgeon Robert Gross were co-authors:

The localization to the left lateral temporal cortex was interesting, because it hadn’t been identified as a region that modulates episodic or hippocampus-dependent memory. [The Emory authors stimulated the amygdala.] The more recent paper found a similar size of memory enhancement, with a slightly different and harder memory task of free recall, using “closed-loop” stimulation based on whether the brain is in a ‘bad’ encoding state. It’s possible that closed-loop stimulation could be used with the amygdala as well. 

Emory’s first opponoent is University of California, San Francisco. We are about half way down on the right side of the bracket.

As far as voting, you can fill out a whole bracket or you can just vote for Emory, along with other places you may feel an allegiance to. The contest will go several rounds. The first round begins on February 26. If Emory advances, then people will be able to continue voting for us starting March 2.

At the moment, you can sign up to be reminded to vote with an email address at:
https://signup.statnews.com/stat-madness

Starting Monday, February 26, you can follow the 2018 STAT Madness bracket and vote here:
https://www.statnews.com/feature/stat-madness/bracket/

Please share on social media using the hashtag #statmadness2018.

STAT is a life sciences-focused news site, launched in 2015 by the owner of the Boston Globe. It covers medical research and biotech nationally and internationally. Emory took part in 2017’s contest, with Tab Ansari’s groundbreaking work on SIV remission, a collaboration with Tony Fauci’s lab at NIAID.

 

 

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Epilepsy pick up sticks

Imagine the game of pick up sticks. It’s hard to extract one stick from the pile without moving others. The same problem exists, in a much more complex way, in the brain. Pulling on one gene or neurotransmitter often nudges a lot of others.

Andrew Escayg, PhD

That’s why a recent paper from Andrew Escayg’s lab is so interesting. He studies genes involved in epilepsy. Several years ago, he showed that mice with mutations in the SCN8A gene have absence epilepsy, while also showing resistance to induced seizures. SCN8A is one of those sticks that touches many others. The gene encodes a voltage-gated sodium channel, involved in setting the thresholds for and triggering neurons’ action potentials. Mutating the gene in mice modifies sleep and even enhances spatial memory.

Escayg’s new paper, with first author Jennifer Wong, looks at the effect of “knocking down” SCN8A in the hippocampus in a mouse model of mesial temporal lobe epilepsy. This model doesn’t involve sodium channel genes; it’s generated by injection of a toxin (kainic acid) into the brain. The finding suggests that inhibiting SCN8A may be applicable to other forms of epilepsy. Escayg notes that mesial temporal lobe epilepsy is one of the most common forms of treatment-resistant epilepsy in adults.

Knocking down SCN8A in the hippocampus 24 hours after injection could prevent the development of seizures in 90 percent of the treated mice. “It is likely that selective reduction in Scn8a expression would have directly decreased neuronal excitability,” the authors write. It did not lead to increased anxiety levels or impaired learning/memory.

Currently, no available drugs target Scn8a specifically. However, antisense approaches for neurodegenerative diseases have been gaining ground – perhaps epilepsy could fit in.

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More on NMDA receptor variants + epilepsy/ID

NMDA receptors are complex electrochemical machines, important for signaling between brain cells. Rare mutations in the corresponding genes cause epilepsy and intellectual disability.

Pre-M1 helices in multi-subunit NMDA receptor. Adapted from Ogden et al PLOS Genetics (2017).

In Emory’s Department of Pharmacology, the Traynelis and Yuan labs have been harvesting the vast amounts of information now available from public genome databases, to better understand how changes in the NMDA receptor genes relate to function. (Take a “deeper dive” into their November 2016 publication on this topic here.)

Their recent paper in PLOS Genetics focuses on a particular region in the NMDA receptor, called the pre-M1 helix (see figure). It also includes experiments on whether drugs now used for Alzheimer’s disease, such as memantine, could be repurposed to have beneficial effects for patients with certain mutations. The in vitro data reported here could inform clinical use. Read more

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Insane in the membrane – inflamed in the brain

Inflammation in the brain is a feature of several neurological diseases, ranging from Parkinson’s and Alzheimer’s to epilepsy. Nick Varvel, a postdoc with Ray Dingledine’s lab at Emory, was recently presenting his research and showed some photos illustrating the phenomenon of brain inflammation in status epilepticus (prolonged life-threatening seizures).

The presentation was at a Center for Neurodegenerative Disease seminar; his research was also published in PNAS and at the 2016 Society for Neuroscience meeting.green-red-brain

Varvel was working with mice in which two different types of cells are marked by fluorescent proteins. Both of the cell types come originally from the blood and can be considered immune cells. However, one kind – marked with green — is in the brain all the time, and the red kind enters the brain only when there is an inflammatory breach of the blood brain barrier.

Both markers, CX3CR1 (green) and CCR2 (red), are chemokine receptors. Green fluorescent protein is selectively produced in microglia, which settle in the brain before birth and are thought to have important housekeeping/maintenance functions.

Monocytes, a distinct type of cell that is not usually in the brain in large numbers, are lit up red. Monocytes rush into the brain in status epilepticus, and in traumatic brain injury, hemorrhagic stroke and West Nile virus encephalitis, to name some other conditions where brain inflammation is also seen.

In the PNAS paper, Varvel and his colleagues include a cautionary note about using these mice for studying situations of more prolonged brain inflammation, such as neurodegenerative diseases: the monocytes may turn down production of the red protein over time, so it’s hard to tell if they’re still in the brain after several days.

Targeting CCR2 – good or bad? Depends on the disease model

The researchers make the case that “inhibiting brain invasion of CCR2+ monocytes could represent a viable method for alleviating several deleterious consequences of status epilepticus.” Read more

Posted on by Quinn Eastman in Immunology, Neuro Leave a comment