Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Department of Internal Medicine, Sanggye Paik Hospital, College of Medicine, Inje University, Seoul, Republic of Korea.
Neurol Sci. 2019 May;40(5):993-1000. doi: 10.1007/s10072-019-03751-4. Epub 2019 Feb 12.
Localizing the source of epileptiform discharges in generalized epilepsy has been controversial for the past few decades. Recent neuroimaging studies have shown that epileptiform discharges in generalized epilepsy can be localized to a particular region. Childhood absence epilepsy (CAE) is the most common generalized epilepsy in childhood and is considered the prototype of idiopathic generalized epilepsy (IGE). To better understand electrophysiological changes and their development in CAE, we investigated the origin of epileptiform discharges. We performed distributed source localization with standardized, low-resolution, brain electromagnetic tomography (sLORETA). In 16 children with CAE, sLORETA images corresponding to the midpoint of the ascending phase and the negative peak of the spike were obtained from a total of 242 EEG epochs (121 epochs at each timepoint). Maximal current source density (CSD) was mostly located in the frontal lobe (69.4%). At the gyral level, maximal CSD was most commonly in the superior frontal gyrus (39.3%) followed by the middle frontal gyrus (14.0%) and medial frontal gyrus (8.7%). At the hemisphere level, maximal CSD was dominant in the right cerebral hemisphere (63.6%). These results were consistent at the midpoint of the ascending phase and the negative peak of the spike. Our results demonstrated that the major source of epileptiform discharges in CAE was the frontal lobe. These results suggest that the frontal lobe is involved in generating CAE. This finding is consistent with recent studies that have suggested selective cortical involvement, especially in the frontal regions, in IGE.
过去几十年来，全身性癫痫中癫痫样放电的起源定位一直存在争议。最近的神经影像学研究表明，全身性癫痫中的癫痫样放电可以定位于特定区域。儿童失神癫痫（CAE）是儿童期最常见的全身性癫痫，被认为是特发性全面性癫痫（IGE）的原型。为了更好地理解 CAE 中的电生理变化及其发展，我们研究了癫痫样放电的起源。我们使用标准化低分辨率脑电磁断层扫描（sLORETA）进行分布式源定位。在 16 名 CAE 患儿中，从总共 242 个 EEG 时段（每个时段 121 个时段）中获得了与上升相中点和棘波负峰相对应的 sLORETA 图像。最大电流源密度（CSD）主要位于额叶（69.4%）。在脑回水平，最大 CSD 最常见于额上回（39.3%），其次是额中回（14.0%）和额内侧回（8.7%）。在半球水平，最大 CSD 主要位于右半球（63.6%）。在上升相中点和棘波负峰处的结果一致。我们的结果表明，CAE 中癫痫样放电的主要来源是额叶。这些结果表明，额叶参与了 CAE 的产生。这一发现与最近的研究一致，这些研究表明 IGE 中存在选择性皮质参与，特别是在额叶区域。
