Researchers have identified a connection between the amygdala in the brain and post-seizure breathing failure, offering insights into SUDEP, a considerable cause of death amongst epilepsy clients.
Seizure activity in the amygdala may assist discuss abrupt unforeseen death in epilepsy.
A research group supported by the National Institutes of Health (NIH) has determined a part of the brain that might be associated with breathing failure following a seizure in people with extreme epilepsy that can not be controlled with medication. The condition, called abrupt unexpected death in epilepsy (SUDEP), is the leading cause of death in this patient population. The new findings, by scientists at the University of Iowa, Iowa City, and published in JCI Insight, might play a vital function in understanding SUDEP, for which causes are not well-explained.
Breathing Interruption After Seizures
It is widely thought that the bulk of SUDEP cases are because of loss of breathing that takes place after a seizure ends, known as postictal apnea. The research study found that people who experience postictal apnea lose a sense of “air appetite”– the primal desire to breathe– or alarm, recommending that the brain might be unable to react and find to increasing carbon dioxide (CO2) levels in the blood when the apnea happens.
Researchers recognized a site in the amygdala vital to breathing loss following a seizure. The blue and purple region represents a probability map of the area connected to consistent apnea, based upon data from 20 topics with uncontrolled epilepsy. Credit: Dlouhy laboratory, University of Iowa
Research Study Design and Findings
Utilizing direct electrical stimulation, the group induced seizures in the individuals under medical guidance to analyze forebrain control of breathing and apnea. They found that seizures that originate in the amygdala, a brain region primarily involved in processing feeling and worry, can trigger postictal apnea and determined the amygdala subregion included in extended breathing loss.
Neural Connections and Further Insights
Consequently, researchers employed a strategy integrating electrical stimulation with functional MRI to identify novel connections in between the amygdala website and the brainstem area vital for noticing modifications in blood CO2 levels and controlling breathing. Taken together, the findings suggest that seizure activity in a subregion of the amygdala can suppress breathing and air appetite for prolonged durations of time following seizure. This is likely managed by means of connections with the brainstem and other brain sites associated with noticing signals from the body. Extra research studies are required to confirm the function of the amygdala in breathing suppression and its involvement in SUDEP.
The findings more boost understanding of SUDEP and may help uncover preventative treatments and recognize those most at threat. The research study was funded in part by the National Institute of Neurological Disorders and Stroke (NINDS), part of NIH.
For more on this research, see Deciphering Unexplained Epilepsy Deaths.
Referral: “Failure to breathe continues without air cravings or alarm following amygdala seizures” by Gail I.S. Harmata, Ariane E. Rhone, Christopher K. Kovach, Sukhbinder Kumar, Md Rakibul Mowla, Rup K. Sainju, Yasunori Nagahama, Hiroyuki Oya, Brian K. Gehlbach, Michael A. Ciliberto, Rashmi N. Mueller, Hiroto Kawasaki, Kyle T.S. Pattinson, Kristina Simonyan, Paul W. Davenport, Matthew A. Howard III, Mitchell Steinschneider, Aubrey C. Chan, George B. Richerson, John A. Wemmie and Brian J. Dlouhy, 3 October 2023, JCI Insight.DOI: 10.1172/ jci.insight.172423.
This research study was supported by NINDS (R01 NS113764, K08 NS112573 01, 5K12NS080223), the National Institute on Drug Abuse (R01DA052953), and the National Institute of General Medical Sciences (T32 GM067795). Extra assistance came from the Congress of Neurological Surgeons, Oxford University Hospitals NHS Trust, University of Oxford, Roy J. Carver Charitable Trust, and the U.S. Department of Veterans Affairs.
A research study group supported by the National Institutes of Health (NIH) has identified a part of the brain that might be associated with breathing failure following a seizure in individuals with severe epilepsy that can not be controlled with medication. Scientist determined a site in the amygdala vital to breathing loss following a seizure. Using direct electrical stimulation, the team induced seizures in the individuals under medical guidance to analyze forebrain control of breathing and apnea. They found that seizures that come from in the amygdala, a brain area mainly included in processing emotion and worry, can cause postictal apnea and identified the amygdala subregion involved in extended breathing loss. Taken together, the findings suggest that seizure activity in a subregion of the amygdala can reduce breathing and air appetite for extended periods of time following seizure.
