4.7 Article

The role of mTORC1 activation in seizure-induced exacerbation of Alzheimer's disease

Journal

BRAIN
Volume 145, Issue 1, Pages 324-339

Publisher

OXFORD UNIV PRESS
DOI: 10.1093/brain/awab268

Keywords

seizures; Alzheimer's disease; mTOR; cognition; neuropathology

Funding

  1. National Institutes of HealthNational Institute of Neurological Disorders and Stroke (NIH NINDS) [R21NS105437, R01NS080565, R37NS115439, R01NS101156, K23NS088341]
  2. National Institute on Aging [T32AG000255-23]
  3. Brightfocus Foundation [A2016244S]
  4. Penn Institute on Aging
  5. Institute for Translational Medicine and Therapeutics (ITMAT)
  6. Intellectual and Developmental Disabilities Research Center (IDDRC) at Children's Hospital of Phildadelphia [U54 HD086984]
  7. NIH/National Institute on Aging [AG010124]

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Seizures are more common in Alzheimer's disease patients, and they exacerbate the progression of the disease by increasing amyloid-beta and tau pathology and activating the mTOR pathway. The mTOR inhibitor rapamycin can rescue memory deficits and attenuate Alzheimer's disease neuropathology.
The risk of seizures is 10-fold higher in patients with Alzheimer's disease than the general population, yet the mechanisms underlying this susceptibility and the effects of these seizures are poorly understood. To elucidate the proposed bidirectional relationship between Alzheimer's disease and seizures, we studied human brain samples (n = 34) from patients with Alzheimer's disease and found that those with a history of seizures (n = 14) had increased amyloid-beta and tau pathology, with upregulation of the mechanistic target of rapamycin (mTOR) pathway, compared with patients without a known history of seizures (n = 20). To establish whether seizures accelerate the progression of Alzheimer's disease, we induced chronic hyperexcitability in the five times familial Alzheimer's disease mouse model by kindling with the chemoconvulsant pentylenetetrazol and observed that the mouse model exhibited more severe seizures than the wild-type. Furthermore, kindled seizures exacerbated later cognitive impairment, Alzheimer's disease neuropathology and mTOR complex 1 activation. Finally, we demonstrated that the administration of the mTOR inhibitor rapamycin following kindled seizures rescued enhanced remote and long-term memory deficits associated with earlier kindling and prevented seizure-induced increases in Alzheimer's disease neuropathology. These data demonstrated an important link between chronic hyperexcitability and progressive Alzheimer's disease pathology and suggest a mechanism whereby rapamycin may serve as an adjunct therapy to attenuate progression of the disease.

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