Moeller Friederike, Siebner Hartwig R, Wolff Stephan, Muhle Hiltrud, Granert Oliver, Jansen Olav, Stephani Ulrich, Siniatchkin Michael
Department of Neuropediatrics, Christian-Albrechts-University, Kiel, Germany.
Epilepsia. 2008 Sep;49(9):1510-9. doi: 10.1111/j.1528-1167.2008.01626.x. Epub 2008 Apr 24.
In patients with idiopathic generalized epilepsy (IGE), blood oxygen level dependent (BOLD) EEG during functional MRI (EEG-fMRI) has been successfully used to link changes in regional neuronal activity to the occurrence of generalized spike-and-wave (GSW) discharges. Most EEG-fMRI studies have been performed on adult patients with long-standing epilepsy who were on antiepileptic medication. Here, we applied EEG-fMRI to investigate BOLD signal changes during absence seizures in children with newly diagnosed childhood absence epilepsy (CAE).
Ten drug-naive children with newly diagnosed CAE underwent simultaneous EEG-fMRI. BOLD signal changes associated with ictal EEG activity (i.e., periods of three per second GSW) were analyzed in predefined regions-of-interests (ROIs), including the thalamus, the precuneus, and caudate nucleus.
In 6 out of 10 children, EEG recordings showed periods of three per second GSW during fMRI. Three per second GSW were associated with regional BOLD signal decreases in parietal areas, precuneus, and caudate nucleus along with a bilateral increase in the BOLD signal in the medial thalamus. Taking into account the normal delay in the hemodynamic response, temporal analysis showed that the onset of BOLD signal changes coincided with the onset of GSW.
In drug-naive individuals with CAE, ictal three per second GSW are associated with BOLD signal changes in the same striato-thalamo-cortical network that changes its regional activity during primary and secondary generalized paroxysms in treated adults. No BOLD signal changes in the striato-thalamo-cortical network preceded the onset of three per second GSW in unmediated children with CAE.
在特发性全身性癫痫（IGE）患者中，功能磁共振成像期间的血氧水平依赖（BOLD）脑电图（EEG-fMRI）已成功用于将区域神经元活动的变化与全身性棘波-慢波（GSW）放电的发生联系起来。大多数EEG-fMRI研究是在长期患有癫痫且正在服用抗癫痫药物的成年患者中进行的。在此，我们应用EEG-fMRI来研究新诊断的儿童失神癫痫（CAE）患儿失神发作期间的BOLD信号变化。
10名新诊断的未服用药物的CAE患儿接受了同步EEG-fMRI检查。在包括丘脑、楔前叶和尾状核在内的预定义感兴趣区域（ROI）中分析与发作期EEG活动（即每秒三次的GSW期）相关的BOLD信号变化。
10名儿童中有6名在fMRI期间EEG记录显示每秒三次的GSW期。每秒三次的GSW与顶叶区域、楔前叶和尾状核的区域BOLD信号降低以及内侧丘脑的BOLD信号双侧增加相关。考虑到血流动力学反应的正常延迟，时间分析表明BOLD信号变化的开始与GSW的开始一致。
在未服用药物的CAE个体中，发作期每秒三次的GSW与相同的纹状体-丘脑-皮质网络中的BOLD信号变化相关，该网络在接受治疗的成年人的原发性和继发性全身性发作期间改变其区域活动。在未经治疗的CAE儿童中，纹状体-丘脑-皮质网络中在每秒三次的GSW开始之前没有BOLD信号变化。
