Blood-brain barrier leakage after status epilepticus in rapamycin-treated rats I: Magnetic resonance imaging

E.A. van Vliet, W.M. Otte, W.J. Wadman, E. Aronica, G. Kooij, H.E. de Vries, R.M. Dijkhuizen, J.A. Gorter

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Abstract

OBJECTIVE: The mammalian target of rapamycin (mTOR) pathway has received increasing attention as a potential antiepileptogenic target. Treatment with the mTOR inhibitor rapamycin after status epilepticus reduces the development of epilepsy in a rat model. To study whether rapamycin mediates this effect via restoration of blood-brain barrier (BBB) dysfunction, contrast-enhanced magnetic resonance imaging (CE-MRI) was used to determine BBB permeability throughout epileptogenesis.
METHODS: Imaging was repeatedly performed until 6 weeks after kainic acid-induced status epilepticus in rapamycin (6 mg/kg for 6 weeks starting 4 h after SE) and vehicle-treated rats, using gadobutrol as contrast agent. Seizures were detected using video monitoring in the week following the last imaging session.
RESULTS: Gadobutrol leakage was widespread and extensive in both rapamycin and vehicle-treated epileptic rats during the acute phase, with the piriform cortex and amygdala as the most affected regions. Gadobutrol leakage was higher in rapamycin-treated rats 4 and 8 days after status epilepticus compared to vehicle-treated rats. However, during the chronic epileptic phase, gadobutrol leakage was lower in rapamycin-treated epileptic rats along with a decreased seizure frequency. This was confirmed by local fluorescein staining in the brains of the same rats. Total brain volume was reduced by this rapamycin treatment regimen.
SIGNIFICANCE: The initial slow recovery of BBB function in rapamycin-treated epileptic rats indicates that rapamycin does not reduce seizure activity by a gradual recovery of BBB integrity. The reduced BBB leakage during the chronic phase, however, could contribute to the decreased seizure frequency in post-status epilepticus rats treated with rapamycin. Furthermore, the data show that CE-MRI (using step-down infusion with gadobutrol) can be used as biomarker for monitoring the effect of drug therapy in rats.
Original languageEnglish
Pages (from-to)59-69
JournalEpilepsia
Volume57
Issue number1
Early online date22 Dec 2015
DOIs
Publication statusPublished - Jan 2016

Keywords

  • Blood-brain barrier
  • Contrast-enhanced magnetic resonance imaging
  • Epileptogenesis
  • Rapamycin
  • Status epilepticus
  • Temporal lobe epilepsy

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