Adrenergic Mechanisms of Audiogenic Seizure-Induced Death in a Mouse Model of SCN8A Encephalopathy

Sudden unexpected death in epilepsy (SUDEP) is the leading cause of death amongst patients whose seizures are not adequately controlled by current therapies. Patients with SCN8A encephalopathy have an elevated risk for SUDEP. While transgenic mouse models have provided insight into the molecular mec...

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Main Authors: Eric R. Wengert, Ian C. Wenker, Elizabeth L. Wagner, Pravin K. Wagley, Ronald P. Gaykema, Jung-Bum Shin, Manoj K. Patel
Format: Article
Language:English
Published: Frontiers Media S.A. 2021-03-01
Series:Frontiers in Neuroscience
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fnins.2021.581048/full
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author Eric R. Wengert
Eric R. Wengert
Ian C. Wenker
Elizabeth L. Wagner
Elizabeth L. Wagner
Pravin K. Wagley
Ronald P. Gaykema
Jung-Bum Shin
Jung-Bum Shin
Manoj K. Patel
Manoj K. Patel
author_facet Eric R. Wengert
Eric R. Wengert
Ian C. Wenker
Elizabeth L. Wagner
Elizabeth L. Wagner
Pravin K. Wagley
Ronald P. Gaykema
Jung-Bum Shin
Jung-Bum Shin
Manoj K. Patel
Manoj K. Patel
author_sort Eric R. Wengert
collection DOAJ
description Sudden unexpected death in epilepsy (SUDEP) is the leading cause of death amongst patients whose seizures are not adequately controlled by current therapies. Patients with SCN8A encephalopathy have an elevated risk for SUDEP. While transgenic mouse models have provided insight into the molecular mechanisms of SCN8A encephalopathy etiology, our understanding of seizure-induced death has been hampered by the inability to reliably trigger both seizures and seizure-induced death in these mice. Here, we demonstrate that mice harboring an Scn8a allele with the patient-derived mutation N1768D (D/+) are susceptible to audiogenic seizures and seizure-induced death. In adult D/+ mice, audiogenic seizures are non-fatal and have nearly identical behavioral, electrographical, and cardiorespiratory characteristics as spontaneous seizures. In contrast, at postnatal days 20–21, D/+ mice exhibit the same seizure behavior, but have a significantly higher incidence of seizure-induced death following an audiogenic seizure. Seizure-induced death was prevented by either stimulating breathing via mechanical ventilation or by acute activation of adrenergic receptors. Conversely, in adult D/+ mice inhibition of adrenergic receptors converted normally non-fatal audiogenic seizures into fatal seizures. Taken together, our studies show that in our novel audiogenic seizure-induced death model adrenergic receptor activation is necessary and sufficient for recovery of breathing and prevention of seizure-induced death.
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spelling doaj.art-c4a1dcfd7e464abf8d51bcd2c11322362022-12-21T22:41:05ZengFrontiers Media S.A.Frontiers in Neuroscience1662-453X2021-03-011510.3389/fnins.2021.581048581048Adrenergic Mechanisms of Audiogenic Seizure-Induced Death in a Mouse Model of SCN8A EncephalopathyEric R. Wengert0Eric R. Wengert1Ian C. Wenker2Elizabeth L. Wagner3Elizabeth L. Wagner4Pravin K. Wagley5Ronald P. Gaykema6Jung-Bum Shin7Jung-Bum Shin8Manoj K. Patel9Manoj K. Patel10Department of Anesthesiology, University of Virginia Health System, Charlottesville, VA, United StatesNeuroscience Graduate Program, University of Virginia Health System, Charlottesville, VA, United StatesDepartment of Anesthesiology, University of Virginia Health System, Charlottesville, VA, United StatesDepartment of Neuroscience, University of Virginia School of Medicine, Charlottesville, VA, United StatesDepartment of Biochemistry and Molecular Genetics, University of Virginia School of Medicine, Charlottesville, VA, United StatesDepartment of Anesthesiology, University of Virginia Health System, Charlottesville, VA, United StatesDepartment of Anesthesiology, University of Virginia Health System, Charlottesville, VA, United StatesNeuroscience Graduate Program, University of Virginia Health System, Charlottesville, VA, United StatesDepartment of Neuroscience, University of Virginia School of Medicine, Charlottesville, VA, United StatesDepartment of Anesthesiology, University of Virginia Health System, Charlottesville, VA, United StatesNeuroscience Graduate Program, University of Virginia Health System, Charlottesville, VA, United StatesSudden unexpected death in epilepsy (SUDEP) is the leading cause of death amongst patients whose seizures are not adequately controlled by current therapies. Patients with SCN8A encephalopathy have an elevated risk for SUDEP. While transgenic mouse models have provided insight into the molecular mechanisms of SCN8A encephalopathy etiology, our understanding of seizure-induced death has been hampered by the inability to reliably trigger both seizures and seizure-induced death in these mice. Here, we demonstrate that mice harboring an Scn8a allele with the patient-derived mutation N1768D (D/+) are susceptible to audiogenic seizures and seizure-induced death. In adult D/+ mice, audiogenic seizures are non-fatal and have nearly identical behavioral, electrographical, and cardiorespiratory characteristics as spontaneous seizures. In contrast, at postnatal days 20–21, D/+ mice exhibit the same seizure behavior, but have a significantly higher incidence of seizure-induced death following an audiogenic seizure. Seizure-induced death was prevented by either stimulating breathing via mechanical ventilation or by acute activation of adrenergic receptors. Conversely, in adult D/+ mice inhibition of adrenergic receptors converted normally non-fatal audiogenic seizures into fatal seizures. Taken together, our studies show that in our novel audiogenic seizure-induced death model adrenergic receptor activation is necessary and sufficient for recovery of breathing and prevention of seizure-induced death.https://www.frontiersin.org/articles/10.3389/fnins.2021.581048/fullSUDEPSCN8A encephalopathyrespiratory arrestadrenergic receptorsaudiogenic seizures
spellingShingle Eric R. Wengert
Eric R. Wengert
Ian C. Wenker
Elizabeth L. Wagner
Elizabeth L. Wagner
Pravin K. Wagley
Ronald P. Gaykema
Jung-Bum Shin
Jung-Bum Shin
Manoj K. Patel
Manoj K. Patel
Adrenergic Mechanisms of Audiogenic Seizure-Induced Death in a Mouse Model of SCN8A Encephalopathy
Frontiers in Neuroscience
SUDEP
SCN8A encephalopathy
respiratory arrest
adrenergic receptors
audiogenic seizures
title Adrenergic Mechanisms of Audiogenic Seizure-Induced Death in a Mouse Model of SCN8A Encephalopathy
title_full Adrenergic Mechanisms of Audiogenic Seizure-Induced Death in a Mouse Model of SCN8A Encephalopathy
title_fullStr Adrenergic Mechanisms of Audiogenic Seizure-Induced Death in a Mouse Model of SCN8A Encephalopathy
title_full_unstemmed Adrenergic Mechanisms of Audiogenic Seizure-Induced Death in a Mouse Model of SCN8A Encephalopathy
title_short Adrenergic Mechanisms of Audiogenic Seizure-Induced Death in a Mouse Model of SCN8A Encephalopathy
title_sort adrenergic mechanisms of audiogenic seizure induced death in a mouse model of scn8a encephalopathy
topic SUDEP
SCN8A encephalopathy
respiratory arrest
adrenergic receptors
audiogenic seizures
url https://www.frontiersin.org/articles/10.3389/fnins.2021.581048/full
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