Voltage-gated ion channels in epilepsies: circuit dysfunctions and treatments

Trends Pharmacol Sci. 2024 Nov;45(11):1018-1032. doi: 10.1016/j.tips.2024.09.004. Epub 2024 Oct 14.

Abstract

Epileptic encephalopathies are generally considered to be functional disruptions in the balance between neural excitation and inhibition. Excitatory and inhibitory voltage-gated ion channels are key targets of antiepileptic drugs, playing a critical role in regulating neuronal excitation and synaptic transmission. Recent research has highlighted the significance of ion channels in various aspects of epilepsy, including presynaptic neurotransmitter release, intrinsic neuronal excitability, and neural synchrony. Genetic alterations in excitatory and inhibitory ion channels within principal neurons and in inhibitory interneurons have also been identified as key contributors to the development of epilepsies. We review these recent studies and shed light on the bidirectional relationship between epilepsy and neuronal excitability and the latest advancements in pharmacological therapeutics targeting ion channels for epilepsy treatment.

Keywords: HCN channels; Kv channels; Nav channels; epileptic encephalopathies; ion channels; new therapeutics; pharmacology; synchrony.

Publication types

  • Review

MeSH terms

  • Animals
  • Anticonvulsants* / pharmacology
  • Anticonvulsants* / therapeutic use
  • Epilepsy* / drug therapy
  • Epilepsy* / metabolism
  • Epilepsy* / physiopathology
  • Humans
  • Ion Channels* / antagonists & inhibitors
  • Ion Channels* / metabolism
  • Neurons / metabolism
  • Synaptic Transmission

Substances

  • Anticonvulsants
  • Ion Channels