Institut de Neurosciences des Systèmes, Aix Marseille University, Marseille, France.
AP-HM, Service de Neurophysiologie Clinique, Hôpital de la Timone, Marseille, France.
Epilepsia. 2017 Jul;58(7):1131-1147. doi: 10.1111/epi.13791. Epub 2017 May 20.
Epileptogenic networks are defined by the brain regions involved in the production and propagation of epileptic activities. In this review we describe the historical, methodologic, and conceptual bases of this model in the analysis of electrophysiologic intracerebral recordings. In the context of epilepsy surgery, the determination of cerebral regions producing seizures (i.e., the "epileptogenic zone") is a crucial objective. In contrast with a traditional focal vision of focal drug-resistant epilepsies, the concept of epileptogenic networks has been progressively introduced as a model better able to describe the complexity of seizure dynamics and realistically describe the distribution of epileptogenic anomalies in the brain. The concept of epileptogenic networks is historically linked to the development of the stereoelectroencephalography (SEEG) method and subsequent introduction of means of quantifying the recorded signals. Seizures, and preictal and interictal discharges produce clear patterns on SEEG. These patterns can be analyzed utilizing signal analysis methods that quantify high-frequency oscillations or changes in functional connectivity. Dramatic changes in SEEG brain connectivity can be described during seizure genesis and propagation within cortical and subcortical regions, associated with the production of different patterns of seizure semiology. The interictal state is characterized by networks generating abnormal activities (interictal spikes) and also by modified functional properties. The introduction of novel approaches to large-scale modeling of these networks offers new methods in the goal of better predicting the effects of epilepsy surgery. The epileptogenic network concept is a key factor in identifying the anatomic distribution of the epileptogenic process, which is particularly important in the context of epilepsy surgery.
致痫网络由参与产生和传播癫痫活动的脑区定义。在这篇综述中,我们描述了该模型在分析电生理颅内记录中的历史、方法学和概念基础。在癫痫手术中,确定产生癫痫发作的脑区(即“致痫区”)是一个关键目标。与传统的局灶性耐药性癫痫的局灶性视野相反,致痫网络的概念逐渐被引入,作为一种能够更好地描述癫痫发作动力学复杂性并真实描述脑内致痫异常分布的模型。致痫网络的概念与立体脑电图(SEEG)方法的发展以及随后引入的量化记录信号的手段密切相关。癫痫发作、发作前和发作间期放电在 SEEG 上产生清晰的模式。这些模式可以利用量化高频振荡或功能连接变化的信号分析方法进行分析。在皮质和皮质下区域内癫痫发作的起源和传播过程中,可以描述 SEEG 脑连接的急剧变化,这与不同的癫痫发作症状模式的产生有关。发作间期状态的特征是产生异常活动(发作间期棘波)的网络,以及功能特性的改变。这些网络的大规模建模的新方法的引入为更好地预测癫痫手术效果提供了新方法。致痫网络概念是确定致痫过程的解剖分布的关键因素,这在癫痫手术中尤为重要。
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