Le Van Quyen M, Martinerie J, Navarro V, Boon P, D'Havé M, Adam C, Renault B, Varela F, Baulac M
Laboratoire de Neurosciences Cognitives et Imagerie Cérébrale, CNRS UPR 640, H pital de la Pitié-Salpêtrière, Paris, France.
Lancet. 2001 Jan 20;357(9251):183-8. doi: 10.1016/S0140-6736(00)03591-1.
New methods derived from non-linear analysis of intracranial recordings permit the anticipation of an epileptic seizure several minutes before the seizure. Nevertheless, anticipation of seizures based on standard scalp electroencephalographical (EEG) signals has not been reported yet. The accessibility to preictal changes from standard EEGs is essential for expanding the clinical applicability of these methods.
We analysed 26 scalp-EEG/video recordings, from 60 min before a seizure, in 23 patients with temporal-lobe epilepsy. For five patients, simultaneous scalp and intracranial EEG recordings were assessed. Long-term changes before seizure onset were identified by a measure of non-linear similarity, which is very robust in spite of large artifacts and runs in real-time.
In 25 of 26 recordings, measurement of non-linear changes in EEG signals allowed the anticipation of a seizure several minutes before it occurred (mean 7 min). These preictal changes in the scalp EEG correspond well with concurrent changes in depth recordings.
Scalp-EEG recordings retain sufficient dynamical information which can be used for the analysis of preictal changes leading to seizures. Seizure anticipation strategies in real-time can now be envisaged for diverse clinical applications, such as devices for patient warning, for efficacy of ictal-single photon emission computed tomography procedures, and eventual treatment interventions for preventing seizures.
源自颅内记录非线性分析的新方法能够在癫痫发作前几分钟预测发作。然而，基于标准头皮脑电图（EEG）信号预测癫痫发作的情况尚未见报道。从标准脑电图中获取发作前变化对于扩大这些方法的临床适用性至关重要。
我们分析了23例颞叶癫痫患者发作前60分钟的26份头皮脑电图/视频记录。对其中5例患者，同时评估了头皮和颅内脑电图记录。通过一种非线性相似性测量方法识别发作开始前的长期变化，该方法尽管存在大量伪迹但仍非常稳健且能实时运行。
在26份记录中的25份中，脑电图信号的非线性变化测量能够在癫痫发作前几分钟（平均7分钟）预测发作。头皮脑电图中的这些发作前变化与深部记录中的同期变化非常吻合。
头皮脑电图记录保留了足够的动态信息，可用于分析导致癫痫发作的发作前变化。现在可以设想针对各种临床应用的实时癫痫发作预测策略，例如患者警报装置、发作期单光子发射计算机断层扫描程序的疗效评估以及最终预防癫痫发作的治疗干预措施。
