Regional microglial populations in central autonomic brain regions in SUDEP

Objective Sudden unexpected death in epilepsy (SUDEP) may arise as a result of autonomic dysfunction during seizure. The central networks (CANs) modulate brainstem cardiorespiratory regulation. Recent magnetic resonance imaging (MRI) studies SUDEP have shown cortical and subcortical volume changes altered connectivity between CAN regions, but the pathological correlate is unknown. Because neuroinflammation both cause consequence seizures relate to regional brain pathology, our aim was evaluate microglial populations CANs SUDEP. Methods In 55 postmortem cases, including SUDEP, controls without nonepilepsy controls, we quantified Iba1-expressing microglia 14 thalamic areas that included known regions. Results Mean Iba1 labeling across all regions significantly higher cases compared controls. There significant variation only, with highest medial thalamus. Significantly than consistently noted superior temporal gyrus. documented up 10 days prior death, mean observed Significance Our findings support activation functions such thalamus This be relevant cellular pathomechanisms underlying cardioregulatory failure