This research has been performed on mice with the gene for producing cystatin B removed, to provide a similar set of symptoms to individuals with ULD. The mechanism currently supported by research is very similar to another theory of epilepsy progression known as kindling. Onset
Current research links cystatin B to production of inhibitory neurons known as GABAergic neurons. It has shown that a lack of cystatin B due to a mutation of the CSTB gene leads to a decrease in the number of inhibitory neurons, and this lack of inhibition makes the cells in the brain, particularly the hippocampus, more excitable. It is hypothesized that this increase in excitability is what causes the myoclonic jerks and tonic-clonic seizures in patients with ULD. Progression
Research also gives evidence to support the idea that cystatin B may be a type of "protecting" molecule in the brain. Normally, after a seizure, the presence of cystatin B prevents the neurons from dying due to toxic levels of neurotransmitters. Studies suggest that the absence of cystatin B leads to the death of affected neurons, leading to a damaged portion of the brain. This damage coupled with the increased excitability of the cells then leads to more damage, which is what makes Unverricht–Lundborg disease progressive. Diagnosis
The only currently available method to diagnose Unverricht–Lundborg disease is a genetic test to check for the presence of the mutated cystatin B gene. If this gene is present in an individual suspected of having the disease, it can be confirmed.
Study of Heterozygous Mice
In humans, it is generally known that unless a patient has both recessive CSTB genes (are homozygous recessive), they will not express ULD symptoms. A recent study has attempted to characterize the effects, if any, seen in mice that carry only one recessive CSTB gene (are heterozygous). The researchers analyzed normal and heterozygous mice by having them perform various tasks. The study found that heterozygous mice performed similar to normal mice when the task was started, but as the task continued or became more complex they were more likely to fail. While the results for the heterozygous mice were not remarkably different from the normal mice, they do indicate that carrying just one recessive CSTB gene may have adverse effects, at least in mice. Analysis of EEG as ULD Progresses
Currently, electroencephalography (EEG) is not very effective as a diagnostic tool for Unverricht–Lundborg disease. This study instead looks to characterize the change in EEG of ULD patients as the disease progresses. The researchers studied twenty-five patients with ULD and monitored their EEG over time. The results show that certain brain waves that are present at the beginning of ULD progression and are also present in unaffected individuals, including spontaneous generalized spike or polyspike wave discharges and photoparoxysmal response, tend to decrease after 10 to 15 years. References
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