title: Intrasubthalamic cell transplants for epilepsy therapy: hopes and concerns.
abstract: The mainstay of treatment of patients suffering from epilepsies involves antiepileptic drug therapy. However, about one-third of patients continue to have seizures or show intolerable adverse effects despite appropriate medication. Neuronal transplantation into key brain regions involved in seizure generation, propagation, or modulation is a promising alternative experimental approach to treat drug-resistant epilepsies. Especially for patients with multiple-epileptic foci, or without a clear focal onset, therapeutic manipulation of brain structures remote to the focus but significantly involved in seizure modulation may be a more advantageous strategy. Using animal experiments, we recently showed that the subthalamic nucleus (STN) may be an auspicious target region in this respect. The STN repeatedly showed up to be highly sensitive to changes in GABAergic transmission, which can be achieved by localized microinjection of GABA-elevating drugs or by grafting GABA-releasing cells. However, there are many hurdles to overcome and questions to resolve before clinical translation of this approach appears realistic. This commentary discusses potential benefits as well as concerns associated with grafting of inhibitory cells into the STN.
authors.affiliation: aDepartment of Pharmacology, Toxicology, and Pharmacy, University of Veterinary Medicine Hannover bCenter for Systems Neuroscience, Hannover, Germany.
authors.forename: Manuela
authors.initials: M
authors.lastname: Gernert
mesh_terms: D000818:Animals; D004827:Epilepsy / Q000503:physiopathology / Q000601:surgery*; D059330:GABAergic Neurons / Q000637:transplantation*; D006801:Humans; D051379:Mice; D009433:Neural Inhibition; D051381:Rats; D020531:Subthalamic Nucleus / Q000502:physiology / Q000601:surgery*