Longitudinal imaging of Microglia-Astrocyte activation in mouse mesial temporal lobe epilepsy with TSPO PET to identify the best therapeutic time windows

Objectives Mesiotemporal lobe epilepsy (MTLE) is the most common type of drug-resistant partial epilepsy with a specific history which begins by a status epilepticus due to a neurological insult followed by a silent period before the recurrent seizures begin. Once established, these seizures can become resistant to medications. Along this period a specific lesion is often found, described as a unilateral hippocampal sclerosis (HS). Currently it is still challenging to determine when and which drugs can be most effective along the constitution of this epileptic process. Neuroinflammation has been reported to play an important role in pathophysiological mechanisms in epilepsy, and therefore brain inflammation probes can be potent epilepsy biomarkers. The Translocator Protein 18 kDa (TSPO) expression is associated with neuroinflammatory processes involving reactive astrocytes and microglia. A unilateral intrahippocampal kainate injection mouse model can reproduce the defining features of human temporal lobe epilepsy with unilateral hippocampal sclerosis and the pattern of chronic pharmacoresistant temporal seizures. We hypothesized that TSPO PET imaging using 18F-DPA-714 TSPO-targeted PET could be a highly potent longitudinal biomarker of epilepsy and could be of interest to determine the therapeutic windows in epilepsy and follow response to treatment in the mouse model of MTLE. Methods The model was induced by unilateral injection of kainic acid into the right dorsal hippocampus of male C57/Bl6 mice. μPET/CT scanning was performed before model induction and along the development of the HS at 7 days, 14 days, 1 month and 6 months. In vitro autoradiography and immunohistofluorescence were performed on additional mice at each time point. Results TSPO PET uptake reached the peak at 7 days and mostly correlated with microglial activation whereas after 14 days, reactive astrocytes were shown to be the main cells expressing TSPO which would be related to the increased PET uptake. Our studies suggest that mTOR signal pathways play an important role in the modulation of astrocyte activities. Our hypothesis is that the neurotoxicity during ictogenesis (aggravation phase) could be due to persistent mTOR reactive signaling in astrocytes. Conclusion : on this knowledge of TSPO expression over time in the MTLE model, TSPO PET imaging could be a valuable tool to evaluate efficacy of mTOR treatments.