Generic placeholder image

Current Neurovascular Research

Editor-in-Chief

ISSN (Print): 1567-2026
ISSN (Online): 1875-5739

Research Article

Low-frequency Electrical Stimulation of the Hippocampus Plays a Role in the Treatment of Pharmacoresistant Epilepsy by Blocking the PKA-CREB Pathway

Author(s): Yuanxin Huang, Dai Shi, Guofeng Wu*, Likun Wang* and Siying Ren

Volume 20, Issue 2, 2023

Published on: 23 June, 2023

Page: [218 - 229] Pages: 12

DOI: 10.2174/1567202620666230614140426

Price: $65

Abstract

Objective: The objective of this study is to study the mechanism of Low frequency electrical stimulation (LFS) in the treatment of drug-resistant epilepsy by regulating the protein kinase A (PKA)-cAMP response element-binding protein (CREB) signaling pathway upstream of gamma aminobutyric acid A (GABAA) receptor.

Methods: Primary hippocampal neurons were extracted and cultured from fetal rat brains and randomly divided into the normal control group, PKA-CREB agonist group, and PKA-CREB inhibitor group. Drug-resistant epileptic rats were established and randomly divided into the pharmacoresistant group, LFS group, PKA-CREB agonist combined with hippocampal LFS group, and PKA-CREB inhibitor combined with hippocampal LFS group. The normal rats were in the normal control group and drug-sensitive rats were in the pharmacosensitive group. The seizure frequency of epileptic rats was determined using video surveillance. The expression of PKA, CREB, p-CREB, and GABAA receptor subunits α1 and β2 of each group were detected using reverse transcription quantitative polymerase chain reaction (RT-qPCR) and western blotting assays.

Results: The in vitro expression levels of PKA, CREB, and p-CREB in the agonist group were significantly higher than those in the normal control group (NRC group), while the expression levels of GABAA receptor subunits α1 and β2 were significantly lower than those in the NRC group. The expression levels of PKA, CREB, and p-CREB in the inhibitor group were significantly lower, while the expression levels of GABAA receptor subunits α1 and β2 were significantly higher than those in the NRC group. The in vivo seizure frequency was significantly lower in the LFS group than in the pharmacoresistant group (PRE group). Compared to the LFS group, the seizure frequency and the expression levels of PKA, CREB, and p-CREB in the rat hippocampus were significantly higher, and the expression levels of GABAA receptor subunits α1 and β2 were significantly lower in the agonist group. The results in the inhibitor group were exactly the opposite of those in the agonist group.

Conclusion: The PKA-CREB signaling pathway is involved in the regulation of GABAA receptor subunits α1 and β2. In addition, LFS plays an important role in increasing GABAA receptor expression by regulating the PKA-CREB signaling pathway.

[1]
Fiest KM, Sauro KM, Wiebe S, et al. Prevalence and incidence of epilepsy. Neurology 2017; 88(3): 296-303.
[http://dx.doi.org/10.1212/WNL.0000000000003509] [PMID: 27986877]
[2]
Chen Z, Brodie MJ, Liew D, Kwan P. Treatment outcomes in patients with newly diagnosed epilepsy treated with established and new antiepileptic drugs. JAMA Neurol 2018; 75(3): 279-86.
[http://dx.doi.org/10.1001/jamaneurol.2017.3949] [PMID: 29279892]
[3]
Li MCH, Cook MJ. Deep brain stimulation for drug-resistant epilepsy. Epilepsia 2018; 59(2): 273-90.
[http://dx.doi.org/10.1111/epi.13964] [PMID: 29218702]
[4]
Cukiert A, Lehtimaki K. Deep brain stimulation targeting in refractory epilepsy. Epilepsia 2017; 58(S1): 80-4.
[http://dx.doi.org/10.1111/epi.13686 ] [PMID: 28386921]
[5]
Yang CS, Chiu SC, Liu PY, Wu SN, Lai MC, Huang CW. Gastrodin alleviates seizure severity and neuronal excitotoxicities in the rat lithium-pilocarpine model of temporal lobe epilepsy via enhancing GABAergic transmission. J Ethnopharmacol 2021; 269: 113751.
[http://dx.doi.org/10.1016/j.jep.2020.113751 ] [PMID: 33359863]
[6]
Sen NER. Stress, CREB, and Memory: A tangled emerging link in disease. Neuroscientist 2019; 25(5): 420-33.
[http://dx.doi.org/10.1177/1073858418816611] [PMID: 30477403]
[7]
Wang H, Xu J, Lazarovici P, Quirion R, Zheng W. cAMP Response Element-Binding Protein (CREB): A Possible signaling molecule link in the pathophysiology of schizophrenia. Front Mol Neurosci 2018; 11: 255.
[http://dx.doi.org/10.3389/fnmol.2018.00255 ] [PMID: 30214393]
[8]
Pardo L, Valor LM, Eraso-Pichot A, et al. CREB regulates distinct adaptive transcriptional programs in astrocytes and neurons. Sci Rep 2017; 7(1): 6390.
[http://dx.doi.org/10.1038/s41598-017-06231-x] [PMID: 28743894]
[9]
Han XR, Wen X, Wang YJ, et al. Effects of CREB1 gene silencing on cognitive dysfunction by mediating PKA-CREB signaling pathway in mice with vascular dementia. Mol Med 2018; 24(1): 18.
[http://dx.doi.org/10.1186/s10020-018-0020-y] [PMID: 30134805]
[10]
Liu M, Xiong Y, Shan S, et al. Eleutheroside E Enhances the long-term memory of radiation-damaged C. elegans through G-protein-coupled receptor and neuropeptide signaling pathways. J Nat Prod 2020; 83(11): 3315-23.
[http://dx.doi.org/10.1021/acs.jnatprod.0c00650] [PMID: 33196193]
[11]
Wu G, Yu J, Wang L, Ren S, Zhang Y. PKC/CREB pathway mediates the expressions of GABAA receptor subunits in cultured hippocampal neurons after low-Mg(2+) solution treatment. Epilepsy Res 2018; 140: 155-61.
[http://dx.doi.org/10.1016/j.eplepsyres.2017.11.004] [PMID: 29414524]
[12]
Wu G, Wang L, Hong Z, Ren S, Zhou F. Hippocampal low-frequency stimulation inhibits afterdischarge and increases GABA (A) receptor expression in amygdala-kindled pharmacoresistant epileptic rats. Neurol Res 2017; 39(8): 733-43.
[http://dx.doi.org/10.1080/01616412.2017.1325120] [PMID: 28502217]
[13]
Sun HL, Deng DP, Pan XH, et al. A sub-threshold dose of pilocarpine increases glutamine synthetase in reactive astrocytes and enhances the progression of amygdaloid-kindling epilepsy in rats. Neuroreport 2016; 27(4): 213-9.
[http://dx.doi.org/10.1097/WNR.0000000000000511] [PMID: 26684398]
[14]
Kim HY, Spector AA. N-Docosahexaenoylethanolamine: A neurotrophic and neuroprotective metabolite of docosahexaenoic acid. Mol Aspects Med 2018; 64: 34-44.
[http://dx.doi.org/10.1016/j.mam.2018.03.004 ] [PMID: 29572109]
[15]
Min SJ, Hyun HW, Kang TC. Leptomycin B attenuates neuronal death via PKA- and PP2B-mediated ERK1/2 activation in the rat hippocampus following status epilepticus. Brain Res 2017; 1670: 14-23.
[http://dx.doi.org/10.1016/j.brainres.2017.06.002 ] [PMID: 28601633]
[16]
Wang L, Shi J, Wu G, Zhou F, Hong Z. Hippocampal low-frequency stimulation increased SV2A expression and inhibited the seizure degree in pharmacoresistant amygdala-kindling epileptic rats. Epilepsy Res 2014; 108(9): 1483-91.
[http://dx.doi.org/10.1016/j.eplepsyres.2014.07.005] [PMID: 25205164]
[17]
Huang Y, Guofeng WSR, Yangting K, Jing W. A new strategy for developing an animal model of temporal lobe epilepsy. neuropsychiatry 2018; 6(8): 1872-86.
[http://dx.doi.org/10.4172/neuropsychiatry.1000530]
[18]
Huang Y, Wang L, Ren S, Wu G, Wu J. The Expression of ZnT3 and GFAP Is potentiated in the hippocampus of drug-resistant epileptic rats induced by amygdala kindling. Neuroimmunomodulation 2020; 27(2): 104-12.
[http://dx.doi.org/10.1159/000510399] [PMID: 33161399]
[19]
Racine RJ. Modification of seizure activity by electrical stimulation: II. Motor seizure. Electroencephalogr Clin Neurophysiol 1972; 32(3): 281-94.
[http://dx.doi.org/10.1016/0013-4694(72)90177-0] [PMID: 4110397]
[20]
Löscher W, Reissmüller E, Ebert U. Kindling alters the anticonvulsant efficacy of phenytoin in Wistar rats. Epilepsy Res 2000; 39(3): 211-20.
[http://dx.doi.org/10.1016/S0920-1211(00)00100-5] [PMID: 10771247]
[21]
Sharma D, Dixit AB, Dey S, Tripathi M, Doddamani R, Sharma MC, et al. Increased levels of alpha4-containing GABAA receptors in focal cortical dysplasia: A possible cause of benzodiazepine resistance. Neurochem Int 2021; 148: 105084.
[http://dx.doi.org/10.1016/j.neuint.2021.105084] [PMID: 34052299]
[22]
Hannan S, Affandi AHB, Minere M, et al. Differential coassembly of α1-GABA A Rs associated with epileptic encephalopathy. J Neurosci 2020; 40(29): 5518-30.
[http://dx.doi.org/10.1523/JNEUROSCI.2748-19.2020] [PMID: 32513829]
[23]
Hernandez CC, Tian X, Hu N, et al. Dravet syndrome-associated mutations in GABRA1, GABRB2 and GABRG2 define the genetic landscape of defects of GABAA receptors. Brain Commun 2021; 3(2): fcab033.
[http://dx.doi.org/10.1093/braincomms/fcab033] [PMID: 34095830]
[24]
Srivastava S, Cohen J, Pevsner J, et al. A novel variant in GABRB2 associated with intellectual disability and epilepsy. Am J Med Genet A 2014; 164(11): 2914-21.
[http://dx.doi.org/10.1002/ajmg.a.36714] [PMID: 25124326]
[25]
Lund IV, Hu Y, Raol YH, et al. BDNF selectively regulates GABAA receptor transcription by activation of the JAK/STAT pathway. Sci Signal 2008; 1(41): ra9.
[http://dx.doi.org/10.1126/scisignal.1162396] [PMID: 18922788]
[26]
Niespodziany I, Ghisdal P, Mullier B, et al. Functional characterization of the antiepileptic drug candidate, padsevonil, on GABA A receptors. Epilepsia 2020; 61(5): 914-23.
[http://dx.doi.org/10.1111/epi.16497] [PMID: 32297665]
[27]
Wiciński M, Puk O, Malinowski B. Cenobamate: Neuroprotective potential of a new antiepileptic drug. Neurochem Res 2021; 46(3): 439-46.
[http://dx.doi.org/10.1007/s11064-020-03188-8] [PMID: 33252771]
[28]
Paudel YN, Kumari Y, Abidin SAZ, Othman I, Shaikh MF. Pilocarpine induced behavioral and biochemical alterations in chronic seizure-like condition in adult zebrafish. Int J Mol Sci 2020; 21(7): 2492.
[http://dx.doi.org/10.3390/ijms21072492] [PMID: 32260203]
[29]
Ye J, Yin Y, Liu H, et al. Tau inhibits PKA by nuclear proteasome‐dependent PKAR2α elevation with suppressed CREB/GluA1 phosphorylation. Aging Cell 2020; 19(1): e13055.
[http://dx.doi.org/10.1111/acel.13055] [PMID: 31668016]
[30]
Landeira BS, Santana TTS, Araújo JAM, et al. Activity-Independent effects of CREB on neuronal survival and differentiation during mouse cerebral cortex development. Cereb Cortex 2016; 28(2): 538-48.
[http://dx.doi.org/10.1093/cercor/bhw387] [PMID: 27999124]
[31]
Esvald EE, Tuvikene J, Sirp A, Patil S, Bramham CR, Timmusk T. CREB family transcription factors are major mediators of BDNF transcriptional autoregulation in cortical neurons. J Neurosci 2020; 40(7): 1405-26.
[http://dx.doi.org/10.1523/JNEUROSCI.0367-19.2019] [PMID: 31915257]
[32]
Tiwari MN, Mohan S, Biala Y, Yaari Y. Protein kinase A-mediated suppression of the slow afterhyperpolarizing KCa3.1 current in temporal lobe epilepsy. J Neurosci 2019; 39(50): 9914-26.
[http://dx.doi.org/10.1523/JNEUROSCI.1603-19.2019] [PMID: 31672789]
[33]
Rashid MA, Katakura M, Kharebava G, Kevala K, Kim HY. N -docosahexaenoylethanolamine is a potent neurogenic factor for neural stem cell differentiation. J Neurochem 2013; 125(6): 869-84.
[http://dx.doi.org/10.1111/jnc.12255] [PMID: 23570577]
[34]
Park T, Chen H, Kevala K, Lee JW, Kim HY. N-Docosahexaenoylethanolamine ameliorates LPS-induced neuroinflammation via cAMP/PKA-dependent signaling. J Neuroinflammation 2016; 13(1): 284.
[http://dx.doi.org/10.1186/s12974-016-0751-z] [PMID: 27809877]
[35]
Kim HY, Huang BX, Spector AA. Molecular and signaling mechanisms for docosahexaenoic acid-derived neurodevelopment and neuroprotection. Int J Mol Sci 2022; 23(9): 4635.
[http://dx.doi.org/10.3390/ijms23094635] [PMID: 35563025]
[36]
Meja KK, Catley MC, Cambridge LM, et al. Adenovirus-mediated delivery and expression of a cAMP-dependent protein kinase inhibitor gene to BEAS-2B epithelial cells abolishes the anti-inflammatory effects of rolipram, salbutamol, and prostaglandin E2: A comparison with H-89. J Pharmacol Exp Ther 2004; 309(2): 833-44.
[http://dx.doi.org/10.1124/jpet.103.060020] [PMID: 14747610]
[37]
Ji M, Zhang Z, Gao F, Yang S, Wang J, Wang X, et al. Curculigoside rescues hippocampal synaptic deficits elicited by PTSD through activating cAMP-PKA signaling. Phytother Res 2022; 37(2): 759-73.
[http://dx.doi.org/10.1002/ptr.7658] [PMID: 36200803]
[38]
Chen YQ, Xie X. Podophyllotoxin induces CREB phosphorylation and CRE-driven gene expression via PKA but not MAPKs. Mol Cells 2010; 29(1): 41-50.
[http://dx.doi.org/10.1007/s10059-010-0015-1] [PMID: 20033853]
[39]
Yu W, Chen FC, Xu WN, Ding SL, Chen PB, Yang L, et al. Inhibition of Y1 receptor promotes osteogenesis in bone marrow stromal cells via cAMP/PKA/CREB pathway. Front Endocrinol 2020; 11: 583105.
[http://dx.doi.org/10.3389/fendo.2020.583105 ] [PMID: 33240219]
[40]
Guerra GP, Mello CF, Bochi GV, et al. Hippocampal PKA/CREB pathway is involved in the improvement of memory induced by spermidine in rats. Neurobiol Learn Mem 2011; 96(2): 324-32.
[http://dx.doi.org/10.1016/j.nlm.2011.06.007] [PMID: 21708277]
[41]
Hang LH, Yang JP, Shao DH, Chen Z, Wang H. Involvement of spinal PKA/CREB signaling pathway in the development of bone cancer pain. Pharmacol Rep 2013; 65(3): 710-6.
[http://dx.doi.org/10.1016/S1734-1140(13)71049-1] [PMID: 23950594]
[42]
Zhong J, Dong W, Qin Y, et al. Roflupram exerts neuroprotection via activation of CREB/PGC‐1α signalling in experimental models of Parkinson’s disease. Br J Pharmacol 2020; 177(10): 2333-50.
[http://dx.doi.org/10.1111/bph.14983] [PMID: 31972868]
[43]
Li Y, Song J, Tong Y, Chung SK, Wong YH. RGS19 upregulates Nm23-H1/2 metastasis suppressors by transcriptional activation via the cAMP/PKA/CREB pathway. Oncotarget 2017; 8(41): 69945-60.
[http://dx.doi.org/10.18632/oncotarget.19509] [PMID: 29050254]
[44]
Zhang X, Xiang L, Ran Q, et al. Crif1 promotes adipogenic differentiation of bone marrow mesenchymal stem cells after irradiation by modulating the PKA/CREB signaling pathway. Stem Cells 2015; 33(6): 1915-26.
[http://dx.doi.org/10.1002/stem.2019] [PMID: 25847389]
[45]
Svejgaard B, Andreasen M, Nedergaard S. Role of GABAB receptors in proepileptic and antiepileptic effects of an applied electric field in rat hippocampus in vitro. Brain Res 2019; 1710: 157-62.
[http://dx.doi.org/10.1016/j.brainres.2018.12.043] [PMID: 30599137]
[46]
Middlebrooks EH, Grewal SS, Stead M, Lundstrom BN, Worrell GA, Van Gompel JJ. Differences in functional connectivity profiles as a predictor of response to anterior thalamic nucleus deep brain stimulation for epilepsy: A hypothesis for the mechanism of action and a potential biomarker for outcomes. Neurosurg Focus 2018; 45(2): E7.
[http://dx.doi.org/10.3171/2018.5.FOCUS18151] [PMID: 30064322]

Rights & Permissions Print Cite
© 2024 Bentham Science Publishers | Privacy Policy