相干源的动态成像揭示了癫痫发作产生和持续背后不同的网络连接性。

Dynamic imaging of coherent sources reveals different network connectivity underlying the generation and perpetuation of epileptic seizures.

作者信息

Elshoff Lydia, Muthuraman Muthuraman, Anwar Abdul Rauf, Deuschl Günther, Stephani Ulrich, Raethjen Jan, Siniatchkin Michael

机构信息

Department of Neuropediatrics, Christian-Albrechts-University, Kiel, Germany.

出版信息

PLoS One. 2013 Oct 23;8(10):e78422. doi: 10.1371/journal.pone.0078422. eCollection 2013.

Abstract

The concept of focal epilepsies includes a seizure origin in brain regions with hyper synchronous activity (epileptogenic zone and seizure onset zone) and a complex epileptic network of different brain areas involved in the generation, propagation, and modulation of seizures. The purpose of this work was to study functional and effective connectivity between regions involved in networks of epileptic seizures. The beginning and middle part of focal seizures from ictal surface EEG data were analyzed using dynamic imaging of coherent sources (DICS), an inverse solution in the frequency domain which describes neuronal networks and coherences of oscillatory brain activities. The information flow (effective connectivity) between coherent sources was investigated using the renormalized partial directed coherence (RPDC) method. In 8/11 patients, the first and second source of epileptic activity as found by DICS were concordant with the operative resection site; these patients became seizure free after epilepsy surgery. In the remaining 3 patients, the results of DICS / RPDC calculations and the resection site were discordant; these patients had a poorer post-operative outcome. The first sources as found by DICS were located predominantly in cortical structures; subsequent sources included some subcortical structures: thalamus, Nucl. Subthalamicus and cerebellum. DICS seems to be a powerful tool to define the seizure onset zone and the epileptic networks involved. Seizure generation seems to be related to the propagation of epileptic activity from the primary source in the seizure onset zone, and maintenance of seizures is attributed to the perpetuation of epileptic activity between nodes in the epileptic network. Despite of these promising results, this proof of principle study needs further confirmation prior to the use of the described methods in the clinical praxis.

摘要

局灶性癫痫的概念包括发作起源于具有高度同步活动的脑区(致痫区和发作起始区)以及参与癫痫发作的产生、传播和调节的不同脑区的复杂癫痫网络。这项工作的目的是研究癫痫发作网络中各区域之间的功能连接和有效连接。使用相干源动态成像(DICS)对发作期头皮脑电图数据中局灶性发作的起始和中间部分进行分析,DICS是一种频域中的逆解方法,用于描述神经元网络和振荡脑活动的相干性。使用重归一化偏定向相干(RPDC)方法研究相干源之间的信息流(有效连接)。在11例患者中的8例中,DICS发现的癫痫活动的第一和第二源与手术切除部位一致;这些患者在癫痫手术后无发作。在其余3例患者中,DICS / RPDC计算结果与切除部位不一致;这些患者术后预后较差。DICS发现的第一源主要位于皮质结构;随后的源包括一些皮质下结构:丘脑、底丘脑核和小脑。DICS似乎是确定发作起始区和所涉及的癫痫网络的有力工具。癫痫发作的产生似乎与癫痫活动从发作起始区的主要源的传播有关,而癫痫发作的维持归因于癫痫网络中节点之间癫痫活动的持续存在。尽管有这些令人鼓舞的结果,但在临床实践中使用所述方法之前,这项原理验证研究需要进一步证实。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a2bf/3806832/e26ef2b543fe/pone.0078422.g001.jpg

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