Cited by 283Epilepsy research and treatmentNeuroscience and Neuropharmacology ResearchNeuroinflammation and Neurodegeneration Mechanisms

Astrocytes in the initiation and progression of epilepsy

Open access
Vezzani, Annamaria, Ravizza, Teresa, Bedner, Peter, Aronica, Eleonora, Steinhäuser, Christian, Boison, Detlev·2022·Nature Reviews Neurology

Abstract

Epilepsy affects ~65 million people worldwide. First-line treatment options include >20 antiseizure medications, but seizure control is not achieved in approximately one-third of patients. Antiseizure medications act primarily on neurons and can provide symptomatic control of seizures, but do not alter the onset and progression of epilepsy and can cause serious adverse effects. Therefore, medications with new cellular and molecular targets and mechanisms of action are needed. Accumulating evidence indicates that astrocytes are crucial to the pathophysiological mechanisms of epilepsy, raising the possibility that these cells could be novel therapeutic targets. In this Review, we discuss how dysregulation of key astrocyte functions - gliotransmission, cell metabolism and immune function - contribute to the development and progression of hyperexcitability in epilepsy. We consider strategies to mitigate astrocyte dysfunction in each of these areas, and provide an overview of how astrocyte activation states can be monitored in vivo not only to assess their contribution to disease but also to identify markers of disease processes and treatment effects. Improved understanding of the roles of astrocytes in epilepsy has the potential to lead to novel therapies to prevent the initiation and progression of epilepsy.

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  • In other contexts, such as acquired epilepsy, the presence of reactive astrocytes alone is sufficient to drive epileptogenesis.

    “In other contexts, such as acquired epilepsy, the presence of reactive astrocytes alone is sufficient to drive epileptogenesis54.”

    From mTORC1 drives cell-autonomous astrocyte reactivity in tuberous sclerosis (2026) · cites this paper as [54]

    The Introduction (page unavailable) says reactive astrocytes might contribute to the onset and progression of acquired epilepsy, and reports that experimentally inducing reactive astrocytes in mice elicits spontaneous seizures. It does not say that their mere presence is sufficient to drive epileptogenesis in acquired epilepsy; it distinguishes that setting from a genetic disease in which astrocytes can initiate epilepsy. (LLM, conf=0.89)

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Research works printed but not linked: 4

  1. [17]Devinsky O Epilepsy. Nat Rev Dis Primers 4, 18024 (2018). 29722352
  2. [42]Araque A, Martín ED, Perea G, Arellano JI & Buño W Synaptically released acetylcholine evokes Ca2+ elevations in astrocytes in hippocampal slices. J Neurosci 22, 2443– 2450 (2002). 11923408 PMC6758296
  3. [113]Zurolo E Activation of TLR, RAGE and HMGB1 signaling in malformations of cortical development. Brain 134, 1015– 32 (2011). 21414994
  4. [163]Kumlien E, Nilsson A, Hagberg G, Langstrom B & Bergstrom B PET with 11C-deuterium-deprenyl and 18F-FDG in focal epilepsy. Acta Neurol Scand 103, 360– 366 (2001). 11421848

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Authors
Vezzani, A., Ravizza, T., Bedner, P., Aronica, E., Steinhäuser, C., & Boison, D.
Affiliations
  • Mario Negri Institute for Pharmacological Research (IT)
  • University of Bonn (DE)
  • Amsterdam Neuroscience (NL)
  • Rutgers, The State University of New Jersey (US)
Corresponding author
Vezzani, Annamaria
Venue
Nature Reviews Neurology
Published
2022-10-24
Volume
18
Issue
12
Pages
707-722
ISSN
  • 1759-4758 (ISSN-L)
  • 1759-4766
OpenAlex
W4307338781
Cited by
272
References
207
Citations by year
2026: 82 · 2025: 96 · 2024: 53 · 2023: 41
FWCI
8.65
Type
journal article
Language
en
Open access
Locations
  • Nature Reviews Neurology (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
  • Pure Amsterdam UMC (acceptedVersion, other-oa)
  • Rutgers University Community Repository (Rutgers University) (submittedVersion)
  • Data Archiving and Networked Services (DANS) (submittedVersion)
  • Amsterdam UMC (VU Amsterdam) - Institutional Repository (submittedVersion)
Funders
  • Citizens United for Research in Epilepsy (NS065957, NS103740)
  • ZonMw
  • Bundesministerium für Bildung und Forschung (16GW0182, 01DN20001 CONNEX, 01DN20001, 16GW0182 CONNEXIN)
  • Epilepsy Society
  • National Institutes of Health (H2020, NS127846)
  • Horizon 2020 Framework Programme (H2020-MSCA, 952455, 722053, H2020-MSCA-ITN)
  • National Institute of Neurological Disorders and Stroke (R01NS061844, R01NS103740, R01NS065957, R01NS127846)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Epilepsy research and treatment
  • Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neuroscience and Neuropharmacology Research
  • Life Sciences › Neuroscience › Neurology › Neuroinflammation and Neurodegeneration Mechanisms
Keywords
astrocytes, epilepsy, epileptogenesis, hyperexcitability, gliotransmission, astrocyte metabolism, astrocyte activation, antiepileptic drugs, novel therapeutic targets
MeSH terms
Astrocytes, Epilepsy, Humans, Neurons, Seizures

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