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局灶性发作中的半球间相互作用:来自人类颅内记录的数据。

Interhemispheric interactions in seizures of focal onset: data from human intracranial recordings.

作者信息

Gotman J

出版信息

Electroencephalogr Clin Neurophysiol. 1987 Aug;67(2):120-33. doi: 10.1016/0013-4694(87)90034-4.

DOI:10.1016/0013-4694(87)90034-4
PMID:2439288
Abstract

Interactions between the two hemispheres were studied during seizures recorded in 8 epileptic patients having chronic intracranial electrodes. Seven had temporal lobe foci and one a fronto-central focus. Strength of interaction was measured by the coherence between the EEGs from symmetrical contralateral locations. Time delays of a few milliseconds between discharges were computed by the coherence and phase method. The evolution of interactions was followed from the time a seizure of focal onset had become bilateral to its end. It was found that interhemispheric coherence was generally low throughout seizures, highest values being reached early in the seizure at the time of spread, or at the very end. Time delays most often indicated a lead from the side of onset, whether they were measured early or late in the seizure. Exceptions to these results were found in 2 of 3 patients with bilateral independent onsets: interhemispheric coherence was higher and time leads were always from the same side, independently of the side of onset. If it is assumed that high interhemispheric coherence is mediated by direct connections such as corpus callosum and anterior commissure, then these results can be interpreted as follows: the major commissures do not play an important role in contralateral spread of temporal lobe seizures although they are sometimes active, particularly at initial spread and at seizure end. Time leads from the side of onset indicate that the focus retains an influence over the contralateral discharge throughout the seizure. A different situation may exist with independent bitemporal foci.

摘要

在8例植入慢性颅内电极的癫痫患者发作期间,对两个半球之间的相互作用进行了研究。其中7例有颞叶病灶,1例有额中央病灶。通过对来自对称对侧部位的脑电图之间的相干性来测量相互作用的强度。通过相干性和相位方法计算放电之间几毫秒的时间延迟。从局灶性发作变为双侧发作到发作结束,跟踪相互作用的演变。结果发现,在整个发作过程中,半球间相干性通常较低,在发作早期扩散时或即将结束时达到最高值。无论在发作早期还是晚期测量,时间延迟最常显示起始侧的领先。在3例双侧独立发作的患者中有2例出现了这些结果的例外情况:半球间相干性较高,时间领先总是来自同一侧,与发作侧无关。如果假设半球间的高相干性是由胼胝体和前连合等直接连接介导的,那么这些结果可以解释如下:主要连合在颞叶癫痫的对侧扩散中不起重要作用,尽管它们有时会活跃,特别是在初始扩散和发作结束时。来自发作侧的时间领先表明病灶在整个发作过程中对侧放电仍有影响。独立的双侧颞叶病灶可能存在不同的情况。

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