Chouchou Florian, Bouet Romain, Pichot Vincent, Catenoix Hélène, Mauguière François, Jung Julien
NeuroPain Lab, Lyon Neuroscience Research Center - Inserm U 1028/CNRS UMR 5292, University of Lyon, France.
Dycog Lab, Lyon Neuroscience Research Center - Inserm U 1028/CNRS UMR 5292, University of Lyon, France.
Clin Neurophysiol. 2017 Sep;128(9):1810-1819. doi: 10.1016/j.clinph.2017.06.033. Epub 2017 Jun 27.
Due to limited information from scalp electroencephalographic (EEG) recordings, brain areas driving changes in cardiac rhythm during Temporal lobe (TL) seizures are not clearly identified. Using stereotactic EEG (SEEG) recordings, we aimed at identifying which of the brain regions involved in autonomic control trigger ictal tachycardia.
The neural activity of several mesial temporal lobe structures including amygdala, hippocampus, insula, and lateral temporal lobe recorded with SEEG were collected during 37 TL seizures in 9 patients, using indices based on High Frequency Activity (HFA). R-R intervals (RR) monitoring and time-frequency spectral analysis were performed to assess parasympathetic (High frequency power (HF)) and sympathetic (Low frequency/High frequency (LF/HF) ratio) reactivities.
Tachycardia was associated with a significant increase in LF/HF ratio and decrease in HF. Autonomic cardiac changes were accompanied by simultaneous SEEG signal changes with an increase in seizure-related HFA in anterior hippocampal formation and amygdala, but not in insula.
In our sample, TL seizures are thus accompanied by an early decrease in parasympathetic control of cardiac rhythm and by an increase of sympathetic tone, concomitant to seizure activity in anterior hippocampus and amygdala.
These results support a pivotal role of hippocampus and amygdala in tachycardia occurring during TL seizures.
由于头皮脑电图（EEG）记录所提供的信息有限，颞叶（TL）癫痫发作期间驱动心律变化的脑区尚未明确确定。我们使用立体定向脑电图（SEEG）记录，旨在确定参与自主控制的脑区中哪些会引发发作性心动过速。
在9例患者的37次TL癫痫发作期间，收集通过SEEG记录的包括杏仁核、海马体、脑岛和颞叶外侧在内的几个颞叶内侧结构的神经活动，采用基于高频活动（HFA）的指标。进行R-R间期（RR）监测和时频谱分析，以评估副交感神经（高频功率（HF））和交感神经（低频/高频（LF/HF）比值）反应性。
心动过速与LF/HF比值显著增加和HF降低相关。自主心脏变化伴随着同步的SEEG信号变化，前海马结构和杏仁核中与癫痫发作相关的HFA增加，而脑岛中则没有。
在我们的样本中，TL癫痫发作伴随着心律副交感神经控制的早期降低和交感神经张力的增加，同时海马前部和杏仁核出现癫痫活动。
这些结果支持海马体和杏仁核在TL癫痫发作期间发生的心动过速中起关键作用。
