The release of inflammatory mediators following cortical spreading depression (CSD) is suggested to play a role in pathophysiology of CSD-related neurological disorders. Toll-like receptors (TLR) are master regulators of innate immune function and involved in the activation of inflammatory responses in the brain. TLR3 agonist poly I:C exerts anti-inflammatory effect and prevents cell injury in the brain. The aim of the present study was to examine the effect of systemic administration of poly I:C on the release of cytokines (TNF-α, IFN-γ, IL-4, TGF-β1, and GM-CSF) in the brain and spleen, splenic lymphocyte proliferation, expression of GAD65, GABAAα, GABAAβ as well as Hsp70, and production of dark neurons after induction of repetitive CSD in juvenile rats. Poly I:C significantly attenuated CSD-induced production of TNF-α and IFN-γ in the brain as well as TNF-α and IL-4 in the spleen. Poly I:C did not affect enhancement of splenic lymphocyte proliferation after CSD. Administration of poly I:C increased expression of GABAAα, GABAAβ as well as Hsp70 and decreased expression of GAD65 in the entorhinal cortex compared to CSD-treated tissues. In addition, poly I:C significantly prevented production of CSD-induced dark neurons. The data indicate neuroprotective and anti-inflammatory effects of TLR3 activation on CSD-induced neuroinflammation. Targeting TLR3 may provide a novel strategy for developing new treatments for CSD-related neurological disorders.
Quality of life is affected by factors such as regional differences in access to treatment choices, and rehabilitation. This study aims to assess the result of epilepsy surgery and its impact on QoL in Iran. The data for 60 patients who underwent epilepsy surgery in Loghman-Hakim hospital between 2003 to 2017 were analyzed prospectively through clinical observation. Clinical variables of interest and the WHOQOL-BREF scale to assess QoL were applied. Scores of operated patients were compared to their preoperative scores as well as epileptic patients controlled with antiepileptic drugs (AEDs) and healthy individuals. The mean age of surgery group patients was 33.78 (34 male; 26 female). Twenty seven patients underwent temporal mesial lobectomy, 20 anterior callosotomy, and 13 neocortical resections. The average QoL score in healthy group was 72.48, in AEDs controls was 56.16, and in operated patients was 65.61. In addition, analysis showed a significant increase in postoperative QoL of the surgical group compared to the AEDs controls. Epilepsy surgery could be the best approach in patients suffering from drug-resistant epilepsy even in developing countries, which can result in seizure relief and a reduction in the frequency of disabling seizures.
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