Jianwei Shi1,2 · Jing Xie3 · Zesheng Li1,2 · Xiaosong He4 · Penghu Wei1,2 · Josemir W Sander5,6,7 · Guoguang Zhao1,2
1 Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
2 China International Neuroscience Institute, Beijing 100053, China
3 Deanery of Biomedical Sciences, Edinburgh Medical School, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh EH8 9AG, UK
4 Department of Psychology, University of Science and Technology of China, Hefei 230022, China
5 Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London WC1N 3BG, UK
6 Chalfont Centre for Epilepsy, Chalfont St Peter, Buckinghamshire SL9 0RJ, UK
7 Neurology Department, West China Hospital of Sichuan University, Chengdu 61004, China
Abstract
Epilepsy affects over 50 million people worldwide. Drug-resistant epilepsy (DRE) accounts for up to a third of these cases, and neuro-inflammation is thought to play a role in such cases. Despite being a long-debated issue in the field of DRE, the mechanisms underlying neuroinflammation have yet to be fully elucidated. The pro-inflammatory microenvironment within the brain tissue of people with DRE has been probed using single-cell multimodal transcriptomics. Evidence suggests that inflammatory cells and pro-inflammatory cytokines in the nervous system can lead to extensive biochemical changes, such as connexin hemichannel excitability and disruption of neurotransmitter homeostasis. The presence of inflammation may give rise to neuronal network abnormalities that suppress endogenous antiepileptic systems. We focus on the role of neuroinflammation and brain network anomalies in DRE from multiple perspectives to identify critical points for clinical application. We hope to provide an insightful overview to advance the quest for better DRE treatments.
Keywords
Neuroglia; Neuro-immune interaction; Brain network; Chronicity; Epilepsy
