Department of Neurology, University of Utah, Clinical Neuroscience Center, George E. Wahlen VA Medical Center, Salt Lake City, UT, USA.
Clin Neurophysiol. 2019 Mar;130(3):396-405. doi: 10.1016/j.clinph.2018.12.011. Epub 2019 Jan 19.
This study looks for differences in the waveforms of interictal epileptiform discharges (IEDs) between cortices expressing only isolated discharges (green-spikes zones) vs those manifesting seizures (red-spikes zones): these can help to understand ictogenesis mechanisms and improve clinical decision in surgical epilepsy. Typical IEDs are triphasic, exhibiting in sequence: a negative-sharp-wave, a positive-baseline-shift and a negative-slow-wave. Negative-slow-waves are thought to reflect neurophysiological inhibition: their features at a focus' edge may reflect peripheral inhibition, a mechanism characterized in experimental models, curbing seizures' spread. This might be weakened in red-spikes.
A retrospective review of human intracranial EEGs was performed, comparing green- and red-spikes for their peripheral slow-waves' amplitudes. Green- and red-spikes were also compared also for the amplitudes of their negative-sharp-waves and positive-baseline-shifts, as well as for their spread pathways.
Green-spikes exhibit more pronounced peripheral slow-waves than red-spikes. They also exhibit more pronounced positive-baseline-shifts, and more frequent propagation pathways' shifts.
Peripheral slow-waves' amplitudes correlate with seizures' suppression and may reflect neurophysiological peripheral inhibition.
This study suggests a novel approach to reading intracranial EEGs: amplitudes measures of IEDs waveforms are technically simple, may help identifying epileptogenic zones and indicate the spatial distribution of underlying ictogenesis mechanisms.
本研究旨在寻找仅表现发作间期癫痫样放电（IEDs）（绿色棘波区）与表现癫痫发作（红色棘波区）的皮质之间的棘波形态差异：这有助于了解癫痫发作机制并改善手术癫痫的临床决策。典型的 IEDs 呈三相波，依次表现为：负相尖波、正基线偏移和负慢波。负慢波被认为反映了神经生理抑制：它们在焦点边缘的特征可能反映了周围抑制，这是一种在实验模型中被描述的机制，可以抑制癫痫发作的传播。这在红色棘波中可能会减弱。
对人类颅内 EEG 进行回顾性分析，比较绿色和红色棘波的周围慢波幅度。还比较了绿色和红色棘波的负相尖波和正基线偏移的幅度，以及它们的传播途径。
绿色棘波比红色棘波表现出更明显的周围慢波。它们还表现出更明显的正基线偏移，以及更频繁的传播途径变化。
周围慢波幅度与癫痫发作的抑制相关，可能反映了神经生理的周围抑制。
本研究提出了一种阅读颅内 EEG 的新方法：IEDs 波形幅度的测量技术简单，有助于识别致痫区，并指示潜在癫痫发作机制的空间分布。
