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Molecular insights into the role of AMPA receptors in the synaptic plasticity, pathogenesis and treatment of epilepsy: therapeutic potentials of perampanel and antisense oligonucleotide (ASO) technology

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Abstract

Glutamate is considered as the predominant excitatory neurotransmitter in the mammalian central nervous systems (CNS). Alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptors (AMPARs) are the main glutamate-gated ionotropic channels that mediate the majority of fast synaptic excitation in the brain. AMPARs are highly dynamic that constitutively move into and out of the postsynaptic membrane. Changes in the postsynaptic number of AMPARs play a key role in controlling synaptic plasticity and also brain functions such as memory formation and forgetting development. Impairments in the regulation of AMPAR function, trafficking, and signaling pathway may also contribute to neuronal hyperexcitability and epileptogenesis process, which offers AMPAR as a potential target for epilepsy therapy. Over the last decade, various types of AMPAR antagonists such as perampanel and talampanel have been developed to treat epilepsy, but they usually show limited efficacy at low doses and produce unwanted cognitive and motor side effects when administered at higher doses. In the present article, the latest findings in the field of molecular mechanisms controlling AMPAR biology, as well as the role of these mechanism dysfunctions in generating epilepsy will be reviewed. Also, a comprehensive summary of recent findings from clinical trials with perampanel, in treating epilepsy, glioma-associated epilepsy and Parkinson’s disease is provided. Finally, antisense oligonucleotide therapy as an alternative strategy for the efficient treatment of epilepsy is discussed.

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Authors and Affiliations

  1. Department of Neurology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, IR, Iran

    Saeid Charsouei

  2. Department of Genetics, Albert Einstein College of Medicine, 1301 Morris Park Avenue, Bronx, NY, 10461, USA

    M. Reza Jabalameli

  3. Division of Genetics, Department of Biology, Faculty of Science, University of Isfahan, Isfahan, IR, Iran

    Amin Karimi-Moghadam

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SC contributed to the writing of the manuscript. MRJ contributed to the writing of the manuscript, advised the conceptual ideas and provided critical feedback on the early draft. AKM conceived the project, performed critical analysis of the current topics, contributed to the writing of the manuscript, and supervised the project. All authors reviewed the final draft.

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Correspondence to Amin Karimi-Moghadam.

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Charsouei, S., Jabalameli, M.R. & Karimi-Moghadam, A. Molecular insights into the role of AMPA receptors in the synaptic plasticity, pathogenesis and treatment of epilepsy: therapeutic potentials of perampanel and antisense oligonucleotide (ASO) technology. Acta Neurol Belg 120, 531–544 (2020). https://doi.org/10.1007/s13760-020-01318-1

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  • DOI: https://doi.org/10.1007/s13760-020-01318-1

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