Ameliorative Effects of Ellagic Acid on Maximal Electroshock and Pentylenetetrazole-Induced Seizures in Mice

authors:

avatar Ahad Khazaei 1 , avatar Seyyed Mohammad Taghi Mansouri 2 , avatar Amir Siahpoosh 1 , 3 , avatar Behnam Ghorbanzadeh 4 , avatar Saeed Salehi 5 , avatar Mohammad Javad Khodayar ORCID 5 , 6 , *

Medicinal Plant Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
Department of Anesthesiology, College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA
Department of Pharmacognosy, Faculty of Pharmacy, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
Department of Pharmacology, School of Medicine, Dezful University of Medical Sciences, Dezful, Iran
Toxicology Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
Department of Toxicology, Faculty of Pharmacy, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran

how to cite: Khazaei A, Mansouri S M T, Siahpoosh A, Ghorbanzadeh B, Salehi S, et al. Ameliorative Effects of Ellagic Acid on Maximal Electroshock and Pentylenetetrazole-Induced Seizures in Mice. Jundishapur J Nat Pharm Prod. 2019;14(3):e80039. https://doi.org/10.5812/jjnpp.80039.

Abstract

Background:

Epilepsy is a series of disorders in the central nervous system defined by disruption and abnormality in the electrical activity of the brain. The mechanisms of epilepsy occurrence are not fully determined and the current pharmacological therapeutics have low efficacy and are associated with adverse reactions due to narrow therapeutic indices. Ellagic acid has neuroprotective and antioxidant effects and increases the brain’s GABA levels.

Objectives:

This study was designed to evaluate the effects of ellagic acid on both maximal electroshock and pentylenetetrazole models of acute seizures in mice.

Methods:

Ellagic acid was administered at the doses of 25, 50, and 100 mg/kg in the two models of seizures.

Results:

The results showed that ellagic acid was effective at the lowest dose in the maximal electroshock-induced seizure in mice and the duration of hind limb tonic extension (HLTE) was significantly shorter in this group than in the untreated convulsive group. In the pentylenetetrazole convulsion model, ellagic acid significantly increased the latency to convulsion and Straub tail response. The latencies with ellagic acid were longer in groups treated with ellagic acid 25 mg/kg than with ellagic acid 50 and 100 mg/kg.

Conclusions:

In conclusion, it seems that ellagic acid has anticonvulsant effects in electroshock and pentylenetetrazole models of convulsion but its effects are attenuated or eliminated at higher doses.

1. Background

Epilepsy is the most common disorder of the central nervous system. It occurs due to the disruption of electrical activity, leading to acute and chronic changes in nerve function and mental abnormality (1). Epidemiologic studies show that 1% of people worldwide are affected by epilepsy and its prevalence is two to three times higher in African countries than in the rest of the world (2). In developed countries, there are 4 to 10 people with epilepsy per 10000 population (3). There is a relationship between the epilepsy prevalence and age so that it is more common in the first 10 years of life, especially in the first year (4). The abnormal discharge of nerve cells by various factors such as low blood sugar, oxygen deficiency, and infection makes imbalance between excitatory and inhibitory systems in the brain and leads to convulsion and the loss of consciousness (5).

In the last decade, plants have found an important role in clinical application as natural resources of pharmaceutical products. Nowadays different types of herbal medicines are commercially available in various dosage forms in the market (6). The World Health Organization estimates that 80% of populations in Asian and African countries use traditional medicine for the remedy of disease (7). Ellagitannins are hydrolyzable tannins that have functions in cell membranes (8). When ellagitannins are exposed to acid or base, the ester bond is hydrolyzed to form ellagic acid as a gallic acid dimer (Figure 1).

The molecular structure of ellagic acid
The molecular structure of ellagic acid

Ellagic acid is found in plants such as pomegranate, walnut, strawberry, blueberry, eucalyptus, and oak (9). Because of the key role of these compounds in the treatment of cancer and cardiovascular diseases, they are considered as useful compounds in the human diet. Several studies confirmed that these effects are attributed to their antioxidant activity (10). Ellagitannins have antidepressant, anti-inflammatory, and analgesic properties, as well (11-13). Several studies showed that ellagic acid is useful for the treatment of colitis, Alzheimer’s disease, Parkinson’s disease, and anxiety and it can reduce the symptoms of nicotine dependence (14-18). In addition, ellagic acid has a protective effect on liver toxicity induced by carbon tetrachloride (19). It has been shown that ellagic acid considerably increases the activity of glutathione S-transferase and glutathione levels in cancer cells (20). Ellagic acid can make increases in the activity or induction of genes involved in the expression of superoxide dismutase, catalase, and NADPH quinones oxidoreductase and it has a neuroprotective effect on neurons against oxidative damage (21). As previously reported, ellagic acid has neuroprotective and antioxidant effects and increases the brain’s GABA levels and GABAergic transmission (22).

2. Objectives

This study was designed to evaluate and compare the effects of ellagic acid on two models of seizures in mice including maximal electroshock (MES)-induced convulsion for grand mal epilepsy and pentylenetetrazole (PTZ)-induced seizure for absence epilepsy.

3. Methods

3.1. Experimental Animals

C57 albino mice in the weight range of 23 ± 3 g were purchased from the Research Center and Experimental Animal House of Ahvaz Jundishapur University of Medical Sciences (AJUMS). The mice were kept in standard cages at 23 ± 2°C under a 12-hour light/dark cycle. All animals had free access to food and water throughout the experiment and benefited from the diet and adequate water because dehydration and lack of adequate food could change the seizure threshold (23). The experiments were carried out at a certain time of day (10 a.m. to 14 p.m.). For adaptation to the environment and elimination of anxiety, the animals were put in the experiment place 30 minutes before the experiments started. The study was approved by the Ethics Committee of AJUMS for Care and Use of Laboratory Animals.

3.2. Drugs and Chemicals

Ellagic acid and PTZ (Sigma-Aldrich, USA), diazepam ampoule (Caspian Pharmaceutical Co., Iran), phenytoin ampoule (Caspian Pharmaceutical Co., Iran), and carboxymethyl cellulose (CMC) (Merck, Germany) were purchased for research in this study. Ellagic acid was suspended in normal saline and CMC 0.1 % and stored at 4°C.

3.3. Selection of Doses

The approved dose of ellagic acid with no side effects in animal models is 778 mg/kg. However, based on a pilot study, ellagic acid was used at the doses of 25, 50, and 100 mg/kg in the current study (12). In addition, PTZ at 85 mg/kg and diazepam at 1 mg/kg were applied (23, 24).

3.4. Animal Models for Evaluation of Anticonvulsant Activity

3.4.1. Maximal Electroshock (MES) Seizure

In the mice model, MES seizure is often induced by an electric current of 50 mA and a frequency of 1500 Hz (21) for 0.2 second. However, the seizure intensity depends on the animal strain and the quality of the apparatus (25-27). In this study, the seizure was induced with an electric current of 50 mA at a frequency of 80 Hz for 0.2 second.

3.4.2. Pentylenetetrazole (PTZ)-Induced Seizure

The convulsant doses of PTZ are between 85 and 150 mg/kg in mice. Thus, we needed first to determine the minimum required dose for seizure induction (28). In this study, PTZ was used at a dose of 85 mg/kg for seizure induction.

3.5. Experimental Protocol

3.5.1. Groups for MES-Induced Convulsions

The MES-induced convulsion groups included Group 1 (control) receiving normal saline (NS, 10 mL/kg) intraperitoneally (i.p.), Group 2 receiving phenytoin injection (50 mg/kg i.p.), and Groups 3, 4, and 5 receiving ellagic acid (25, 50, and 100 mg/kg i.p., respectively). After 30 minutes, the electric shock was inserted to animals’ ears with the intensity of 50 mA and the frequency of 80 Hz for 0.2 second through two pegs soaked with salt water. Then, the symptoms of seizures were evaluated by measuring the percent protection and duration of hind limb tonic extension (HLTE). The HLTE was the duration of the legs stretched backward and gathered inside the body.

3.5.2. Groups for PTZ-Induced Convulsions

The PTZ-induced convulsion groups included Group 1 (control) receiving NS (10 mL/kg i.p.), Group 2 receiving diazepam (1 mg/kg, i.p.), and Groups 3, 4, and 5 receiving ellagic acid (25, 50, and 100 mg/kg i.p., respectively). After 30 minutes, PTZ (85 mg/kg, i.p.) was injected to mice and then the latency to convulsions and Straub tail response, myoclonic activity duration, and the rate of mortality were recorded.

3.6. Statistical Analysis

All results are expressed as means ± SEM. To compare the effects of different doses of ellagic acid on seizure, the one-way ANOVA followed by Tukey’s post hoc test was used. P values of < 0.05 were considered statistically significant.

4. Results

4.1. Effects of Ellagic Acid on MES-Induced Convulsions

As shown in Table 1, MES could induce seizures in the control and ellagic acid-treated groups while phenytoin prevented seizure in mice. The duration of HLTE was significantly different between the group treated with ellagic acid 25 mg/kg and the control group (P < 0.05). The increased dose of ellagic acid led to the longer duration of HTLE so that ellagic acid at the dose of 100 mg/kg could not prevent seizure. It seems that the higher doses of ellagic acid were not effective in the MES model of convulsion in mice.

Table 1.

Effects of Ellagic Acid and Phenytoin Administration on MES-Induced Convulsion in Micea

GroupbDoseHTLE Duration (s)c
Control10 mL/kg i.p. NS18.90 ± 0.91
Phenytoin25 mg/kg, i.p.0 ± 0
EA 2525 mg/kg, i.p.16.59 ± 1.05d
EA 5050 mg/kg, i.p.17.38 ± 1.86
EA 100100 mg/kg, i.p.17.21 ± 0.88

4.2. Effects of Ellagic Acid on PTZ-Induced Convulsion

The results showed that PTZ could induce convulsion, which was associated with the decreased latency to convulsion and latency to Straub tail (Table 2); in addition, the duration of the myoclonic activity was significantly longer in this group than in the group treated with diazepam and ellagic acid. Ellagic acid effects on seizure were dose-dependent in reverse so that the latency to convulsion and latency to Straub tail were shorter in the group treated with ellagic acid 100 mg/kg than in the group treated with ellagic acid 25 mg/kg. These suggest that the anticonvulsant effects of ellagic acid decreased with increasing dose. Furthermore, ellagic acid 25 mg/kg resulted in the decreased duration of myoclonic activity, but this reduction was not statistically significant. Ellagic acid also led to a reduction in mortality rate (3/6, 2/6, and 2/6 in groups treated with ellagic acid 25, 50, and 100 mg/kg, respectively). Diazepam (1 mg/kg, i.p.) failed to show any convulsive activity in mice.

Table 2.

Effect of Ellagic Acid and Diazepam Administration on PTZ-Induced Convulsion in Micea

GroupbDoseLatency to Convulsion (s)cLatency to Straub Tail (s)cDuration of Myoclonic Activity (s)cMortality Rate (%)
Control10 mL NS/kg, i.p.65.52 ± 2.4890 ± 211.48 ± 0.596/6 (100)
Diazepam1 mg/kg, i.p.1280.2 ± 26.58d1800 ± 0d0 ± 0d0/6 (0)
EA 2525 mg/kg, i.p.681.17 ± 9.17d690 ± 8.67d10.59 ± 1.023/6 (50)
EA 5050 mg/kg, i.p.363.67 ± 13.11d375.83 ± 15d10.71 ± 0.282/6 (33.3)
EA 100100 mg/kg, i.p.296.4 ± 5.86d298.8 ± 6.61d11.2 ± 0.202/6 (33.3)

5. Discussion

Ellagic acid is a polyphenol with antioxidant properties. This compound is found in fruits such as pomegranate (29). Maximal electroshock (MES) is a model for the induction of generalized seizures of the tonic-clonic (grand mal) type. In this model, seizures are induced in animals by the electric current (27, 30). Recent reports have declared that MES represents a good model to study the early stages of epilepsy (31). The sudden discharge of neurons by the electric current occurs once the animal goes to the phase of HTLE and then returns to the initial state or dies. If the electric current is not adequate to create HLTE or the animal is protected by a drug, the animal will not enter this phase (32). In this study, the effect of ellagic acid was evaluated on the HLTE time. The results showed that only were mice in the group treated with ellagic acid 25 mg/kg protected against electroshock. The protective effects of orally administered ellagic acid on different models of seizure have been reported in the literature (22). Absence seizure occurs due to interferences in the function of GABA made by GABAA receptor agonists (33), similar to the one that occurs in the animal model of seizure induced by PTZ. Our results showed that the duration of myoclonic activity was not significantly different between groups treated with different doses of ellagic acid and the untreated control group. Nevertheless, the beneficial effects of ellagic acid on latency to convulsion and latency to Straub tail were seen at lower doses. Therefore, latency to convulsion and latency to Straub tail were significantly more in the group treated with ellagic acid 25 mg/kg than in the groups treated with ellagic acid 50 and 100 mg/kg. In addition, the lowest mortality (50%) was seen in the group treated with ellagic acid 25 mg/kg. The increased dose of ellagic acid was not effective in the reduction of seizure symptoms presumably because ellagic acid was toxic at higher doses (22). Previous studies indicated that flavonoids had the ability to affect the mood and some flavonoids showed antidepressant properties by inhibiting the monoamine oxidase (MAO) enzyme (34). Flavonoids such as flavonols and anthocyanins have anti-inflammatory effects in neurons (28). Animal studies confirm that rutin, vitexin, and naringenin have anticonvulsant effects (35-37). The anticonvulsant mechanism of ellagic acid is not fully determined; however, the elevation of GABAergic transmission is the most prominent mechanism (22). Furthermore, flavonoids can act as ligands for GABAA receptors and exhibit anticonvulsant effects (38, 39). They are also able to bind to the benzodiazepine site in GABAA receptors in the CNS (central nervous system). Many phenolic compounds can prevent ROS (reactive oxygen species) formation. Various studies have shown that ellagic acid has anti-mutagenic and antioxidant properties (40, 41). The role of oxidative stress in epileptogenesis and epilepsy initiation and progression has been proven (42). PTZ-induced convulsion is associated with oxidative stress and depletion of antioxidant levels in the brain (43, 44). This supports that ellagic acid may be an anticonvulsant due to its antioxidant properties. Previous studies confirmed that ellagic acid reduced free radicals formation in brain cells (10). Yang et al. showed that ellagic acid could inhibit the formation of reactive oxygen species in astrocytes (45).

Based on the current study and previous studies, ellagic acid can alleviate convulsions in mice (Figure 2) through the suppression of oxidative stress and modulation of the GABAA pathway. In conclusion, we suggest that ellagic acid has neuroprotective effects in both PTZ and MES models of seizures and its anticonvulsant effects may be exerted through decreasing oxidative stress and increasing GABAA transmission in the brain.

Graphical abstract regarding the anticonvulsant effects of ellagic acid. Ellagic acid at low doses could decrease the duration of hind limb tonic extension in maximal electroshock (MES)-induced seizure in mice as a preclinical model of grand mal epilepsy. Furthermore, ellagic acid delayed the time to the first convulsion and Straub tail and decreased mortality in pentylenetetrazole (PTZ)-induced convulsion in mice as a preclinical model of absence epilepsy.
Graphical abstract regarding the anticonvulsant effects of ellagic acid. Ellagic acid at low doses could decrease the duration of hind limb tonic extension in maximal electroshock (MES)-induced seizure in mice as a preclinical model of grand mal epilepsy. Furthermore, ellagic acid delayed the time to the first convulsion and Straub tail and decreased mortality in pentylenetetrazole (PTZ)-induced convulsion in mice as a preclinical model of absence epilepsy.

Acknowledgements

References

  • 1.

    Raviglione MC, O'Brien RJ, Kasper D, Braunwald E, Fauci A, Hauser S, et al. Harrison's principles of internal medicine. 2005.

  • 2.

    Preux PM, Druet-Cabanac M. Epidemiology and aetiology of epilepsy in sub-Saharan Africa. Lancet Neurol. 2005;4(1):21-31. [PubMed ID: 15620854]. https://doi.org/10.1016/S1474-4422(04)00963-9.

  • 3.

    Bradley WG, Daroff RB, Fenichel GM, Jankovic J. Diagnosis of neurological disease. Neurology in clinical practice: Principles of diagnosis and management. 2004.

  • 4.

    Kotsopoulos I, de Krom M, Kessels F, Lodder J, Troost J, Twellaar M, et al. Incidence of epilepsy and predictive factors of epileptic and non-epileptic seizures. Seizure. 2005;14(3):175-82. [PubMed ID: 15797352]. https://doi.org/10.1016/j.seizure.2005.01.005.

  • 5.

    Schindler K, Leung H, Elger CE, Lehnertz K. Assessing seizure dynamics by analysing the correlation structure of multichannel intracranial EEG. Brain. 2007;130(Pt 1):65-77. [PubMed ID: 17082199]. https://doi.org/10.1093/brain/awl304.

  • 6.

    Kalantari H, Larki A, Latifi SM. The genotoxicity study of garlic and pasipy herbal drops by peripheral blood micronucleus test. Acta Physiol Hung. 2007;94(3):261-6. [PubMed ID: 17853777]. https://doi.org/10.1556/APhysiol.94.2007.3.10.

  • 7.

    Loscher W, Fassbender CP, Nolting B. The role of technical, biological and pharmacological factors in the laboratory evaluation of anticonvulsant drugs. II. Maximal electroshock seizure models. Epilepsy Res. 1991;8(2):79-94. [PubMed ID: 2065646].

  • 8.

    Larrosa M, Garcia-Conesa MT, Espin JC, Tomas-Barberan FA. Ellagitannins, ellagic acid and vascular health. Mol Aspects Med. 2010;31(6):513-39. [PubMed ID: 20837052]. https://doi.org/10.1016/j.mam.2010.09.005.

  • 9.

    Seeram NP, Adams LS, Henning SM, Niu Y, Zhang Y, Nair MG, et al. In vitro antiproliferative, apoptotic and antioxidant activities of punicalagin, ellagic acid and a total pomegranate tannin extract are enhanced in combination with other polyphenols as found in pomegranate juice. J Nutr Biochem. 2005;16(6):360-7. [PubMed ID: 15936648]. https://doi.org/10.1016/j.jnutbio.2005.01.006.

  • 10.

    Ascacio-Valdes JA, Buenrostro-Figueroa JJ, Aguilera-Carbo A, Prado-Barragan A, Rodriguez-Herrera R, Aguilar CN. Ellagitannins: Biosynthesis, biodegradation and biological properties. J Med Plants Res. 2011;5(19):4696-703.

  • 11.

    Whitley AC, Stoner GD, Darby MV, Walle T. Intestinal epithelial cell accumulation of the cancer preventive polyphenol ellagic acid--extensive binding to protein and DNA. Biochem Pharmacol. 2003;66(6):907-15. [PubMed ID: 12963477]. https://doi.org/10.1016/s0006-2952(03)00413-1.

  • 12.

    Tasaki M, Umemura T, Maeda M, Ishii Y, Okamura T, Inoue T, et al. Safety assessment of ellagic acid, a food additive, in a subchronic toxicity study using F344 rats. Food Chem Toxicol. 2008;46(3):1119-24. [PubMed ID: 18155344]. https://doi.org/10.1016/j.fct.2007.10.043.

  • 13.

    Mansouri MT, Naghizadeh B, Ghorbanzadeh B, Farbood Y. Central and peripheral antinociceptive effects of ellagic acid in different animal models of pain. Eur J Pharmacol. 2013;707(1-3):46-53. [PubMed ID: 23528359]. https://doi.org/10.1016/j.ejphar.2013.03.031.

  • 14.

    Marin M, Maria Giner R, Rios JL, Recio MC. Intestinal anti-inflammatory activity of ellagic acid in the acute and chronic dextrane sulfate sodium models of mice colitis. J Ethnopharmacol. 2013;150(3):925-34. [PubMed ID: 24140585]. https://doi.org/10.1016/j.jep.2013.09.030.

  • 15.

    Feng Y, Yang SG, Du XT, Zhang X, Sun XX, Zhao M, et al. Ellagic acid promotes Abeta42 fibrillization and inhibits Abeta42-induced neurotoxicity. Biochem Biophys Res Commun. 2009;390(4):1250-4. [PubMed ID: 19878655]. https://doi.org/10.1016/j.bbrc.2009.10.130.

  • 16.

    Pérez-Pasten R, Atitlan-Gil A, Zuniga-Perez C, Filardo-Kestrupp S, Otazo-Sanchez ME, Madrigal-Santillan O, et al. Ellagic acid reduced nicotine induced withdrawal syndrome in mice. Toxicology Letters. 2009;189:S111-2. https://doi.org/10.1016/j.toxlet.2009.06.360.

  • 17.

    Sarkaki A, Farbood Y, Dolatshahi M, Mansouri SMT, Khodadadi A. Neuroprotective effects of ellagic acid in a rat model of Parkinson's disease. Acta Medica Iranica. 2016;54(8):494-502.

  • 18.

    Girish C, Raj V, Arya J, Balakrishnan S. Involvement of the GABAergic system in the anxiolytic-like effect of the flavonoid ellagic acid in mice. Eur J Pharmacol. 2013;710(1-3):49-58. [PubMed ID: 23603526]. https://doi.org/10.1016/j.ejphar.2013.04.003.

  • 19.

    Singh K, Khanna AK, Chander R. Hepatoprotective activity of ellagic acid against carbon tetrachloride induced hepatotoxicity in rats. Indian J Exp Biol. 1999;37(10):1025-6. [PubMed ID: 10783760].

  • 20.

    Teel RW, Babcock MS, Dixit R, Stoner GD. Ellagic acid toxicity and interaction with benzo[a]pyrene and benzo[a]pyrene 7,8-dihydrodiol in human bronchial epithelial cells. Cell Biol Toxicol. 1986;2(1):53-62. [PubMed ID: 3267445].

  • 21.

    Uzar E, Alp H, Cevik MU, Firat U, Evliyaoglu O, Tufek A, et al. Ellagic acid attenuates oxidative stress on brain and sciatic nerve and improves histopathology of brain in streptozotocin-induced diabetic rats. Neurol Sci. 2012;33(3):567-74. [PubMed ID: 21922312]. https://doi.org/10.1007/s10072-011-0775-1.

  • 22.

    Dhingra D, Jangra A. Antiepileptic activity of ellagic acid, a naturally occurring polyphenolic compound, in mice. Journal of Functional Foods. 2014;10:364-9. https://doi.org/10.1016/j.jff.2014.07.011.

  • 23.

    Albertson TE, Peterson SL. Neuropharmacology methods in epilepsy research. CRC press; 1998.

  • 24.

    Ojewole JA. Analgesic and anticonvulsant properties of Tetrapleura tetraptera (Taub) (Fabaceae) fruit aqueous extract in mice. Phytother Res. 2005;19(12):1023-9. [PubMed ID: 16372367]. https://doi.org/10.1002/ptr.1779.

  • 25.

    Piredda SG, Woodhead JH, Swinyard EA. Effect of stimulus intensity on the profile of anticonvulsant activity of phenytoin, ethosuximide and valproate. J Pharmacol Exp Ther. 1985;232(3):741-5. [PubMed ID: 3919174].

  • 26.

    Swinyard EA, Kupferberg HJ, editors. Antiepileptic drugs: Detection, quantification, and evaluation. Federation proceedings. 1985. p. 2629-33.

  • 27.

    Loscher W, Schmidt D. Which animal models should be used in the search for new antiepileptic drugs? A proposal based on experimental and clinical considerations. Epilepsy Res. 1988;2(3):145-81. [PubMed ID: 3058469].

  • 28.

    Reddy DS, Rogawski MA. Stress-induced deoxycorticosterone-derived neurosteroids modulate GABA(A) receptor function and seizure susceptibility. J Neurosci. 2002;22(9):3795-805. [PubMed ID: 11978855].

  • 29.

    Yoshimura M, Watanabe Y, Kasai K, Yamakoshi J, Koga T. Inhibitory effect of an ellagic acid-rich pomegranate extract on tyrosinase activity and ultraviolet-induced pigmentation. Biosci Biotechnol Biochem. 2005;69(12):2368-73. [PubMed ID: 16377895]. https://doi.org/10.1271/bbb.69.2368.

  • 30.

    White HS. Preclinical development of antiepileptic drugs: Past, present, and future directions. Epilepsia. 2003;44 Suppl 7:2-8. [PubMed ID: 12919332].

  • 31.

    Rogawski MA. Molecular targets versus models for new antiepileptic drug discovery. Epilepsy Res. 2006;68(1):22-8. [PubMed ID: 16377151]. [PubMed Central ID: PMC1373807]. https://doi.org/10.1016/j.eplepsyres.2005.09.012.

  • 32.

    Castel-Branco MM, Alves GL, Figueiredo IV, Falcao AC, Caramona MM. The maximal electroshock seizure (MES) model in the preclinical assessment of potential new antiepileptic drugs. Methods Find Exp Clin Pharmacol. 2009;31(2):101-6. [PubMed ID: 19455265]. https://doi.org/10.1358/mf.2009.31.2.1338414.

  • 33.

    Han HA, Cortez MA, Carter Snead Iii O. GABAB receptors in absence epilepsy. Epilepsia. 2010;51:24. https://doi.org/10.1111/j.1528-1167.2010.02810.x.

  • 34.

    Jager AK, Saaby L. Flavonoids and the CNS. Molecules. 2011;16(2):1471-85. [PubMed ID: 21311414]. [PubMed Central ID: PMC6259921]. https://doi.org/10.3390/molecules16021471.

  • 35.

    Nassiri-Asl M, Shariati-Rad S, Zamansoltani F. Anticonvulsive effects of intracerebroventricular administration of rutin in rats. Prog Neuropsychopharmacol Biol Psychiatry. 2008;32(4):989-93. [PubMed ID: 18262708]. https://doi.org/10.1016/j.pnpbp.2008.01.011.

  • 36.

    Abbasi E, Nassiri-Asl M, Shafeei M, Sheikhi M. Neuroprotective effects of vitexin, a flavonoid, on pentylenetetrazole-induced seizure in rats. Chem Biol Drug Des. 2012;80(2):274-8. [PubMed ID: 22554436]. https://doi.org/10.1111/j.1747-0285.2012.01400.x.

  • 37.

    Khodayar MJ, Salehi S, Rezaei M, Siahpoosh A, Khazaei A, Houshmand G. Evaluation of the effect of naringenin on pentylenetetrazole and maximal electroshock-induced convulsions in mice. Jundishapur J Nat Pharm Prod. 2016;12(1). https://doi.org/10.5812/jjnpp.31384.

  • 38.

    Medina JH, Viola H, Wolfman C, Marder M, Wasowski C, Calvo D, et al. Overview--flavonoids: A new family of benzodiazepine receptor ligands. Neurochem Res. 1997;22(4):419-25. [PubMed ID: 9130252].

  • 39.

    Marder M, Paladini AC. GABA(A)-receptor ligands of flavonoid structure. Curr Top Med Chem. 2002;2(8):853-67. [PubMed ID: 12171576].

  • 40.

    Khanduja KL, Gandhi RK, Pathania V, Syal N. Prevention of N-nitrosodiethylamine-induced lung tumorigenesis by ellagic acid and quercetin in mice. Food Chem Toxicol. 1999;37(4):313-8. [PubMed ID: 10418948].

  • 41.

    Loarca-Pina G, Kuzmicky PA, de Mejia EG, Kado NY. Inhibitory effects of ellagic acid on the direct-acting mutagenicity of aflatoxin B1 in the Salmonella microsuspension assay. Mutat Res. 1998;398(1-2):183-7. [PubMed ID: 9626978]. https://doi.org/10.1016/s0027-5107(97)00245-5.

  • 42.

    Geronzi U, Lotti F, Grosso S. Oxidative stress in epilepsy. Expert Rev Neurother. 2018;18(5):427-34. [PubMed ID: 29651881]. https://doi.org/10.1080/14737175.2018.1465410.

  • 43.

    Singh N, Vijayanti S, Saha L, Bhatia A, Banerjee D, Chakrabarti A. Neuroprotective effect of Nrf2 activator dimethyl fumarate, on the hippocampal neurons in chemical kindling model in rat. Epilepsy Res. 2018;143:98-104. [PubMed ID: 29691120]. https://doi.org/10.1016/j.eplepsyres.2018.02.011.

  • 44.

    Shin EJ, Jeong JH, Chung YH, Kim WK, Ko KH, Bach JH, et al. Role of oxidative stress in epileptic seizures. Neurochem Int. 2011;59(2):122-37. [PubMed ID: 21672578]. [PubMed Central ID: PMC3606551]. https://doi.org/10.1016/j.neuint.2011.03.025.

  • 45.

    Yang CS, Tzou BC, Liu YP, Tsai MJ, Shyue SK, Tzeng SF. Inhibition of cadmium-induced oxidative injury in rat primary astrocytes by the addition of antioxidants and the reduction of intracellular calcium. J Cell Biochem. 2008;103(3):825-34. [PubMed ID: 17631669]. https://doi.org/10.1002/jcb.21452.