Mesial temporal lobe epilepsy and serotonin: the role of HTR2A receptor

Purpose: Evidences from animal models have demonstrated that depletion of brain serotonin (5-HT), a neurotransmitter with a pivotal role in neurodevelopment and brain plasticity, lowers the threshold to induced seizures. It was also demonstrated that anti-epileptic drugs increase endogenous 5-HT concentrations. Studies in brain tissue from Mesial Temporal lobe Epilepsy (MTLE) patients have showed that serotonin type 2a receptor (HTR2A) is downregulated in these patients. HTR2A expression levels may be modulated by a 102 T>C polymorphism. The aim of this study was to analyse the association between 102T>C polymorphism and the development and clinical features of MTLE-HS in a Portuguese population. Methods: A cohort of 112 MTLE-HS patients (62F, 50M, mean age = 44 11 years, age of onset = 13 9 years, 97 patients with drug refractory epilepsy) was compared with a cohort of 183 healthy individuals (HI). Genotyping was performed by Real Time PCR using High Melting Resolution methodology. Results: HTR2A 102 T>C genotype frequencies were similar between patients and controls (TT: 24.1% vs. 25.1% in HI; TC: 45.5% vs. 43.2% in HI; CC: 31.3% vs. 31.7% in HI). No association was found between this polymorphism and MTLE-HS clinical features (age of onset, FS antecedents and anti-epileptic drug response). Conclusion: The present results do not provide evidence that HTR2A polymorphism 102T>C may confer susceptibility to MTLE-HS. Nevertheless a possible role for the serotonergic system in epileptogenesis cannot be excluded. The study of other 5-HT receptors and transporters is underway.