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Neonatal seizures are commonly associated with acute perinatal brain injury, while understanding regarding the downstream molecular pathways related to seizures remains unclear. Furthermore, effective treatment and reliable biomarkers are still lacking. Post-translational modifications can contribute to changes in protein function, and post-translational citrullination, which is caused by modification of arginine to citrulline via the calcium-mediated activation of the peptidylarginine deiminase (PAD) enzyme family, is being increasingly linked to neurological injury. Extracellular vesicles (EVs) are lipid-bilayer structures released from cells; they can be isolated from most body fluids and act as potential liquid biomarkers for disease conditions and response to treatment. As EVs carry a range of genetic and protein cargo that can be characteristic of pathological processes, the current study assessed modified citrullinated protein cargo in EVs isolated from plasma and CSF in a piglet neonatal seizure model, also following phenobarbitone treatment. Our findings provide novel insights into roles for PAD-mediated changes on EV signatures in neonatal seizures and highlight the potential of plasma- and CSF-EVs to monitor responses to treatment. [ABSTRACT FROM AUTHOR]

B MATERIALS AND METHODOLOGY: b 21 healthy newborn piglets were divided into 3 cohorts to either receive normal saline vehicles (control group A, n=6), bicuculine 4mg/kg IV (seizure group B, n= 7) to induce seizures or bicuculine 4mg/kg IV followed by phenobarbitone loading dose 20mg/kg after 10 min of continuous electrical seizures (treated seizure group C, n=8) over two time points 3h apart. Electrographic seizures were identified in 296 (33.9%) newborns, in which 26 (10.6%) had status epilepticus, 170 (69.7%) repetitive seizures and 48 (19.7%) single seizure. A comparison of treatment pathways for seizures in newborns across rural and non-rural level... B Dickman J b SP 1 sp , Carrasco McCaul M SP 1 sp I SP 1 sp University Of Wisconsin School Of Medicine And Public Health, Madison, United States i B BACKGROUND: b Seizures are more common during the neonatal period than at any other age, occurring at a rate of 1.10-5.5 per 1,000 live births. Amplitude integrated electroencephalography combined with raw electroencephalography and video imaging (video aEEG/EEG) provides real-time screening for seizure detection. The survey collected information regarding the evaluation of neonatal seizures, anti-seizure medication availability, electroencephalogram (EEG) monitoring methods, and if and how an official treatment pathway for neonatal seizure patients was established at their institution. [Extracted from the article]