This study aimed to determine if orally administered cannabidiol (CBD) lessens the cortical over-release of glutamate induced by a severe traumatic brain injury (TBI) and facilitates functional recovery. The short-term experiment focused on identifying the optimal oral pretreatment of CBD. Male Wistar rats were pretreated with oral administration of CBD (50, 100, or 200 mg/kg) daily for 7 days. Then, extracellular glutamate concentration was estimated by cortical microdialysis before and immediately after a severe TBI. The long-term experiment focused on evaluating the effect of the optimal treatment of CBD (pre- vs. pre- and post-TBI) 30 days after trauma. Sensorimotor function, body weight, and mortality rate were evaluated. In the short term, TBI induced a high release of glutamate (738% ± 173%; p < 0.001 vs. basal). Oral pretreatment with CBD at all doses tested reduced glutamate concentration but with higher potency at when animals received 100 mg/kg (222 ± 33%, p < 0.01 vs. TBI), an effect associated with a lower mortality rate (22%, p < 0.001 vs. TBI). In the long-term experiment, the TBI group showed a high glutamate concentration (149% p < 0.01 vs. SHAM). In contrast, animals receiving the optimal treatment of CBD (pre- and pre/post-TBI) showed glutamate concentrations like the SHAM group (p > 0.05). This effect was associated with high sensorimotor function improvement. CBD pretreatment, but not pre-/post-treatment, induced a higher body weight gain (39% ± 2.7%, p < 0.01 vs. TBI) and lower mortality rate (22%, p < 0.01 vs. TBI). These results support that orally administered CBD reduces short- and long-term TBI-induced excitotoxicity and facilitated functional recovery. Indeed, pretreatment with CBD was sufficient to lessen the adverse sequelae of TBI.

Drug-resistant epilepsy (DRE) is associated with high extracellular levels of glutamate. Studies support the idea that cannabidiol (CBD) decreases glutamate over-release. This study focused on investigating whether CBD reduces the evoked glutamate release in cortical synaptic terminals obtained from patients with DRE as well as in a preclinical model of epilepsy. Synaptic terminals (synaptosomes) were obtained from the epileptic neocortex of patients with drug-resistant temporal lobe epilepsy (DR-TLE, n = 10) or drug-resistant extratemporal lobe epilepsy (DR-ETLE, n = 10) submitted to epilepsy surgery. Synaptosomes highly purified by Percoll-sucrose density gradient were characterized by confocal microscopy and Western blot. Synaptosomes were used to estimate the high KCl (33 mM)-evoked glutamate release in the presence of CBD at different concentrations. Our results revealed responsive tissue obtained from seven patients with DR-TLE and seven patients with DR-ETLE. Responsive tissue showed lower glutamate release (p < 0.05) when incubated with CBD at low concentrations (less than 100 µM) but not at higher concentrations. Tissue that was non-responsive to CBD (DR-TLE, n = 3 and DR-ELTE, n = 3) showed high glutamate release despite CBD exposure at different concentrations. Simultaneously, a block of the human epileptic neocortex was used to determine its viability through whole-cell and extracellular electrophysiological recordings. The electrophysiological evaluations supported that the responsive and non-responsive human epileptic neocortices used in the present study exhibited proper neuronal viability and stability to acquire electrophysiological responses. We also investigated whether the subchronic administration of CBD could reduce glutamate over-release in a preclinical model of temporal lobe epilepsy. Administration of CBD (200 mg/kg, p.o. every 24 h for 7 days) to rats with lithium-pilocarpine-evoked spontaneous recurrent seizures reduced glutamate over-release in the hippocampus. The present study revealed that acute exposure to low concentrations of CBD can reduce the glutamate over-release in synaptic terminals obtained from some patients with DRE. This effect is also evident when applied subchronically in rats with spontaneous recurrent seizures. An important finding was the identification of a group of patients that were non-responsive to CBD effects. Future studies are essential to identify biomarkers of responsiveness to CBD to control DRE.

Although neuronal hyperexcitability is the primary mechanism underlying seizure activity in epilepsy, little is known about how different neuronal mechanisms at different organizational levels contribute to network hyperexcitability in the human epileptic brain. In this study, we determined a series of cellular and synaptic properties of Layer V pyramidal neurons from neocortical tissue of patients with drug-resistant epilepsy that may contribute to the hyperexcitable state associated with epilepsy. Using the whole cell, patch-clamp technique, and extracellular recordings, we determined the passive and active electrophysiological properties of Layer V pyramidal neurons with regular spiking phenotypes from temporal, parietal, and frontal neocortices surgically resected from individuals with drug-resistant epilepsy. Also, the glutamatergic strength, the synaptic coupling between presynaptic volleys and field excitatory postsynaptic potentials, and short-term, frequency-dependent plasticity were determined. Our data revealed that pyramidal neurons exhibit minimal spontaneous synaptic activity, similar resting membrane potentials, and input resistance values among the temporal, parietal, and frontal neocortices. Although frontal neurons were more hyperexcitable than temporal and parietal neurons, the firing output was comparable to that previously observed in non-pathological human tissue. In contrast, the extracellular recordings uncovered significant decoupling between presynaptic excitability and postsynaptic activity and the lack of short-term depression in response to gamma-range (30 Hz) repetitive stimulation. Our data suggest that neocortical Layer V pyramidal neurons from individuals with drug-resistance epilepsy, particularly intratelencephalic-2 neurons, which exhibit regular firing, are not necessarily hyperexcitable at the somatic level. Instead, synaptic alterations, such as synaptic decoupling and the lack of frequency-dependent short-term depression, may significantly contribute to the hyperexcitable state observed during seizure activity.

Although neuronal hyperexcitability is the primary mechanism underlying seizure activity in epilepsy, little is known about how different neuronal mechanisms at different organizational levels contribute to network hyperexcitability in the human epileptic brain. In this study, we determined a series of cellular and synaptic properties of layer V pyramidal neurons from neocortical tissue of patients with drug-resistant epilepsy that may contribute the hyperexcitable state associated with epilepsy. Using the whole cell, patch-clamp technique, and extracellular recordings, we determined the passive and active electrophysiological properties of layer V pyramidal neurons with regular spiking phenotypes from temporal, parietal, and frontal neocortices surgically resected from individuals with drug-resistant epilepsy. Also, the glutamatergic strength, the synchronicity between presynaptic volleys and field excitatory postsynaptic potentials, and short-term, frequency-dependent plasticity were determined at the synaptic level. Lastly, biocytin-filled pyramidal neurons were used to perform post hoc digital reconstructions and morphometric analyses. The collected data revealed that pyramidal neurons exhibit minimal spontaneous activity, similar resting membrane potentials, and input resistance values among the temporal, parietal, and frontal neocortices. Although frontal neurons were more hyperexcitable than temporal and parietal neurons, the firing output was comparable to that previously observed in non-pathological human tissue. The digital reconstructions confirmed the identity of pyramidal neurons and revealed alterations in dendritic complexity. In contrast, the analyses of the extracellular recordings uncovered significant desynchronization between presynaptic excitability and postsynaptic activity and loss of short-term depression in response to repetitive stimulation within the gamma range (30 Hz). Our data suggest that neocortical layer V pyramidal neurons from individuals with drug-resistant epilepsy are not necessarily hyperexcitable at the somatic level. Instead, synaptic alterations, such as synaptic desynchronization and a loss of frequency-dependent short-term depression may significantly contribute to the hyperexcitable state observed during seizure activity.