Clemens Béla, Piros Pálma, Bessenyei Mónika, Tóth Márton, Hollódy Katalin, Kondákor István
Kenézy Gyula Memorial Hospital, Neurological Department, Debrecen, Hungary.
Epilepsy Res. 2008 Oct;81(2-3):204-10. doi: 10.1016/j.eplepsyres.2008.06.002. Epub 2008 Jul 23.
Anatomical localization of the cortical effect of lamotrigine (LTG) in patients with idiopathic generalized epilepsy (IGE).
19 patients with untreated IGE were investigated. EEG was recorded in the untreated condition and 3 months later when LTG treatment abolished the seizures. 19-channel EEG was recorded, and a total of 2min artifact-free, waking EEG was processed to low-resolution electromagnetic tomography (LORETA) analysis. Activity (that is, current source density, A/m(2)) was computed in four frequency bands (delta, theta, alpha, and beta), for 2394 voxels that represented the cortical gray matter and the hippocampi. Group differences between the untreated and treated conditions were computed for the four bands and all voxels by multiple t-tests for interdependent datasets. The results were presented in terms of anatomical distribution and statistical significance.
p<0.01 (uncorrected) changes (decrease of activity) emerged in the theta and the alpha bands. Theta activity decreased in a large cluster of voxels including parts of the temporal, parietal, occipital cortex bilaterally, and in the transverse temporal gyri, insula, hippocampus, and uncus on the right side. Alpha activity decreased in a relatively smaller cortical area involving the right temporo-parietal junction and surrounding parts of the cortex, and part of the insula on the right side.
LTG decreased theta activity in several cortical areas where abnormally increased theta activity had been found in a prior study in another cohort of untreated IGE patients [Clemens, B., Bessenyei, M., Piros, P., Tóth, M., Seress, L., Kondákor, I., 2007b. Characteristic distribution of interictal brain electrical activity in idiopathic generalized epilepsy. Epilepsia 48, 941-949]. These LTG-related changes might be related to the decrease of seizure propensity in IGE.
对拉莫三嗪（LTG）在特发性全身性癫痫（IGE）患者中的皮质效应进行解剖定位。
对19例未经治疗的IGE患者进行研究。在未经治疗状态下以及LTG治疗3个月后癫痫发作消失时记录脑电图。记录19导脑电图，并对总共2分钟无伪迹的清醒脑电图进行低分辨率电磁断层扫描（LORETA）分析。针对代表皮质灰质和海马体的2394个体素，在四个频段（δ波、θ波、α波和β波）计算活动度（即电流源密度，A/m²）。通过对相互依存数据集的多重t检验，计算未经治疗和治疗状态之间四个频段及所有体素的组间差异。结果以解剖分布和统计学意义呈现。
在θ波和α波频段出现p<0.01（未校正）的变化（活动度降低）。θ波活动度在一大群体素中降低，包括双侧颞叶、顶叶、枕叶皮质的部分区域，以及右侧颞横回、岛叶、海马体和钩回。α波活动度在一个相对较小的皮质区域降低，该区域包括右侧颞顶交界区及周围皮质部分，以及右侧岛叶的一部分。
在先前另一组未经治疗的IGE患者研究中发现，在几个皮质区域存在θ波活动异常增加，而LTG降低了这些区域的θ波活动度[克莱门斯，B.，贝塞涅伊，M.，皮罗斯，P.，托特，M.，塞雷斯，L.，孔达科尔，I.，2007b。特发性全身性癫痫发作间期脑电活动的特征分布。癫痫杂志48，941 - 949]。这些与LTG相关的变化可能与IGE患者癫痫发作倾向的降低有关。
