In the healthy brain, neuronal excitability and synaptic strength are homeostatically regulated to keep neuronal network activity within physiological boundaries. Epilepsy is characterized by episodes of highly synchronized firing across in widespread neuronal populations, due to a failure in regulation of network activity. Here we consider epilepsy as a failure of homeostatic plasticity or as a maladaptive response to perturbations in the activity. How homeostatic compensation is involved in epileptogenic processes or in the chronic phase of epilepsy, is still debated. Although several theories have been proposed, there is relatively little experimental evidence to evaluate them. In this perspective, we will discuss recent results that shed light on the potential role of homeostatic plasticity in epilepsy. First, we will present some recent insights on how homeostatic compensations are probably active before and during epileptogenesis and how their actions are temporally regulated and closely dependent on the progression of pathology. Then, we will consider the dual role of transcriptional regulation during epileptogenesis, and finally, we will underline the importance of homeostatic plasticity in the context of therapeutic interventions for epilepsy. While classic pharmacological interventions may be counteracted by the epileptic brain to maintain its potentially dysfunctional set point, novel therapeutic approaches may provide the neuronal network with the tools necessary to restore its physiological balance.

在健康的大脑中，神经元兴奋性和突触强度受到稳态调节，以使神经元网络活动保持在生理范围内。癫痫病的特征是由于网络活动调节失败而在广泛的神经元群体中发生高度同步的放电发作。在这里，我们将癫痫病视为体内稳态可塑性的失败或对活动中摄动的不良适应性反应。稳态补偿如何参与癫痫发生过程或在癫痫的慢性阶段，仍存在争议。尽管已经提出了几种理论，但是评估它们的实验证据相对较少。从这个角度出发，我们将讨论最近的结果，这些结果阐明了稳态可塑性在癫痫中的潜在作用。第一，我们将提供一些最近的见解，以探讨在癫痫发生之前和过程中稳态补偿可能如何起作用，以及它们的作用如何在时间上受到调节并密切依赖于病理学的进展。然后，我们将考虑在癫痫发生过程中转录调控的双重作用，最后，我们将强调在癫痫的治疗干预中体内平衡可塑性的重要性。虽然经典的药理学干预措施可能会被癫痫脑所抵消，以维持其潜在的功能障碍设定点，但新颖的治疗方法可能会为神经元网络提供恢复其生理平衡所必需的工具。