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They usually have resistance to antiepileptic drugs, difficulties in precise seizure location and poor surgical outcomes. Adenosine is a neuroprotective neuromodulator that acts as a seizure terminator in the brain. The role of adenosine in no\u2010HS MTLE is still unclear. Further research to explore the aetiology and pathogenesis of no\u2010HS MTLE may help to find new therapeutic targets.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In surgically resected hippocampal specimens, we examined the maladaptive changes of the adenosine system of patients with no\u2010HS MTLE. In order to better understand the dysregulation of the adenosine pathway in no\u2010HS MTLE, we developed a rat model based on the induction of focal cortical lesions through a prenatal freeze injury.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We first examined the adenosine system in no\u2010HS MTLE patients who lack hippocampal neuronal loss and found ectopic expression of the astrocytic adenosine metabolising enzyme adenosine kinase (ADK) in hippocampal pyramidal neurons, as well as downregulation of neuronal A<jats:sub>1<\/jats:sub> receptors (A<jats:sub>1<\/jats:sub>Rs) in the hippocampus. In the no\u2010HS MTLE model rats, the transition of ADK from neuronal expression to an adult pattern of glial expression in the hippocampus was significantly delayed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Ectopic expression of neuronal ADK might be a pathological hallmark of no\u2010HS MTLE. Maladaptive changes in adenosine metabolism might be a novel target for therapeutic intervention in no\u2010HS MTLE.<\/jats:p><\/jats:sec>","DOI":"10.1111\/nan.12926","type":"journal-article","created":{"date-parts":[[2023,7,22]],"date-time":"2023-07-22T07:06:52Z","timestamp":1690009612000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Ectopic expression of neuronal adenosine kinase, a biomarker in mesial temporal lobe epilepsy without hippocampal sclerosis"],"prefix":"10.1111","volume":"49","author":[{"given":"Mengyi","family":"Guo","sequence":"first","affiliation":[{"name":"Department of Brain Institute, Center of Epilepsy, Beijing Institute for Brain Disorders, Beijing Key Laboratory of Epilepsy Research, Sanbo Brain Hospital Capital Medical University  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Wang","sequence":"additional","affiliation":[{"name":"Department 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