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Review: Neuropathology findings in autonomic brain regions in SUDEP and future research directions

Patodia, S; Somani, A; Thom, M; (2021) Review: Neuropathology findings in autonomic brain regions in SUDEP and future research directions. Autonomic Neuroscience , 235 , Article 102862. 10.1016/j.autneu.2021.102862. Green open access

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Abstract

Autonomic dysfunction is implicated from clinical, neuroimaging and experimental studies in sudden and unexpected death in epilepsy (SUDEP). Neuropathological analysis in SUDEP series enable exploration of acquired, seizure-related cellular adaptations in autonomic and brainstem autonomic centres of relevance to dysfunction in the peri-ictal period. Alterations in SUDEP compared to control groups have been identified in the ventrolateral medulla, amygdala, hippocampus and central autonomic regions. These involve neuropeptidergic, serotonergic and adenosine systems, as well as specific regional astroglial and microglial populations, as potential neuronal modulators, orchestrating autonomic dysfunction. Future research studies need to extend to clinically and genetically characterized epilepsies, to explore if common or distinct pathways of autonomic dysfunction mediate SUDEP. The ultimate objective of SUDEP research is the identification of disease biomarkers for at risk patients, to improve post-mortem recognition and disease categorisation, but ultimately, for exposing potential treatment targets of pharmacologically modifiable and reversible cellular alterations.

Type: Article
Title: Review: Neuropathology findings in autonomic brain regions in SUDEP and future research directions
Location: Netherlands
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/j.autneu.2021.102862
Publisher version: https://doi.org/10.1016/j.autneu.2021.102862
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Amygdala, Brainstem, Neuropathology, Respiratory nuclei, SUDEP, Autonomic Nervous System, Brain, Death, Sudden, Epilepsy, Humans, Sudden Unexpected Death in Epilepsy
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology > Clinical and Experimental Epilepsy
URI: https://discovery.ucl.ac.uk/id/eprint/10137244
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