Allen Luke A, Harper Ronald M, Lhatoo Samden, Lemieux Louis, Diehl Beate
Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, United Kingdom.
Epilepsy Society MRI Unit, Chalfont St Peter, London, United Kingdom.
Front Neurol. 2019 Mar 5;10:185. doi: 10.3389/fneur.2019.00185. eCollection 2019.
The elusive nature of sudden unexpected death in epilepsy (SUDEP) has led to investigations of mechanisms and identification of biomarkers of this fatal scenario that constitutes the leading cause of premature death in epilepsy. In this short review, we compile evidence from structural and functional neuroimaging that demonstrates alterations to brain structures and networks involved in central autonomic and respiratory control in SUDEP and those at elevated risk. These findings suggest that compromised central control of vital regulatory processes may contribute to SUDEP. Both structural changes and dysfunctional interactions indicate potential mechanisms underlying the fatal event; contributions to individual risk prediction will require further study. The nature and sites of functional disruptions suggest potential non-invasive interventions to overcome failing processes.
癫痫性猝死（SUDEP）难以捉摸的特性促使人们对其机制展开研究，并寻找这种致命情况的生物标志物，而SUDEP是癫痫患者过早死亡的主要原因。在这篇简短的综述中，我们汇集了来自结构和功能神经影像学的证据，这些证据表明，在SUDEP患者以及高危人群中，参与中枢自主神经和呼吸控制的脑结构和神经网络发生了改变。这些发现表明，对重要调节过程的中枢控制受损可能导致SUDEP。结构变化和功能失调的相互作用都表明了这一致命事件的潜在机制；对个体风险预测的贡献还需要进一步研究。功能破坏的性质和部位提示了可能克服功能障碍过程的潜在非侵入性干预措施。
