There are two main types of adrenergic receptors (alpha and beta) with several subtypes in the human and animal brain. Alpha2-adrenergic receptors are of particular interest, because they are involved in the modulation of sleep and absence epilepsy. In 2023, a group of young scientists led by a senior researcher, Dr. Evgenia Sitnikova, have studied the adrenergic mechanisms of sleep and epilepsy. The results of their research were published in the International Journal of Molecular Science and Frontiers in Neurology [1, 2, 3]. Therapeutic doses of alpha2 adrenergic agonists (such as dexmedetomidine) are known to cause sedation and drug-induced sleep in humans and animals. These drugs in low doses were found to induce spike-wave activity in the electroencephalogram, i.e. manifestation of absence epilepsy, in genetically prone rats (WAG/Rij) [1, 2, 3]. А single (intraperitoneal) injection of dexmedetomidine at the dose of 0.005 mg/kg increased absence epilepsy in WAG/Rij rats (i.e., genetic model of absence epilepsy) up to status epilepticus in subjects with severe absence epilepsy, but did not cause de novo absence epilepsy in asymptomatic rats [1, 2]. Dexmedetomidine has been regularly used in clinical practice for decades, and low doses of this drug may help in the diagnosis of latent forms of absence epilepsy during EEG examination. Dexmedetomidine, along with other central alpha2-adrenergic agonists, could be a pharmacological tool for differential diagnosis. The high risk of provoking absence status should be taken into account when using alpha2-adrenergic receptor agonists in patients with absence epilepsy or with a genetic predisposition to this disease [1].

A new concept of targeted pharmacotherapy of absence epilepsy using alpha2B-adrenergic receptor antagonists was proposed based on our experimental and literature data [1, 3].

  1. Sitnikova E. Adrenergic mechanisms of absence status epilepticus Front. Neurol. 2023 14: 1298310. DOI: 10.3389/fneur.2023.1298310
  2. Sitnikova E., Pupikina M., Rutskova E. Alpha2 Adrenergic Modulation of Spike-Wave Epilepsy: Experimental Study of Pro-Epileptic and Sedative Effects of Dexmedetomidine. International Journal of Molecular Sciences. 2023. 24(11): 9445. DOI: 10.3390/ijms24119445 .
  3. Sitnikova E., Rutskova E., Smirnov K. Alpha2-Adrenergic Receptors as a Pharmacological Target for Spike-Wave Epilepsy. International Journal of Molecular Sciences. 2023. 24(2):1477. DOI: 10.3390/ijms24021477.

The illustration [3] licensed under CC BY 4.0. © 2023 authors