Ung Hoameng, Davis Kathryn A, Wulsin Drausin, Wagenaar Joost, Fox Emily, McDonnell John J, Patterson Ned, Vite Charles H, Worrell Gregory, Litt Brian
Department of Bioengineering, University of Pennsylvania, Philadelphia, Pennsylvania, U.S.A.
Department of Neurology, University of Pennsylvania, Philadelphia, Pennsylvania, U.S.A.
Epilepsia. 2016 Dec;57(12):1949-1957. doi: 10.1111/epi.13591. Epub 2016 Nov 3.
Epilepsy is a chronic disorder, but seizure recordings are usually obtained in the acute setting. The chronic behavior of seizures and the interictal bursts that sometimes initiate them is unknown. We investigate the variability of these electrographic patterns over an extended period of time using chronic intracranial recordings in canine epilepsy.
Continuous, yearlong intracranial electroencephalography (iEEG) recordings from four dogs with naturally occurring epilepsy were analyzed for seizures and interictal bursts. Following automated detection and clinician verification of interictal bursts and seizures, temporal trends of seizures, burst count, and burst-burst similarities were determined. One dog developed status epilepticus, the recordings of which were also investigated.
Multiple seizure types, determined by onset channels, were observed in each dog, with significant temporal variation between types. The first 14 days of invasive recording, analogous to the average duration of clinical invasive recordings in humans, did not capture the entirety of seizure types. Seizures typically occurred in clusters, and isolated seizures were rare. The count and dynamics of interictal bursts form distinct groups and do not stabilize until several weeks after implantation.
There is significant temporal variability in seizures and interictal bursts after electrode implantation that requires several weeks to reach steady state. These findings, comparable to those reported in humans implanted with the NeuroPace Responsive Neurostimulator System (RNS) device, suggest that transient network changes following electrode implantation may need to be taken into account when interpreting or analyzing iEEG during evaluation for epilepsy surgery. Chronic, ambulatory iEEG may be better suited to accurately map epileptic networks in appropriate individuals.
癫痫是一种慢性疾病,但发作记录通常是在急性情况下获得的。癫痫发作的慢性行为以及有时引发发作的发作间期突发情况尚不清楚。我们使用犬类癫痫的慢性颅内记录来研究这些脑电图模式在较长时间内的变异性。
对四只患有自然发生癫痫的犬进行连续一年的颅内脑电图(iEEG)记录,分析癫痫发作和发作间期突发情况。在自动检测并经临床医生确认发作间期突发情况和癫痫发作后,确定癫痫发作的时间趋势、突发计数以及突发之间的相似性。其中一只犬发生了癫痫持续状态,对其记录也进行了研究。
在每只犬中观察到由发作起始通道确定的多种癫痫发作类型,不同类型之间存在显著的时间变化。侵入性记录的前14天,类似于人类临床侵入性记录的平均持续时间,并未涵盖所有癫痫发作类型。癫痫发作通常成簇发生,孤立发作很少见。发作间期突发的计数和动态形成不同的组,直到植入后几周才稳定下来。
电极植入后癫痫发作和发作间期突发情况存在显著的时间变异性,需要几周时间才能达到稳定状态。这些发现与植入NeuroPace响应式神经刺激系统(RNS)设备的人类报告结果相似,表明在癫痫手术评估期间解释或分析iEEG时,可能需要考虑电极植入后短暂的网络变化。慢性、动态的iEEG可能更适合于准确绘制合适个体的癫痫网络。