Convulsive seizures and some behavioral comorbidities are uncoupled in the Scn1aA1783V Dravet syndrome mouse model

S Fadila, S Quinn, A Turchetti Maia, D Yakubovich… - …, 2020 - Wiley Online Library
S Fadila, S Quinn, A Turchetti Maia, D Yakubovich, M Ovadia, KL Anderson, M Giladi
Epilepsia, 2020Wiley Online Library
Abstract Objective Dravet syndrome (Dravet) is a severe childhood epileptic
encephalopathy. The disease begins with a febrile stage, characterized by febrile seizures
with otherwise normal development. Progression to the worsening stage features recurrent
intractable seizures and the presentation of additional nonepileptic comorbidities, including
global developmental delay, hyperactivity, and motor deficits. Later in life, at the stabilization
stage, seizure burden decreases, whereas Dravet‐associated comorbidities persist. To date …
Objective
Dravet syndrome (Dravet) is a severe childhood epileptic encephalopathy. The disease begins with a febrile stage, characterized by febrile seizures with otherwise normal development. Progression to the worsening stage features recurrent intractable seizures and the presentation of additional nonepileptic comorbidities, including global developmental delay, hyperactivity, and motor deficits. Later in life, at the stabilization stage, seizure burden decreases, whereas Dravet‐associated comorbidities persist. To date, it remains debated whether the nonepileptic comorbidities result from severe epilepsy or represent an independent phenotypic feature.
Methods
Dravet mice (DS) faithfully recapitulate many clinical aspects of Dravet. Using wild‐type (WT) and DS at different ages, we monitored multiple behavioral features as well as background electroencephalogram (EEG) activity during the different stages of Dravet epilepsy.
Results
Behavioral tests of WT and DS demonstrated that some deficits manifest already at the pre‐epileptic stage, prior to the onset of convulsive seizures. These include motor impairment and hyperactivity in the open field. Deficits in cognitive functions were detected at the onset of severe spontaneous seizures. Power spectral analysis of background EEG activity, measured through development, showed that DS exhibit normal background oscillations at the pre‐epileptic stage, a marked reduction in total power during the onset of severe epilepsy, and a subsequent smaller reduction later in life. Importantly, low EEG power at the stage of severe frequent convulsive seizures correlated with increased risk for premature death.
Significance
Our data provide a comprehensive developmental trajectory of Dravet epilepsy and Dravet‐associated comorbidities in mice, under controlled settings, demonstrating that the convulsive seizures and some nonepileptic comorbidities may be uncoupled. Moreover, we report the existence of an inverse correlation, on average, between the power of background EEG and the severity of epileptic phenotypes, suggesting that such measurements may potentially serve as a biomarker for Dravet severity.
Wiley Online Library