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Cardiovascular Psychiatry and Neurology
Volume 2011 (2011), Article ID 461263, 8 pages
http://dx.doi.org/10.1155/2011/461263
Review Article

Elucidating the Complex Interactions between Stress and Epileptogenic Pathways

1Department of Integrative Biology, University of California-Berkeley, Berkeley, CA 94720-3140, USA
2Institute of Neurophysiology, Charité University Medicine, 10117 Berlin, Germany
3Department of Psychiatry and Psychotherapy, Charité University Medicine, 10117 Berlin, Germany
4Helen Wills Neuroscience Institute, University of California-Berkeley, Berkeley, CA 94720-3140, USA

Received 13 November 2010; Accepted 22 January 2011

Academic Editor: Alon Friedman

Copyright © 2011 Aaron R. Friedman et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Clinical and experimental data suggest that stress contributes to the pathology of epilepsy. We review mechanisms by which stress, primarily via stress hormones, may exacerbate epilepsy, focusing on the intersection between stress-induced pathways and the progression of pathological events that occur before, during, and after the onset of epileptogenesis. In addition to this temporal nuance, we discuss other complexities in stress-epilepsy interactions, including the role of blood-brain barrier dysfunction, neuron-glia interactions, and inflammatory/cytokine pathways that may be protective or damaging depending on context. We advocate the use of global analytical tools, such as microarray, in support of a shift away from a narrow focus on seizures and towards profiling the complex, early process of epileptogenesis, in which multiple pathways may interact to dictate the ultimate onset of chronic, recurring seizures.